Diet

Resuming a Normal Diet after Ostomy Surgery

Colostomies and Urostomies

Following surgery, colostomates and urostomates are usually able to return to their previous eating habits with little or no alteration. However, it would be best use caution and common sense when eating for a week or two after leaving the hospital. Chew your food well and take it easy with items like nuts, fruit skins, raw vegetables and popcorn. It is also bets to ask an NSWOC or a dietician for their recommendations.

Ileostomies

It was once thought that many foods were strictly off-limits but this need not always be the case. Ileostomy surgery removes most or all of the large bowel and may change how your body processes food. Ileostomates need to learn how their body reacts to traditional foods and carefully re-introduce these items back into their diet. You need not fear mealtimes. Soft cooked items are gentle on a healing system where as raw fruits, vegetables or skins may be hard to pass through your system. Although fibre is good for you and necessary for a balanced diet, you may need to experiment with what agrees and what does not and is not as essential for those with ileostomies. Below are some common foods and hints on safely eating them for those recently returned home from ostomy surgery.

Vegetables

Vegetables like celery, asparagus, and broccoli can have long fibrous strands and such strands are hard to digest and may ‘ball up’, causing a painful blockage. When eating such vegetables, peel off the tough outer stalk, or eat only the tender ‘hearts.’ Asparagus can cause odour in the urine, while onions can cause odour in the stool. Whatever gave you gas before will continue to give you gas. Mushrooms, especially fresh ones, are notorious for going through the system undigested or causing blockages for some people. Slice them thin and chew them well. Corn on the cob, canned corn and popcorn are often the cause of bowel obstructions or blockages, so eat these in moderation. If in doubt about trying a vegetable for the first time, peel the skin and steam or soft-cook it.

Fruit

Fresh fruit can, and should, be included in a well-balanced diet. Bananas can be beneficial to ileostomates to replace lost potassium. If you have trouble digesting oranges or grapefruit, try just squeezing the juice. Try peeling apples, pears, plums and peaches to start. Be cautious with fresh coconut. You may be able to eat all of these items right away; however, it’s best to approach fruit with caution and moderation post-surgery. Remember that fruit is also a natural laxative that may increase bathroom visits (for colostomies and ileostomies).

Nuts

Hard nuts such as peanuts, almonds and hazelnuts should be introduced in minimal amounts and chewed well. Peanut butter will act as a stool thickener in some people, which can help with diarrhea.

Meats

Poultry does not present significant problems, but steak, chops, roasts or hamburgers must be carefully chewed and consumed in moderation. After ileostomy or colostomy surgery, high-fat items, heavy casings on sausage, and gristle may be more difficult to digest. Eat slowly, avoid the gristle and limit your intake.

Spicy Foods

Heavily spiced foods and sauces can act as cathartics (cause loose stool) and gas producers.

Foods that increase odour

Asparagus, broccoli, Brussel sprouts, cabbage, cauliflower, beans, eggs, fish, onions and some spices.

FoodsThat Increase Gas

Beans, beer, broccoli, Brussel sprouts, cabbage, corn, cucumbers, cauliflower, mushrooms, peas, radishes, spinach, dairy products, excess sugar. Consult a local dietician or NSWOC if you have other questions.

Foods that thicken stool (slow output)

Applesauce, bananas, cheese, boiled milk, marshmallows, pasta, smooth peanut butter, pretzels, rice, bread, tapioca, yogurt, bagels, oatmeal.

Foods that loosen stool

Green beans, beer, broccoli, fresh fruit, grape juice, raw vegetables, prunes, juice, spicy foods, leafy greens, chocolate, spinach, aspartame, nutra-sweet, sugar.

High-fiberfoods that may cause blockages

Dried fruit, grape fruit, nuts, raisins, celery, corn, popcorn, coconut, seeds, coleslaw, mango, Chinese vegetables, oranges,meast with casings.

High-fiberfoods that may cause blockages

Dried fruit, grape fruit, nuts, raisins, celery, corn, popcorn, coconut, seeds, coleslaw, mango, Chinese vegetables, oranges,meast with casings.

Can you still drink alcohol?

Yes! And you may find that gastrointestinal upsets associated with alcohol that used to occur before surgery are gone with the removal of the diseased bowel. However, those with ileostomies are at greater risk of dehydration and electrolyte loss and you should have water, juice, or pop with your drink. Beer and carbonated drinks can produce gas. Alcohol may give you loose output or extra output, or it may not affect stool at all. Everybody’s different.

Can You Control the Amount of Waste Produced by Selective Diet?

You will have little or no output if you stop eating, but starving yourself or limiting liquids to avoid producing waste is dangerous. Never restrict fluid intake – the consequences of dehydration are severe for an ostomate. Sticking to regular mealtimes can help you learn your body’s behaviour patterns and anticipate the times when your output is lowest. Some people eat less at certain times of the day or evening to help make their stoma less active. However, skipping meals will not stop ileostomy output and can produce more gas than eating regular meals. Ileostomies and urostomies will always have output.

Some foods do produce more waste than others. Cellulose is the chief component of plants, so it stands to reason that consumption of most fruits and vegetables will increase output. Refined grains such as white rice or white bread produce relatively little residue, as do things like eggs, cheese or chicken. Examples of foods that thicken or slow output are oatmeal, peanut butter, marshmallows and bananas. Drinking large amounts of fluids will not affect stool output; it will increase urine output. You cannot control your ostomy completely with a selective diet.

Source: A Handbook for New Ostomy Patients. Used with permission from Debra Rooney, Vancouver Ostomy Chapter.
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