When you have an ileostomy or colostomy you may have few questions about your diet. Should I stick to a special diet? Are there foods I cannot eat? What about alcohol? In general, the food that was good and healthy for you before your surgery is still good for you – and the same goes for the more unhealthy options. However, you may still have some questions about how diet effects people with an ileostomy or colostomy. 

What to eat and drink when you have an ileostomy or colostomy

happy woman Dietary guidelines for people with an ostomy Read what to expect the first 2-6 weeks after surgery as well as when you are fully recovered – there are few things you might want to keep in mind. Tips for your diet
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Dietary advice for people with an ostomy

In general, people with an ostomy can eat and drink what they want unless they have been given other guidance or instruction from their WOC nurse or healthcare provider. However, you may want to pay more attention to your diet before and immediately after ostomy surgery. Before your surgery, some food may be easier to digest than others, and right after surgery you may want to spend more time thinking about your food choices and how they affect your digestion and your stoma. 

Right after surgery

You should follow your healthcare providers directions on what to eat immediately after surgery. In general. Foods should be added back to your diet gradually. As always, remember to chew your food thoroughly.

During the first 2-4 weeks 

  • Your body is still healing, so eating foods that are softer or easier to digest will allow your body to recover.
  • You may feel a bit bloated, so try eating little and often at first. 
  • Bland foods can be good for a start. 
  • Chewing carefully and thoroughly is very important. 

Weeks 4-6 after ostomy surgery

  • It's normal to experience a decrease in appetite the first 4-6 weeks after an ostomy procedure. 
  • It may be necessary to supplement the diet with protein and energy drinks. They can be bought ready-made or made at home. You should always talk with your doctor before adding additional supplements   

Is there anything I cannot eat?

There’s no reason to restrict yourself from certain foods unless you have been instructed to do so by your WOC nurse or healthcare provider. Even if you don't have any dietary restrictions, it’s good to know that different foods will have different effects on the output from your stoma. If there’s a particular kind of food that you’re unsure about, just try a small amount. If there are no problems, then go for it!

Don’t be afraid to try new foods - just be sensible. Try not to add too many new foods at once so you can understand how the foods affect your body and digestive system. You will probably find that certain foods produce more gas than others, and even though they are not bad for you, you may want to cut down on these foods. The same applies to chewing gum.

It may take a little trial-and-error to find a balanced diet that feels right for you. Some foods, especially high fiber foods, can cause a food blockage, where undigested parts of food can possibly block the bowel. Chewing thoroughly can help, but a food blockage can be serious. Read about food blockage here. 

What about fruits and vegetables?

The recommended five servings of fruits and vegetables still stands when you have an ostomy! The skins of some fruits and vegetables can be really tough to digest, so it might be best to peel them to avoid any problems, especially potato skins and apple skins. You might  you need to prepare your fruits and vegetables in new ways – try soups to get those vegetables in, or maybe try some fruit smoothies.

To help with digestion, allow vegetables to soften a bit during cooking or try mashing up some of those root vegetables or try mashing some of those root vegetables. 

If an accident occurs

One bad experience with a food choice shouldn't make it necessary for you to cut that food entirely of your diet. Pay attention to trends and how the same or similar foods effect your body. If you have the same reaction to a food multiple times, it may be time to remove it from your diet. 

Just remember: everyone has different reactions, so what works for one may not work for one other.

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People drinking red wine What you drink affects the digestive system What you drink has an impact on the digestive system. Read tips for people with an ileostomy and colostomy. Read about beverages
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What you drink affects the digestive system

 Just like before your ostomy surgery, it is recommended that drink at least 2 liters of liquid every day..If you have a colostomy, this  may help you avoid constipation. As an ostomate you may wonder if you can still have your morning coffee, enjoy a glass of wine or drink carbonated drinks. Here are a few guidelines:

 

  • Coffee and tea are fine, but just like other foods, be aware of any reactions in your digestive system.
  • Carbonated drinks may cause gas. 
  • Beer can cause the output from the ostomy to become more liquid
  • You can drink alcohol. Alcohol can cause dehydration, so make sure to drink enough water. Remember to consult with your physician before using alcoholic beverages as   alcohol may not mix well with your medication

Guidelines for ileostomates

Right after your surgery, it is expected that your body will lose additional fluid through your intestinal system. Therefore it’s generally recommended that you drink at least 2 liters of water per day plus the equivalent of what you lose via the stool. Your physician will let you know how much fluid is best for you. 3-12 weeks after surgery, the small intestine gradually gets used to absorbing more liquid from the stool, so you may not have to drink as much water as you did in the beginning. People with an ileostomy lose two to three times more liquid and salt than other people through the stool, so sprinkling a little salt on your food may be a good idea. 

 

These are general guidelines and are not to replace the medical advice you receive from your health care provider.

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happy man Be prepared for dining out It’s one thing preparing your own meals at home, but what about when you go out for a meal or order take out? Get tips on how to prepare and what to think about. Get ready for dining out
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Get ready for dining out

It might feel like a big step at first, but there is no reason why you shouldn’t be able to enjoy a meal out in a restaurant. 

Be well-prepared

You can always contact the restaurant before you go so that you are prepared ahead of time, and a lot of the bigger restaurants have their menus online so you can always check the menu before you arrive at the restaurant.

Where to go?

