Diet Recommendations for Living With Ostomies and Internal Pouches
After you have had time to heal from intestinal surgery and you get the go-ahead from your doctor or Trellus Health Care Team, you can begin to start eating a more general diet again, gradually incorporating new foods to test your tolerance.
Foods that are tolerated vary from person to person, depending on the type of surgery and the amount of intestine remaining. What works well for someone else may not work for you, so there will be some trial and error to see how your body responds to different foods.
You may also need to modify your diet more if you have an ostomy versus an internal pouch (like a J-pouch). If you try a food and it doesn’t agree with you, don’t despair! You can try the food again later as you continue to heal and adjust.
The stool that collects in either the internal pouch or external pouch appliance is often referred to as “output.” You can influence the texture, thickness, or odor of the stool output by making modifications to your diet. You can use these diet modifications to troubleshoot problems you may be experiencing.
Foods that increase the risk of stoma blockage
If you have an ileostomy or colostomy, you may be at greater risk of developing a blockage in the opening in your abdomen (stoma). If you experience symptoms of a blockage such as no output for 4–6 hours with cramping or nausea, make sure you seek immediate medical care.
Some foods have more potential to cause a blockage, so it’s recommended to introduce them very slowly and chew them very well. It’s also a good idea to start with a small amount of a more fibrous food. A high volume of a more difficult-to-digest food increases the risk of causing a blockage until your digestive tract has adjusted.
- Dried fruit
- Tougher skins of fruits and vegetables
- Whole kernel corn
- Whole nuts or seeds
Foods that might increase pouch output
If it seems like your output is very loose or watery, you can limit these foods until your body adjusts.
- Alcohol, including beer
- Coffee or caffeine
- Fruit juices, especially apples, grapes, or prunes
- Greasy or fried foods
- Leafy greens like spinach or cabbage
- Milk or other high lactose dairy products if lactose intolerant or in a current IBD (Inflammatory Bowel Disease) flare
- Raw vegetables
- Spicy foods
- Sugar-sweetened beverages
Foods that might increase gas
You may want to limit these foods that can cause excess gas in your internal or external pouch.
- Beans and legumes (lentils, split peas)*
- Carbonated beverages like soda, sparkling water, or seltzer
- Chewing gum (when you chew gum, it introduces more air into your digestive tract)
- Cruciferous vegetables (broccoli, brussels sprouts, cabbage, cauliflower)
*You can try an over-the-counter digestive enzyme like Beano® to see if this helps reduce gas from beans.
Foods that might thicken pouch output
If you find your pouch output is too loose and would like to thicken it, you can add these foods to your diet.
- Creamy peanut butter
- Hot cereals (like Cream of Wheat or Cream of Rice)
- Mashed or baked potatoes with no peel
- Tapioca pudding
- White bread or noodles
- White rice
Additional eating strategies
Once your body has adjusted to the change in your digestive system, you should be able to enjoy most foods again. There are some good strategies to use during food introduction and to keep your pouch output manageable.
Introduce foods slowly
Introduce new foods one at a time to see how you handle them. If you try too many at once you may be eating too much fiber (which can cause symptoms) and you may not be able to pick out which one caused you a problem. Try to space out the introduction of new foods by 2–3 days.
Remember to chew
Chew your foods thoroughly. Chewing helps to break up fibrous foods and helps to absorb more nutrients from them as well as allowing them to pass easier through a stoma or internal pouch.
Make sure you drink plenty of fluids during the day, aiming for at least eight to ten, 8-ounce cups (1.9–2.4 liters total). Limiting fluids will not reduce watery output and may cause dehydration.
Rest and digest
Eating when you feel stressed or anxious can increase how quickly food moves through your digestive system. If you do feel high stress or anxiety when it’s time to eat, take a few minutes to do some deep breathing exercises to help shift your body into rest and digest mode.