Ileostomy diet and hydration advice

After your surgery you may find your appetite is reduced, but it is still important to eat little and often to help your recovery. You should be able to eat normal foods and return back to the food you enjoyed before your surgery. You may find that some foods can upset your stoma but this may be a one off and we would advise you to try them again in a couple of weeks. Certain foods will alter the consistency of your output, therefore what you eat plays an important part in controlling the output. You should aim for a porridge-like consistency, which can be easier to manage. Some foods can cause blockages, so should be avoided or eaten with caution.

Tip: Eating little and often will help regulate your output.

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Dietary tips for the early days:

You are likely to have lost weight following your surgery. It is important to increase your intake of calories, fat and protein to aid your body’s healing process. In addition to your normal diet, you should look to include the following foods:

  • Full fat milk and cheese
  • Double cream (add to soup, mashed potato and puddings)
  • Snack on biscuits and cakes
  • Foods high in protein each day such as fish, tender meat and eggs
  • Drink regularly to avoid dehydration
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Ongoing dietary advice:

  • Eat and drink regularly
  • Include fruit and vegetables daily
  • Have foods high in protein each day such as meat, fish, eggs, cheese, milk or yoghurt
  • Include carbohydrates with each meal such as bread, potatoes, pasta, rice and breakfast cereals
  • Include milk and dairy foods two to three times per day as they are rich in calcium – choose lower-fat varieties as a healthier option
  • Experiment and try everything in small amounts, gradually increasing quantities. If something disagrees with you, avoid it for a couple of weeks and then try a small amount again

People with an ileostomy will experience the same common digestive issues that they may have had before their surgery, such as wind, odour and loose output.

Loose output:

This can be caused by many things including diet, medication and your emotions. Common foods that can cause loose output:

  • Green vegetables
  • Spicy foods
  • Alcohol
  • Raw fruit
  • Fruit juices
  • Wholemeal varieties of foods

Tip: Cooking fruit breaks down the fibre in it, so you could try stewing fruit.

Solutions to thicken output:

  • Starchy foods such as: white rice, pasta, white bread and potatoes
  • Very ripe banana
  • Marshmallows or jelly babies
  • Live yoghurt
  • Cheese
  • Noodles
  • Tapioca and other milk puddings
  • Smooth peanut butter

If you take anti-diarrhoeal medication, such as Imodium/ Loperamide, ask your Doctor for tablets or syrup rather than capsules, as these may not be broken down in the small bowel and so may have a limited effect. If you experience loose output, it is important to reduce the risk of dehydration.

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Dehydration:

Dehydration is a condition that occurs when the loss of body fluids, mostly water, exceeds the amount that is taken in. When we lose too much water, our bodies may become out of balance or dehydrate.

Severe dehydration can be life threatening. If your output loosens and you find you are emptying your bag more frequently, you may be at risk of dehydration. Please contact your Stoma Care Nurse if you are at all concerned.

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Sign & symptoms of dehydration:

  • Increased thirst
  • Dry mouth
  • Weakness/lethargy
  • Confusion, sluggishness, or fainting
  • Decrease urine output

Salt helps your body to absorb fluid and keep hydrated so it is advisable that you include an extra teaspoon of salt in your diet every day to help prevent dehydration, unless you have been advised to avoid salt or limit your intake because of another underlying medical condition.

If this is the case please discuss with your Stoma Care Nurse and/or GP.

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Tips to avoid dehydration:

  • Aim to drink 8 glasses/mugs of fluid a day (preferably water)
  • Salty foods such as Bovril or Marmite; either spread on toast or as a drink
  • Salted crisps
  • Full sugar fizzy drinks (allowed to go flat)
  • Isotonic sports drinks

Treatment of dehydration:

Contact your GP, Stoma Care Nurse or call NHS 111 for advice

Food blockages:

Some foods can swell in the bowel and may cause a blockage. This will cause your ileostomy to stop working normally. You should seek urgent advice from your Stoma Care Nurse or GP if you think this may be happening to you.

Signs and symptoms:

  • Your output will decrease, stop altogether or may contain large amounts of watery fluid
  • You may experience pain
  • You may feel or be sick
  • Your abdomen may swell
  • Your stoma may swell and look bigger
  • You may experience reduced wind or it may stop altogether

Tips to avoid food blockages:

It is important to chew your food really well. The following foods are known to increase the risk of food blockages, so extra care should be taken:

  • Nuts
  • Coconut
  • Celery
  • Mushrooms
  • Sweetcorn
  • Raw fruit skins
  • Bean sprouts and bamboo shoots
  • Dried fruit such as currants and raisins
  • Pith, pips and stones
  • Popcorn

Treatment of food blockages:

If you suspect a food blockage, stop eating solid foods. You could also try the following:

  • Increase your fluid intake
  • Take pain relief
  • Massage your abdomen
  • Go for a walk and move around

Wind:

Sometimes certain foods can give you wind. The following foods may increase wind:

  • Cabbage
  • Beans/lentils/pulses
  • Cauliflower
  • Sprouts
  • Spicy foods
  • Onions
  • Fizzy drinks
  • Chewing gum

Tip: Leafy green vegetables can cause more wind in the early days. Try root vegetables such as carrots, parsnips and sweet potatoes.

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Solutions to reduce wind:

  • Avoid talking and drinking whilst eating and keep your mouth closed whilst chewing
  • Avoid drinking with a straw
  • Eat regularly and avoid long gaps between meals
  • Allow fizzy drinks to go flat
  • Try drinking peppermint drinks such as cordial or tea
  • Eat live yoghurt – 1 carton per day. The natural kind seems more effective
  • Keep mobile
  • Avoid smoking and chewing gum

Odour:

The following foods can sometimes cause odour:

  • Fish
  • Eggs
  • Onions
  • Cabbage
  • Garlic
  • Asparagus

Solutions to reduce odour:

  • Eat live yoghurt
  • Peppermint oil capsules (available from chemists and health food shops)
  • Peppermint cordial, diluted to taste
  • Peppermint tea

If you have any concerns about the effect of your diet or medication on your ileostomy, please seek the advice of your Stoma Care Nurse or GP.