Nutrition with an Ostomy
Where do I begin?
Ease your way back to proper nutrition with small quantities of food. Experts recommend eating three or more times per day in smaller quantities and portions. Try to eat meals at the same time each day to help regulate bowel movements. Eating more frequently and in smaller quantities, and with adequate liquids, will help aid your body’s ability to process food and help with unnecessary gas.
For the first several weeks after your surgery, eating simple and bland soft foods will be easier to digest. Keep in mind that chewing your food well also adds to the ease of digestion – the more broken up it is, the easier it will be to process. Take your time with introducing high-fiber foods back into your diet, as these may be harder to digest and can cause blockages. Ileostomates are often encouraged to avoid high-fiber foods to prevent risk of obstruction, yet fiber is important to CRC prevention - start small and gradually increase and be sure to drink water throughout the day! Always follow the advice of your medical team or dietitian regarding any dietary restrictions right after surgery or on a long-term basis.
If you are trying new foods, start them slowly and one at a time. This will help you to have a better understanding of how your body works with the new foods and if any will cause excess gas, constipation, strange odors, or diarrhea. Slowly incorporate them into your diet and make note of how your body responds to them. Remember that everybody is different, and what affects someone else may not affect you in the same way. This is why it can be helpful to keep a journal or diary of how your body responds to different foods. Foods that you have decided to eliminate today - because of gas, bloating or constipation/diarrhea, may be tolerated a few weeks down the road... be patient and re-try foods in small amounts to see how well things adjust. Keep in mind some foods may continue to be a problem long-term.
What about liquids?
Drink Liquids - Lots of them!
It is important to drink lots of liquids with an ostomy. If you have an ileostomy, more specific ileostomy dietary guidelines will be helpful. Dehydration can happen, as you lose more fluids daily after an ileostomy, due to the fluid not being reabsorbed into the large intestine. Make sure to hydrate even more on hot and humid days or if you are participating in active sports. (low sugar sports drinks and drinks with added electrolytes such as potassium, magnesium, etc. may help with this)
Coffee and tea are fine to drink, but water and diluted real juices (without added sugar) are still better sources of liquid because they contain no caffeine which can dehydrate, so be careful not to use coffee or tea as a substitute for water.
Can I drink alcohol or carbonated beverages?
Yes, but in moderation.
Alcohol is a carcinogen and it is best not to drink alcohol; if you do choose to drink do so in moderation (less than 1 drink/day). Try one drink (or even a half) and see how it affects your body. Like other carbonated beverages, beer may cause extra gas and uncomfortable bloating, especially wheat-based beers. Everybody is different and what affects one person may not affect another in the same way. Liquor is commonly consumed with added flavorings - be careful, alcohol is a source of low nutrient calories that can contribute to unhealthy weight gain.
Consider problem foods
Even though you can still enjoy most of the foods you loved before surgery, there are some foods to be aware of after your ostomy, specifically foods that are hard on digestion and can cause blockages. These are some common foods that may cause intestinal symptoms:
- Popcorn and corn
- Dried fruit
- Raw-crunchy vegetables
Eat these foods in small quantities, at least at first, until it is clear what symptoms may appear. Be sure to chew thoroughly and drink plenty of water with them. If you think you have a food blockage, you should call your doctor or ostomy nurse. Having an ostomy certainly doesn’t mean you have to completely change your diet. By steering clear of problem foods and making sure to stay hydrated, you can get back to enjoying the foods you love.
If you're unsure how foods will affect you, consider trying them at home one at a time before eating them out in public. Knowing how each food affects your digestion means you'll spend less time worrying and more time having fun with friends.
What are some common intestinal reactions to food?
Common intestinal reactions by food type.
|Gas Producing||Asparagus, beans, beer, broccoli, Brussels sprouts, cabbage, carbonated beverages, cauliflower, chewing gum, cucumbers, dairy products (eggs, milk), legumes (lentils), melons, nuts, onions, peas, pickles, radishes, soy products, spicy foods|
|Incomplete digestion*||Apple peels, cabbage, celery, Chinese vegetables, coconut, corn, dried fruit, leafy green vegetables, mushrooms, nuts, pineapple, pith from citrus (white fibrous coverings of oranges), popcorn, raw/crunchy vegetables, raw/undercooked meat (sushi, rare steaks), seeds, skins from fruits, skins from vegetables|
|Thickened stool||Applesauce, bananas, cheese, creamy peanut butter, hot cereals (Cream of Wheat, oatmeal, rice), marshmallows, pasta, pudding, potato (without skin), rice, tapioca, unseasoned crackers, white bread/toast, yogurt|
|Thinned stool||Alcoholic beverages, apple juice, baked beans, chocolate, fresh/raw fruits, fresh/raw vegetables, fried foods, grape juice, high-sugar foods, leafy green vegetables, milk, prune juice, spicy foods|
|Increased odor||Alcohol, asparagus, broccoli, brussel sprouts, cabbage, cauliflower, dried beans, eggs, fatty foods, fish, garlic, legumes, onions, peas, radishes, smoked foods, strong cheese, some medications, some vitamins|
|Reduced odor||Buttermilk, cranberry juice, parsley, probiotics (e.g. yogurt), smaller/more frequent meals, staying well hydrated, odor eliminators (drops, gels, sprays, tablets, essential oils, sachets that can be placed in the ostomy pouch)|
|Constipation Relief**||Bran products, coffee (warm/hot), fruit (fresh, raw, or cooked), oatmeal, prunes, raisins, vegetables (fresh, raw, or cooked), water, warm beverages, warm soups, whole grains|
|Color Changes||Asparagus, beets, food colorings, iron pills, licorice, red jello, strawberries, tomato sauce|
*Mainly applies to an ileostomy. People with an ileostomy are at greater risk for
stoma blockage/obstruction. These food types should be eaten with caution and not introduced into the
diet until 4-6 weeks after surgery. Introduce them slowly, one at a time, and chew well.
**Mainly applies to colostomy. Increasing the amount of fiber in your diet will help you avoid becoming constipated. Discuss options with your MD.
What if I need more support?
Get in touch with other people with ostomies — sometimes called ostomates. Blue Hope Nation is one place for doing this. You can ask questions that you might be embarrassed to ask your doctor or nurse. And you can get tips to help you adapt to life with an ostomy.
The Alliance’s Buddy Program connects you with someone who has been through a similar diagnosis to offer meaningful and useful advice.
Remember that it will take time to adjust but you can still live life with an ostomy. Some things you can do with an ostomy:
- Participate in sports
- Go back to work
- Tell - or not tell - whomever you want about your ostomy
- Hide your ostomy
- Wear whatever you want
- Go wherever you want
- Have intimate relationships
- Live a long, healthy life