Diet advice
Everybody needs a healthy and well balanced diet, whether they have a stoma or not.
- Some people find that smaller, regular meals suit them better and prefer not to eat late at night. People living with a stoma should eat regularly (at least 3 times per day) as this helps to ensure the stoma functions efficiently and helps avoid wind.
- Always chew food well and eat slowly: this helps digestion.
- People living with a stoma should vary foods. They can experiment and try everything in small amounts, gradually increasing the quantities. If something disagrees with them, they should avoid it for a couple of weeks and then try a small amount again.
- Include high-fibre foods to reduce the risk of constipation (colostomy only). Fibre is found in fruit, vegetables, wholemeal bread, wheatgrain cereals, brown rice and wholemeal pasta.
- Some people living with a stoma find that they are unable to tolerate foods that are rich in fat, e.g. cream, pastry, full cream milk, cheese and chocolate. Alternatives would be semi-skimmed or skimmed milk, lower-fat cheeses and low-fat spreads.
- As for any of us, people living with a stoma should drink plenty of fluids – approximately 2 litres each day. This can include tea and coffee, but water and squash are preferable
- Ileostomists may wish to avoid high-fibre foods as they may cause food bolus blockage.
Wind
Foods that may increase wind:
Cabbage, beans/lentils/pulses, cauliflower, rich fatty foods, sprouts, spicy foods, onions, eggs, fizzy drinks/beer.
Non-food causes of wind:
Chewing gum, eating with mouth open, talking while eating, eating irregularly, smoking, drinking with a straw.
- Eat at regular intervals throughout the day and try to avoid long gaps between meals
- Eat with mouth closed and don’t talk!
- Allow fizzy drinks to go flat
- Don’t use a straw for drinking
- Try drinking peppermint drinks, e.g. cordial or tea
- Eat live yoghurt – 1 carton per day. The natural kind seems to be more effective. If this is too sour, a teaspoon of honey or jam can be added, or it can be mixed with jelly, or frozen and eaten as ice cream.
Odour
Fish, eggs, baked beans, onions, cabbage, garlic, asparagus, green leafy vegetables.
- Eat live yoghurt
- Peppermint oil capsules (available from pharmacists and health food shops)
- Peppermint cordial, diluted to taste
- Buttermilk.
Loose Stools (Colostomy/Ileostomy)
Green vegetables, spicy foods, beer, raw fruit, prunes or prune juice, sorbitol (a low-calorie sweetener) and some medications.
- Eat a very ripe banana
- Live yoghurt
- Cheese
- Marshmallows or jelly babies
- Apple sauce
- Noodles
- Boiled milk
- Rice
- Tapioca
- Smooth peanut butter
- Instant mashed potato.
NB: Colostomists experiencing loose stools may wish to use a drainable appliance that can be emptied, rather than repeatedly removing a closed appliance as this can make the skin sore.
Diet advice for Urostomists
Tea, coffee and alcohol are all diuretics, so it may be advisable for urostomists to reduce these before bedtime.
If they do experience excess urine production at night as a result of this extra fluid intake, urostomists may wish to use an overnight drainage bag. Similarly, if making a long journey, a leg bag attachment may be used to increase the capacity of the appliance.
Foods high in vitamin C help make urine more acidic and so may reduce the risk of infections.
Vitamin C is found in:
- Citrus fruits and soft berries
- Cranberries or cranberry juice (which may help reduce mucus). Please note: please be aware that if a person living with a stoma is taking warfarin, they should avoid any products containing cranberries
- Blackcurrant cordial.
Odour
May be caused by asparagus and fish. Drinking tomato juice may help.
Colour of urine
Some medication and some foods may discolour urine:
- Beetroot
- Radishes
- Food dyes
- Spinach
If the person living with a stoma has any concerns about their diet and its effect on their stoma, they should seek the advice of the Stoma Care Nurse.
Sex and Relationships
Contraception
For ileostomists, some contraceptive pills may not give adequate protection. The coil may not be an option. It may be necessary to use a barrier method, especially if output from the stoma is high or a tummy upset is present.
Pregnancy
It is possible to have a normal pregnancy with a stoma. It may be necessary to alter the template of the appliance as pregnancy progresses.
Sexual function
Males living with a stoma may experience problems with erection. Females may have vaginal dryness and some discomfort with deep penetration. Lubricating gels may be useful for dryness. Should problems continue, they should discuss these with the Stoma Care Nurse.
Exercise
It is important that people living with a stoma get back to a healthy lifestyle as soon as they feel able. The normal convalescence period is three months.
Whatever activities they enjoyed prior to surgery, they should be able to return to after their recovery. This will, however, depend on their general condition and the type of, and reason for, surgery.
Lifting
- Heavy lifting should be avoided for 12 weeks following surgery.
- Activity should be gradually increased. Many household jobs, such as ironing or washing-up, can be done while sitting down.
- The person living with a stoma must avoid stretching to reach high cupboards.
- They should slide furniture, rather than lifting it.
- Heavy loads of shopping should not be carried; it should be divided into two bags to balance it.
- Nothing heavier than a full kettle of water should be lifted for a few weeks.
- They should not vacuum clean for 12 weeks.
- If lifting is a necessity, they must ensure knees are bent and objects are kept close to the body.
- If lifting is to be carried out regularly, a support garment or belt should be considered.
Rectal Discharge
This can be normal after surgery, when the rectum or rectal stump have not been removed. In most cases, the discharge will gradually decrease. However, pads may need to be worn to protect clothing. The discharge will generally be mucus and/or old blood. Good hygiene and a barrier cream or wipe may be necessary to protect the skin. If problems persist, please refer to the Stoma Care Nurse for advice.
