Persistent bowel dysfunction is a common occurrence that has a significant impact on quality of life for many rectal cancer survivors. Many patients try to modify their diets, but without structured guidance, they don’t always make the best choices to help manage their symptoms and get the nutrition they need.

Diet modification coaching for bowel symptoms management might be an effective way to help these patients. Therefore, a group of researchers conducted a pilot study to examine the feasibility of this type of intervention. Their findings were published in the Clinical Journal of Oncology Nursing.

The researchers evaluated altering intake and managing symptoms (AIMS), a telephone-based coaching intervention for bowel dysfunction in cancer survivors. Trained health coaches held 10 telephone sessions with each patient in the study over the course of 4 months. Eleven cancer survivors from a comprehensive cancer center in Southern California agreed to participate, 9 of whom completed all 10 telephone coaching sessions.

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The coaches encouraged the participants to set SMART (specific, measurable, attainable, relevant, and timely) goals for direct behavior changes. Participants also tracked their daily diets and symptoms in a diary. The coaches discussed issues such as identifying helpful or troublesome foods, as well as supplements and medications that could help with symptoms.

The impact of low anterior resection syndrome (LARS), a group of postoperative bowel symptoms, was measured using the LARS score, and bowel dysfunction was assessed with the Memorial Sloan Kettering Cancer Center Bowel Function Index. They also administered the City of Hope-Quality of Life-Colorectal Cancer survey, which is used to assess physical, psychological, social, and spiritual well-being. All of these assessments were conducted at baseline and then at 4 and 6 months.

“There is an urgent need to advance the quality of care for rectal cancer survivors to improve their bowel function, adherence to cancer survivor dietary guidance, and [quality of life] after treatment,” the researchers concluded. Their results demonstrate that AIMS is a feasible and acceptable strategy for posttreatment care for survivors of rectal cancer. Additionally, oncology nurses can be trained to assist survivors set and achieve SMART goals that will improve their bowel control — as well as their quality of life — during and after treatment.

Study limitations include a small sample size, which can be attributed to its nature as a pilot feasibility study. The researchers also noted they didn’t assess for statistical significance before and after the intervention, nor did they assess for outcomes based on ostomy status. These study findings would have greater generalizability if more male patients had participated.


Sun V, Crane TE, Freylersythe S, et al. Altering intake and managing symptoms: feasibility of a diet modification intervention for post-treatment bowel dysfunctional in rectal cancer. Clin J Oncol Nurs. 2022;26(3):283-292. doi:10.1188/22.CJON.283-292