Managing Nutrition

There are differences in nutrition management for individuals with an ilieostomy and those with a colostomy.

For Individuals with an Ileostomy

Some dietary changes are required for individuals with an ileostomy. Most of the changes are temporary, about 6 weeks after surgery (while the small bowel adapts after surgery), and some are more long term. If you had specific dietary restrictions before your surgery, you may want to discuss and review these with a dietitian.

Sometimes the restrictions are no longer required while at other times they should be maintained. If you need more long term changes (for example, ongoing difficulty with high outputs), a dietitian can review your dietary needs and restrictions more specifically.

Short-term restrictions include limiting fibrous fruits and vegetables (particularly raw), as well as whole wheat and whole grain products as these may not readily pass through the stoma during the initial stages (due to post-operative swelling). Cooked vegetables and fruits (chewed well) in limited quantities are acceptable. Nuts and seeds (whole) should also be limited during this time. Gradual re-introduction of these food items can occur after 6 weeks, adding one restricted item at a time and monitoring your response to it (cramping, loose stools).

Long term considerations can include adequately chewing foods before swallowing, separating solid foods from fluids during meals, and ensuring adequate fluid intake during the day. Fluid intake should be in the range of 8 to 10 glasses a day. Certain foods like popcorn can sometimes continue to be problematic, thus long term avoidance is based on individual food tolerances.

Some foods may cause increased gas or odour when emptying. These foods do not necessarily need to be eliminated from the diet, but you may want to choose when you consume these items so that it best fits in with your lifestyle and environment. Remember that sucking through a straw, chewing gum, sucking on candies/lozenges, chewing food with your mouth open, and smoking will cause you to swallow more air and will increase the gas through your pouch.

For Individuals with a Colostomy

For the most part, dietary changes are not required for individuals with a colostomy. There may be some initial temporary changes, due to the effects of surgery, but otherwise, there are no restrictions or concerns. If you had specific dietary concerns before your surgery, you may want to discuss and review these with a dietitian. Sometimes these restrictions are no longer required while at other times they should be maintained.

The most common concerns for individuals with a colostomy are gas and odour. Some foods may cause increased gas or odour when emptying. These foods do not necessarily need to be eliminated from your diet, but you may want to choose when you consume these items so that it best fits in with your lifestyle and environment. You may find that it takes about six to eight hours after the consumption of gas forming foods for gas to appear in the pouch. Some people find that over the counter enzyme preparations, such as Beano, are helpful for reducing the amount of gas produced.