As a Macmillan oncology dietitian, one of the hardest aspects of my job is looking after women with ovarian cancer who develop bowel obstruction. My role is to ensure that my patients are getting enough nutrition, but it is often difficult.
In 2014 we started to use a specially formulated nutritional supplement drink that has been shown to benefit patients with Crohn’s disease, a condition that causes inflammation and narrowing in the intestines and requires bowel rest. We applied the logic that this might be an option for ovarian cancer patients who have developed a bowel obstruction. The drinks contain carbohydrate, proteins, fats as well as vitamins and minerals which are water soluble and are absorbed high up in our gut. This means that they do not need to be digested like most of the food and fluids that we normally eat and drink.
For the past 2 and a half years at the Royal Surrey County Hospital in Guildford, we have been using elemental drinks with patients in bowel obstruction who are able to tolerate small amounts of fluids. The majority seem to like the product, and more importantly it does not cause pain, like other food and fluids. This is not a cure for bowel obstruction, but providing a small amount of nutrition has brought relief to our patients and their families. In some cases it has meant that patients have been well enough to receive further treatment.
As healthcare professionals, it is important to prove to the scientific and medical world that a new treatment has been properly tried and tested. Target Ovarian Cancer has very generously funded the study called EDMONd: A feasibility study of Elemental Diet as an alternative to parenteral nutrition for ovarian cancer patients with inoperable malignant bowel Obstruction. The aim of the study is to prove to healthcare professionals throughout the UK that Elemental Diet is a suitable alternative to the current treatment options.
We plan to recruit 35 patients to the study. They will be asked to drink the elemental diet for a period of two weeks and we will collect data on whether they like the taste of the product, and also whether it causes vomiting or pain. We will also measure changes in quality of life scores.
Our aim is to be able to prove that the elemental diet can provide small amounts of nutrition to patients to improve their quality of life. We also hope that this research will contribute to future guidelines in the UK for managing ovarian cancer.