Healthy Eating With A Stoma

Healthy eating is key when you have an ileostomy or colostomy, its difficult to know what to do after surgery and how to maintain a healthy diet as theres so much out there on the web. I wanted to share with you a few ideas on what to eat. I will also be sharing a couple of recipes from juicing, protein supplement drinks, recipes that work for me.

The following information is general advice on things that have worked for me whilst living with an ostomy.

If your consultant or stoma nurse has given you different advice due to a specific problem you have, it is important to check with them before you change your diet.

Healthy Diet

Most people with stomas do not need to change their diets and should follow a normal healthy eating pattern like the rest of the population. If you have recently had your surgery or have been unwell, ensuring that you get all the essential nutrients from your diet is even more important and putting unnecessary restrictions on your diet could slow down your recovery and healing.

When eating with an ostomy the trick is to eat little and often rather than eating one big meal. This can really help with unwanted noises in the day and also really helped me manage my output. The other thing to consider some foods may not suit you straight away however its always worth trying it again rather than forgetting it all together, when I had surgery I didn’t get on with bananas however now they are great. I also found that I couldn’t have lactose prior to surgery however now I have re introduced it and I am getting on really well with it (in moderation)

A balanced diet is made up of:

•Starchy foods such as potatoes, rice & grains, bread and pasta, for energy. Try different varieties, including wholemeal vs refined/white rice and pasta, to see which are most helpful for your stoma management.

•Fruit and vegetables provide a wide range of vitamins and minerals and both soluble and insoluble fibre. Soluble fibre is found in the flesh of fruit & veg and can help lower cholesterol as well as make stool thicker, softer and easier to pass (helpful for those with a colostomy or ileostomy who wish to thicken their output). Insoluble fibre is found in the skins of fruit & veg and helps move waste through your bowel, so can help with constipation (helpful for those with a colostomy who experience pancaking and anyone who experiences constipation). If you have a colostomy or ileostomy, immediately after surgery foods containing insoluble fibre may make your stoma behave unpredictably, so you may wish to avoid or limit your intake of them. As your bowel adjusts you can re-introduce them and see how they affect you.

•Protein rich foods for growth and healing. Protein comes from meat, fish, eggs, soya and pulses and it is the substance we use to heal wounds and regain muscle.

•To promote general wellbeing, fatty foods should be limited. However, if you are recovering from surgery or have a small appetite and need to gain weight, including more of these foods in the short term is a good idea.

Eating After Surgery 

After I had surgery my health care team made me stick to foods which I would describe as baby food! Mash potato, yogurts, ice cream etc then they start to introduce you to solids before you leave the hospital.

When I came home I remember being terrified of eating certain foods as all I saw all over the web was peoples horror stories of blockages and I really didn’t want that. My advice keep it simple the worst thing people do is leave hospital and think I can eat anything I want and not worry about running to the toilet … wrong!!

You are probably thinking why not?? Your small bowel is very swollen for weeks after surgery so you have to remember everything you eat has to pass through very small gaps! I found after surgery I had a tiny appetite! So you need to build this up just take your time.

I started eating mash and fish to begin with and small meals and often. From there I introduced well cooked skinless vegetables I.E: Sweet Potato/White Potato cooked well  and no skins, carrots and any root vegetables I find mashing them to begin with was easier to digest! Stick with white bread, white pasta etc goes against everything we say when your into your fitness! But it digests much easier than wholemeal. With regard to meats mince is always a good starter meat as its semi broken down already I then found any lean meat worked well for me just needed to chew it well when eating it. Keep this up for a good few weeks I know its boring but it saves you having a blockage. Peppermint tea is my best friend I drink it after every meal in particular if I have eaten meat as it really helped me digest everything.

After a few weeks I started to increase the frequency of how many meals I ate and I now eat a regular 5/6 small meals a day this really helps me with gas or noises and the best thing to do here is to prepare your food in advance (there is nothing worse than sitting in a meeting and your ostomy kicking up and making noises so I always eat just before I go in to save the embarrassment)

I then started to introduce new foods like salad, oats & cereals, protein supplement drinks etc and it really is a case of trial and error! I now have a well balanced diet and touch wood no issues yet.

The one thing I will say is tuple wear will be your saviour! Be prepared in advance, I will plan and cook all my meals the night before so I always have something with me throughout the day.

Everybody Is Different 

The following information applies to those with a colostomy or ileostomy I will refer to this as an Ostomy.

The impact of food and drink on your stoma is hard to predict as diet is very individual. While many people find that they can eat just the same diet as before their surgery, some find there are things that can have an adverse effect on the activity of their stoma. They may then choose to avoid those foods, or include them in their diets and be prepared for the effects.

When trying foods there may be a certain degree of trial and error, especially in the first few months after your stoma is formed when the bowel is swollen.

Chew Chew Chew 

It sounds very obvious, but it is vitally important to chew food thoroughly when eating. Chewing is the first stage of digestion and in doing this we make more nutrients available from our food. Foods that contain cellulose such as nuts, grain, fruit & vegetables (particularly the skins) cannot be completely broken down in the digestive system. I steer clear from nuts and popcorn although I may be fine I just feel that its better to be safe than sorry!

I find that cooking foods such as vegetables for longer makes them easier to digest.

Drinking 

It is essential for everyone to drink enough to keep their kidneys healthy. I still drink tea and coffee however I drink them in moderation as coffee can make your output much more frequent! Drinking whilst you’re eating also helps things pass through smoother so with every meal I always have a glass of water or soft drink (non fizzy). I also find drinking a peppermint tea after food really aids my digestion.

If you have a colostomy, your fluid intake can remain as normal unless you are experiencing constipation or pancaking. If you have this problem, increasing your fluid intake can be really helpful.

People with ileostomies, do need to drink more and this is because it is the role of the large bowel to absorb water (and salt) and for people with ileostomies this is no longer being used. I also started drinking isotonic drinks you can make them up yourself they taste great and keep you hydrated! (shop bought isotonic are full of sugar) They are incredibly easy to make and will do a how to shortly.

Peppermint tea really works for me after meals in particular if I have just had meat, it helps me with digestion.

Salt

Salt is important for nerve and muscle function and is found naturally in most food and drink. There are risks associated with both having too much and too little salt in our diets. While there is some evidence that people with ileostomies can lose the equivalent to up to a teaspoon of table salt because this would normally be absorbed in the large intestine, each person with an ileostomy will differ in terms of the amount they lose. But, in the first few weeks after surgery you may need to add salt to your food and have additional salty snacks. I don’t have tons of salt in my diet however if you’re drinking isotonic drinks as well as adding salt on your food you should be fine.

The important thing to remember … 

•Chew your food well

•Drink with meals and throughout the day

•Eat little and often

•Keep trying foods you may be surprised

•Eat in moderation

•Be careful of skins on fruit and vegetables