If you’re going to have ostomy surgery, you may wonder what that means for you nutritionally. Nutrition plays a large role in both your recovery journey and your overall health.
Keep in mind that your digestive system has just suffered a major insult, and it’s not going to tolerate any fancy foods or even a lot of food for a while. Ease your way back into eating by opting for five or six small meals a day instead of three large ones, and make sure you drink plenty of water to help everything keep moving through the plumbing and prevent gas buildup. In addition, make sure you get enough protein, as your tissues need it to repair themselves.
For the first few weeks following your ostomy surgery, your digestive tract will respond best to simple and bland soft foods. Stay away from fried or spicy foods, alcohol, and raw fruits and vegetables. And any food you have to chew, make sure you chew it well, as that aids in digestion and takes the load off your gut.
Unless your doctor instructs you not to eat high-fiber foods, you’ll want to introduce them, but do so slowly and methodically, as they may trigger excess gas, as well as blockages in people with strictures (scarring that narrows the digestive tract). If you still have a colon, though, fiber is important in keeping the organ healthy. When you do introduce it, be sure also to drink plenty of water to prevent the food from getting stuck in the GI tract and to enable you to pass stool easily.
As you begin to introduce new foods, make sure to only add them one at a time. This will help you determine how your body handles each one and if any will cause gas, constipation, strange odors, or diarrhea. If you don’t tolerate the food, stop it immediately. It doesn’t mean you can’t try it again at a later date; your GI tract may simply not be able to handle it so soon after the surgery.
A number of foods are notoriously hard to digest and can cause blockages in people with strictures, and sometimes even in people without them. These include:
- Nuts
Seeds
Corn (especially popcorn)
Dried fruit
Pineapple
Mushrooms
Raw/crunchy vegetables
If you’re going to eat any of these, try only small quantities at first, chew well, and drink plenty of water. Popcorn, though, with its sharp hull and high fiber content, may cause gut distress or blockages even in people who don’t have strictures, so it’s best to eliminate it from your diet. There are varieties of puffed corn without hulls you can substitute; they’re found in most grocery stores.
If you’ve had an ileostomy, where the small intestine forms the stoma, you’ll be able to see a lot of what you eat in your pouch output. Since food passes through your GI tract so quickly, you incompletely digest a number of different foods. These include cabbage, celery, Chinese vegetables, corn, leafy greens, mushrooms, melons, fruit and vegetable skins, dried fruit, nuts, and seeds. As any of these may cause a blockage in the bowel, you shouldn’t introduce them into your diet for at least 4-6 weeks post-surgery, and then only in small amounts to see how you tolerate them. And even if you do tolerate them, they may not be completely digested before exiting the body as waste.
If you’ve had a colostomy, where the large intestine (colon) forms the stoma, drinking water and eating a lot of fiber are more important than with an ileostomy, as they help prevent constipation. Load up on bran products; fresh, raw, or cooked fruits and vegetables; warm beverages or soups; prunes and raisins; and whole grains.
No matter which type of ostomy you’ve had, you may also notice that certain foods, such as asparagus, beets, licorice, strawberries, and tomato sauce, will cause a color change in your stool or urine. While it may look like blood, it’s nothing to be concerned about; it’s just the colorant from the food.
You can cut down on your gas output by avoiding beans and lentils, cruciferous vegetables, cucumbers, onions, peas, pickled items, soy products, dairy products, and spicy foods.
If you do have gas buildup, you can take simethicone (generic Gas-X®) to help neutralize it, and you can eliminate any related odors with deodorant drops or tablets you put in your pouch (available at Amazon and other retailers) or with a pouch that has a built-in odor filter.
Finally, try to eat your meals — however many you have a day — at the same times each day. That will help you keep to a regular schedule for emptying and cleaning your pouch. Aim for emptying it when it gets about one-third full (so it doesn’t pull at and dislodge the adhesive barrier) and before bed (so you don’t have any leakages during the night).
Still have questions about ostomies and nutrition? Your best source of information is your ostomy nurse or dietician — they understand the requirements of ostomies and have the experience of what works best for each type of procedure. Many hospitals have ostomy clinics, where you can make an appointment to see one of these nurses (WCONs — wound, continence, and ostomy nurses), and many support groups are attended by WCONs, too. Check with the United Ostomy Associations of America (UOAA) to locate a group near you.
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