A good idea is to start with a restaurant you know well and keep it simple when ordering. There is no need to be too cautious, just be practical. Order what you want, but be aware of how certain foods make you react. Also, don’t be afraid to ask the waiter what ingredients are used for the meals. 

If possible, you may want to order a type of food that you have already tried at home first so you know how you will be likely to react. As you slowly eat more and different foods, you will feel more confident when eating out as well. Even if you are used to having a drink at home, it could be best to 'start small'. For example, drink a small beer rather than a large one. This will help your body build up your tolerance to alcohol again and help reduce – or completely avoid – any reactions. 

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Man in conversation with woman Ballooning in the pouch Ballooning happens when there’s a build-up of gas in the stoma pouch, but what can you do to prevent it? Learn about ballooning
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Learn about ballooning

Ballooning happens when there’s a build-up of gas in the stoma pouch, making it inflate like a balloon. Pouches have charcoal filters that help deal with gas by deodorizing and releasing it from the pouch. But if the filter capacity cannot handle the gas produced, or if it has become moist or blocked by solid output from the stoma, gas build-up can occur.

What can you do to prevent ballooning?

One of the main ways to prevent ballooning is to minimize the amount of gas your digestive system produces. Chewing food thoroughly really helps, as can limiting food and drinks that you know make you produce a lot of gas. These could be nuts, beans, carbonated drinks or sparkling wine.

What to do when you experience ballooning?

If ballooning does occur, you can release the gas from the pouch in the privacy of a toilet, if you use an open bag or use a two-piece system. Changing the pouch if the filter blocks can also help prevent ballooning. Finally, it may be worth trying another type of stoma pouch and filter type.

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boy looking at mum's ostomy pouch What causes pancaking Pancaking happens when there is a vacuum in the stoma bag and the bag sticks together. But what to do about it? Tips for pancaking
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Tips for pancaking

Pancaking happens when there is a vacuum in the stoma bag and the bag sticks together. This stops the output from dropping to the bottom of the bag and can block the filter. There is then a risk that the pouch will be pushed off the abdomen.

What can you do to prevent pancaking?

Blowing air into the pouch before putting it on will help stop a vacuum from occurring. In addition, a drop of oil or lubricant in the pouch will help the output to get to the bottom of the bag.

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woman cooking with her son Experiencing diarrhea? Like everyone else, you may have diarrhea once-in-a-while. Find out what to do when it happens. What to do about diarrhea?
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What to do about diarrhea?

Like everyone else, you may have diarrhea once-in-a-while. But in general, a brief period of diarrhea is not something to be worried about – it could be related to something you ate and will often take care of itself. 

However, three or more loose stools in a row are indeed a cause for concern, as you risk becoming dehydrated, and you should consult your ostomy care nurse or healthcare provider.

If you have an ileostomy

If you have an ileostomy and experience diarrhea you will lose a lot of salt – around 1 teaspoon per liter of stool. Therefore, it is very important to sprinkle some extra salt on your meals.

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woman buying vegetables Trouble with food blockage? Some food may cause a food blockage, so read about how to prevent it and what to do in case it happens. Learn more about food blockage
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Learn about food blockage - and what to do

Chewing carefully is very important to get a good start to the digestive process. This applies especially if you eat foods that are hard to digest (such as nuts). Some foods, especially high fiber foods, can cause a food blockage, where undigested parts of food block the bowel. Chewing well can help, but a food blockage can be serious.

How do I know I have a food blockage?

It can cause cramping; pain and watery stool, and your abdomen and ostomy may become swollen. If you think you have a food blockage, you should:

  • Call your doctor or nurse or go to an emergency room. 
  • Drink plenty of water
  • Avoid solid foods for 24 hours and stick to soups instead

Preventing a blockage is easier than treating one, so chew your food thoroughly and be sensible with your food options, and you should be able to have a normal, healthy diet.

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Irrigation of a colostomy

Irrigation of a colostomy

Learn about irrigation of a colostomy.

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Irrigation of a colostomy

What is irrigation?

Irrigation is a water enema. To irrigate requires the stool to be comparatively firm. Therefore only people with a colostomy whose ostomy is placed in the descending section of the colon (descendens or sigmoideum) can use this method.

Can I just perform an irrigation if I want to?

Irrigation should not be learned on ones own but supervised by a competent professional. Training can occur no sooner than 10 days after surgery. Irrigation should be scheduled as a regular routine every 48 hours, and is therefore not a procedure to be performed occasionally. Occasional irrigation will result in a risk of diarrhoea – this is also the case if irrigation is used as an enema in constipation.

How long does it take?

To irrigate takes three quarters of an hour up to an hour, which makes it appropriate to place the irrigation at a time that considers other family members. 

What are the pros and cons of irrigation?

The advantages with irrigation can be:

  • That you regain some control over the emptying of the bowel
  • It is possible to use a smaller form of bandage, i.e. a cap or Minicab, which reduces the risk of skin irritation, and has fewer sound and odor problems when passing wind, which in turn increases comfort, and has fewer psychosocial issues attached to it.
  • Vision, learning ability, motor skills, and diseases of the intestine can be cause the need for irrigation

The disadvantages of irrigation are:

  • The procedure is rather time consuming 45-60 minutes
  • It requires access to a toilet
  • You have to do it every time – you cannot just decide to do it occasionally as this can lead to diarrhea. 
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