Ileostomy diet: Avoiding common complications

As an individual living with an ileostomy, it is important to focus your diet to ensure adequate nutrition while your colon heals and support your colon health in the future. Your diet will most likely be more restrictive in the first 4-6 weeks following surgery and then you may be able to reintroduce more foods. Always listen to your healthcare provider when it comes to deciding on what foods to include in your diet.

Ileostomy diet after surgery

1. Drink a lot of water to avoid dehydration and constipation. The amount considered sufficient depends on such factors as your activity level, the climate you live in, medications you take, and more. Consult your doctor before deciding how much water to drink¹.

2. Favor small regular meals over large occasional meals. Don’t eat too much in the evening. This will help limit bowel movements at night¹.

3. Eat a low fiber diet. A low-fiber diet may help prevent cramping, bloating and other digestive symptoms¹.

4. Focus on eating soft, bland foods¹.

5. Cut food into small pieces and make sure to chew well before swallowing².

Ileostomy diet after 6 weeks

Exercise caution when reintroducing foods into your diet following surgery. Always consult your doctor when considering making any changes.

1. When you add foods back into your diet, reintroduce them one at a time and monitor your body's reaction. The goal is to eat the way you did before surgery, however, if some food items cause unpleasant digestive symptoms, you may need to eliminate them. For this reason, consider how you feel after reintroducing foods: watch out for gas, bloating and changes in stoma output.

2. If a specific food causes discomfort, remove it from your diet for a few weeks, then try reintroducing it.

3. It's a good idea to keep a food diary and keep track of how you feel after meals.

Ileostomy diet and ensuring proper nutrition

People with ileostomies are believed to be at a higher risk of nutritional deficiencies, specifically iron, vitamin B, magnesium and folate².

Taking a supplement may be beneficial if you have a deficiency. Talk to your healthcare provider about getting a blood test to determine if or not you need to supplement or adjust your diet (for example, to include more protein or take a supplement).

Recommended foods for people with ileostomy*

The following lists include examples of foods that are considered bland and low fiber**. There may be other foods you are able to eat that are not on this list, please talk to your doctor about which foods are best for you.

*Always follow your doctor's recommendations first. Monitor how you feel after eating different foods. Everyone is unique, and what they can handle is different. If you experience diarrhea, bloating, constipation or other unpleasant digestive symptoms after consuming certain foods, exclude them and see if your symptoms improve.

**These foods are considered low-FODMAP by Monash University. FODMAPs are types of carbohydrates found in certain foods that are believed to cause excess gas. Some examples of FODMAPs are milk, garlic, onion and wheat.

Avoiding common problems

Some of the common problems with ileostomies have been linked to certain foods. Note how you personally feel after consuming foods and make decisions accordingly.

Odor

Potential dietary causes for odor include onions, garlic, brussels sprouts, broccoli, cabbage, cauliflower, various beans, asparagus, eggs and strong cheeses.

Gas

Foods that may cause gas or air to be released from your ileostomy include onion, garlic, legumes (e.g. beans, lentils and peas), soda and beer.

Loose stools

Diarrhea can be caused by spicy foods, high fiber foods, fried foods, alcohol and fruit juices.

FAQ:

What is the best diet for ileostomy?

Bland, low fiber, cooked (as opposed to raw) foods are usually recommended for people with an ileostomy.

What is the rationale for a low residue diet in the patient with an ileostomy?

A low residue diet restricts the amount of indigestible material you eat. The term “residue” refers to the hard to digest parts of food that remain in the GI tract and ultimately contributes to fecal bulking^3,5. In theory, a low residue diet may result in a lower stool quantity and frequency. A low residue diet includes eggs, refined grains, white rice, seafood, meat and poultry. Dairy intake is limited, and high fiber-containing foods as well as whole grains are typically avoided^4,5.

References:

1. Memorial Sloan Kettering hospital. Diet Guidelines for People With an Ileostomy, 2022. Retrieved from: https://www.mskcc.org/cancer-care/patient-education/diet-guidelines-people-ileostomy

2. Alberta Health Services. Eating Well after Ileostomy Surgery, 2024. Retrieved from: https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-eating-well-after-ileostomy-surgery.pdf

3. E. Cunningham. Are low-residue diets still applicable? Journal of the Academy of Nutrition and Dietetics, 2012. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/22709819/

4. E. Vanhauwaert, C. Matthys, L. Verdonck, V. De Preter. Low-residue and low-fiber diets in gastrointestinal disease management. Advances in Nutrition, 2015. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/26567203/

5. A. Z. Sorathia; S. J. Sorathia. Low Residue Diet. StatPearls Publishing; 2024. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK557693/

This information is for educational purposes only. It is not intended to substitute for professional medical advice and should not be interpreted to contain treatment recommendations. You should rely on the healthcare professional who knows your individual history for personal medical advice and diagnosis.