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Achieving a sensible, balanced diet when you have a stoma

We all know that a balanced diet keeps you healthy and hydrated, but as a new ostomate you may have many different concerns about diet. It takes a while for your appetite to return after stoma surgery so try to remember your bowel has been through major trauma and it takes time for your gut to calm down. Often ostomates have lost weight before their surgery due to illness or bowel disease, so you may want to be gaining some weight again now that you are well. You may find that after surgery you do not have much appetite, so it is important to try and eat little and often to aid recovery and help with wound healing. Find somewhere quiet and relaxing to enjoy your meals and importantly take the time to enjoy your food.  Chew your food well and have a drink to hand as it all helps with digestion.

Here are some tips to help to help with achieving a sensible, balanced diet:

  • Eat three small meals a day, with snacks in between about 4-6 times per day.
  • Start by eating a light, bland and easily digestible diet
  • Avoid fatty, spicey or high fibre foods.
  • Drink plenty of fluids at least 6 cups per day (8 cups per day for those with ileostomies)
  • If your bowels are loose, try to limit fruit, vegetables, wholegrain breads and cereals, coffee, and alcohol as they act as bowel stimulants.
  • Avoid fizzy drinks which can cause gas/wind.

What to eat when you have a stoma:

Unless specified by a health care professional, you should be able to eat what you like. However, it may be that you need to be more careful now you have a stoma and adjust your eating habits slightly. Following surgery, you may want to stick with foods you could tolerate well prior to surgery. Avoid any foods which caused issues before, these can be re-introduced again at a much later date, to see if you can tolerate them.

As part of a well-balanced diet, it is important to increase your calories, fat and protein to aid your bodies healing process. Here are some calorific foods following surgery:

  • Full fat milk and cheese
  • Double cream (add this to soups, mashed potato, and puddings)
  • Snacks on biscuits and cakes
  • Foods high in protein each day such as fish, tender meat and eggs
  • Drink regularly to keep well hydrated.

Certain undigested foods can cause blockages if you have an ileostomy, so It’s good to know which these are. Here are some examples but it is good to have a full comprehensive list to keep with you:  fruits and raw vegetables with skins on (ie apples/cucumber), seeds and nuts, sweetcorn, popcorn, dried fruit, wholegrains, museli, fibrous fruits and vegetables such as Chinese vegetables.

Starchy foods can help thicken the output from your stoma, making it more manageable. There are many good diet tips for those with a colostomy who may be prone to constipation, such as increasing fluids and fibre and many others. It is also good to be aware of foods which can make your urine more smelly for those with a urostomy such as fish, garlic, onions and asparagus.  Plus those foods which can cause excessive wind/gas for you stoma such as green vegetables (cabbage, sprouts, cauliflower), baked beans, onions, mushrooms, cucumber, root vegetables.

Make sure you take the time to read any literature given to you on discharge from hospital on these topics, which will help prevent any issues in the future.

Dietary tips when you have stoma:

  • Eat and drink regularly.
  • Include fruit and vegetables daily.
  • Protein rich foods such as meat, fish, beans, lentils, eggs, cheese, milk, or yogurt
  • Carbohydrates (starchy foods) such as bread, potato, 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 healthy options.
  • If you cannot eat dairy, try dairy free alternatives such a soya/almond/coconut/oat milk which are fortified with calcium.
  • If you are under weight fat is an important source of energy, include olive oil in cooking, butter in mashed potatoes, milk pudding made with full cream milk. Oily fish twice per week can ensure you are getting enough Omega 3 essential fatty acids. 

Watching what you eat:

In the early days of managing your stoma, you will be getting used to the new sounds, smells and the amount of output from your stoma. Over time you will start to recognise which foods cause gas/wind or change to your output consistency. The most important dietary concerns for the ostomate are preventing blockages. Some foods are prone to obstructing stomas than others, to be clear that does not mean that you can’t eat them, but its worth being aware of. This is more likely with an ileostomy than a colostomy or urostomy.

Further down the line:

Once you are feeling more like yourself following surgery you will find your appetite returns. At this stage you may be able to gradually introduce more foods to your diet. A balanced diet can help to further normalise your stoma output and achieve consistency. So, make sure your diet is a healthy mix of protein rich foods, calcium rich dairy foods, carbohydrates, fruits and vegetables. Staying hydrated is also a vital as an ostomate, to help prevent any blockages and dehydration.

In the early days of managing and getting to grips with your stoma you may feel a bit nervous and self-conscious about any smells, sounds or consistency of your stoma output and this is completely normal. As your gut settles down you will learn which foods pass through your gut the best and also those foods which may have a negative impact on your stoma. By re-introducing foods slowly this will help your body process foods and avoid any blockages, wind, or diarrhoea.

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