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Dietary advice for Colostomy and Ileostomy patients

A colostomy is a surgical procedure used in the treatment of bowel cancer and severe cases of inflammatory bowel diseases (IBD) such as Chron's disease and colitis.

The large intestine or colon is re-directed through an incision made in the abdominal wall (stoma), and waste and faeces are collected in a pouch and disposed of manually.

An ileostomy is a similar procedure, but the small intestine is re-directed to the stoma, and the colon is bypassed or removed.

In the long term, neither procedure should require any permanent lifestyle or dietary changes. As the gut adjusts post-surgery however, some short-term changes are necessary for the comfort of the patient and to make sure the procedure leads to the most successful outcome.

Immediately post-surgery, as the patient adjusts, and the wounds heal, it's beneficial for stools to pass comfortably and regularly. Patients may also wish to consider odour as they adjust to removing waste manually.

The consistency, odour and frequency of stools can largely be controlled through the foods consumed. The following information provides guidance for all colostomy and ileostomy immediately after surgery.

Foods that may help constipation

Prunes, fruit, coffee, vegetables, spices, water, wheat bran, apple juice.

Foods that may cause gas

Nuts, fruit, sprouts, beans, onions, sweetcorn, alcohol, fizzy drinks, cucumber, sweet potato, melon, turkey, legumes.

Foods that may cause odour

Asparagus, eggs, dairy, beans, fish, cauliflower, garlic, spices, cabbage, turnips.

Foods that may combat odour

Natural yoghurt, parsley.

Foods that may thicken stools

White rice, bananas, yoghurt, pasta, oats, barley, smooth peanut butter.

Nutrition management for individuals with a colostomy

In general, there are likely to be no long-term dietary changes required for individuals with a colostomy. If food intolerances existed pre-surgery, these should be discussed with a dietician.

Nutrition management for individuals with an ileostomy

An ileostomy removes or bypasses the colon which serves essential physiological functions. One of the primary purposes of the colon is to absorb water, salt and potassium. The patient must be aware that this function may be restricted and learn how to recognise the signs of dehydration and an electrolyte imbalance.

Dehydration

If your body becomes dehydrated, you may notice a dry mouth, dry skin, fatigue, dark urine and possible dizziness or cloudiness. Drinking fluids, ideally water, will combat the symptoms of dehydration.

Get into the habit of drinking between two and three litres of water a day rather than waiting for the signs of dehydration to show.

Sodium loss

If you notice cold arms and legs, fatigue and stomach cramps, you might be experiencing sodium loss. Sodium is present in some canned soups, salted biscuits, tomato juice and some cheeses.

Increasing pure salt intake can potentially lead to more complicated health concerns such as high cholesterol and heart disease, so it's recommended that sodium intake is monitored under the guidance of an expert.

Potassium loss

Lack of potassium can present itself in shortness of breath, numb arms and legs, and bloating. Increase intake of vegetables, potatoes, salad, oranges, avocado, peanut butter and coffee.

In most cases, dietary changes required post-surgery will be short-term and temporary. The following general advice is for all patients immediately after a colostomy or ileostomy:

  • Chew food thoroughly, so it's easier to digest.
  • Everyone digests foods differently so adapting to a colostomy or ileostomy can largely be down to trial and error.
  • Consult regularly with a dietician to review output.
  • Immediately after surgery, the bowel will be delicate, swollen and inflamed. It will heal, so introduce foods gradually. Foods that are difficult to digest may cause pain and discomfort too soon after surgery but that doesn't necessarily mean they should be avoided long-term so persevere with small amounts at a later date.
  • Don't remove whole food groups as this can lead to nutritional deficiencies and further health concerns.
  • Maintain substantial fluid intake to aid digestion (at least two to three litres of water a day).
  • Restrict chewing gum, drinking through a straw, sucking on hard-boiled sweets and smoking. These all increase the amount of air swallowed which increases gas.

Dr White is committed to offering a holistic treatment program for colostomy and ileostomy patients. If you require further advice, make a consultation appointment by calling 07 5598 0955