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Dietary advice for Colostomy and Ileostomy patients

A colostomy is a surgical procedure performed to treat inflammatory bowel diseases (IBD) such as Chron's disease, colitis, and some incidences of bowel cancer.

In a colostomy, the damaged or diseased part of the colon is removed, and the cut end is re-directed from the rectum to an opening in the abdomen where waste removal takes place through a stoma bag.

An ileostomy is the same procedure with the only difference that the diseased part of the ileum is removed rather than the colon.

With a significant change to physiological functions arising from a colostomy or an ileostomy, some short and long-term lifestyle and dietary changes may be required post-surgery.

While the procedure can appear overwhelming at first, most patients live a normal life post-colostomy or ileostomy with little-to-no disruption to their daily routine.

Dietary advice for colostomy patients

After a colostomy, it's advisable to maintain a diet that helps your bowels move as efficiently as possible. Consume extra fluid (at least 8-10 glasses of water a day) and eat lots of fresh fruit, vegetables and wheat bran to help avoid constipation.

Dietary advice for ileostomy patients

The ileum is the part of the small intestine that helps your body absorb salt, water, and potassium. Post-ileostomy, the patient should be aware of signs of deficiency in these nutrients and take steps to replace them.

Water

Lack of water can lead to dehydration. Signs include increased thirst, dry mouth, less urine and struggling to breathe. To overcome dehydration caused by lack of water absorption, increase fluids. To achieve optimum health post-ileostomy, it's advisable to increase water intake without waiting for the signs of dehydration to appear.

Sodium (salt)

Signs of sodium deficiency include stomach cramps, extreme tiredness and cold limbs. To overcome this, increase consumption of salt within the recommended guidelines set by a dietician.

Potassium

Signs of potassium deficiency include bloating, fatigue, shortness of breath and loss of sensation in arms and legs.

If the patient suspects they’re experiencing lack of potassium, increase consumption of tomatoes, vegetables, peanut butter and fresh fruits like grapefruit, melon and avocado.

Nutrition management – ileostomy

An ileostomy will likely require the patient to make some short and possibly long-term dietary changes. Immediately after surgery the bowel will be swollen and inflamed. The patient should restrict consumption of foods that won't pass easily through the stoma such as fibrous fruit and vegetables, whole wheat, and whole grains for up to six weeks. Nuts and seeds should also be restricted but can be introduced gradually as the bowel heals.

Long term, if dietary requirements were present before the ileostomy, these should now be discussed with a nutritionist as they may no longer be applicable.

Nutrition management – colostomy

While the body heals from surgery, it's recommended that the patient eats carefully to consume foods that are easy to pass and which don't put any extra pressure on the bowel. Long-term, there may not be any need to change the diet although awareness of foods that thicken stools (such as rice, bananas, pasta, and yoghurt), and those that loosen them (alcohol, grapes, spinach, and coffee) will be beneficial.

After an ileostomy or a colostomy, waste is removed from the body through a manual process. While a stoma bag is completely discreet, the patient may choose to consume foods which cause more odour (like fish, cauliflower, garlic, spicy foods and strong cheeses) and gas (like cabbage, cucumber, onion, sweet potato and beer) at a time that suits their lifestyle.