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Introduction: Rectal adenocarcinoma patients have high risk of malnourished and require increase protein intake especially post operation to support speedy recovery.
Case presentation: A 35-year-old man, low rectal adenocarcinoma and underwent ultra-low anterior resection, having drastically weight loss, cachexia and lethargy. Patient discharged and referred to diet clinic for further intervention. Patient looked lethargic and walked with assistance. Patient’s weight 44kg, muscle mass 37.6kg and body fat 9.7%. Total weight loss 27% within 6 months and SGA C. Estimated energy intake was 1560kcal/day and protein intake 38g/day. The patient felt early satiety and not complied with oral nutritional supplement because dislike its taste and worried on high stoma output. Inadequate oral intake related to physiological cause result in decreased ability to consume sufficient protein intake as evidence by diet history. High protein high calories diet and collagen peptides supplement daily were prescribed. Patient reported diet recall and drank a bottle of collagen peptides in diet clinic daily for a week to ensure compliance of diet prescription. After a week, patient's anthropometry improved: weight 46.2kg, muscle mass 38.6kg and body fat 12.7%. Patient was able to walk and start working in following week. Total energy intake 1690kcal/day with 56g/day protein. Concentrated collagen peptides might help malnourished patients to achieve protein requirement in small volume. It benefits in results of crossing the intestinal barrier, by a dietary bioactive peptides, which reach the blood circulation for metabolic processes. Intensive nutritional intervention in diet outpatient clinic helped in patient's compliance and optimizing nutritional status especially in post-operation cancer patient. Conclusion: Concentrated collagen peptides and intensive nutritional intervention might help to improve compliance of protein prescription and ultimately, muscle bulking post operation. It is recommended that further investigations be conducted to provide more concrete evidence on the role of collagen peptides in cancer patient post operation.