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Ileostomates shouldn't need a special ileostomy diet
It takes a while for your small intestine to adapt after ileostomy surgery, but eventually your stoma output should thicken up (to a porridge-like consistency) and reduce to around 400-800ml (4-5 bags emptied per day). You should then be able to manage a perfectly normal diet, without needing to eat any special foods.
You may still want to be mindful of the following:
- Drink larger amounts of water than you did before your surgery (unless you have been advised not to), and ensure you have enough salt in your diet as you will lose more salt than other people
- Be aware that high-fibre foods can stimulate your gut and give you diarrhoea or may cause a blockage. These foods include: cabbage, pineapple, bean sprouts, tomato skins, nuts, coconuts, bamboo shoots, orange pith, lettuce, celery, popcorn, mushrooms and dried fruit
- Chew all high-fibre foods well to aid digestion and avoid colic. You are advised to peel all fruit that you eat
- Drink extra fluid and increase your salt intake if you take part in vigorous physical exercise, or if the weather is hot
- Make sure you eat regularly as this helps to regulate stoma function
- Occasionally, some people have ongoing problems with how their ileostomy bag needs changing, or the consistency of their bowel movements. If this happens, you may need to take medication to control it
Although a good fluid intake is an important part of any healthy diet, it is particularly important if you have an ileostomy. In order to prevent dehydration you should try to drink 8-10 cups of fluid a day. Avoid or restrict alcohol as this is dehydrating. As salt losses are very high it is also important to have extra salt in your diet. If you undertake vigorous physical exercise such as competitive sport, or if the weather is very hot, you will need to be careful to drink enough fluid and to further increase your salt intake. Isotonic drinks such as Lucozade Sport can be useful for ileostomists, alongside salty snacks such as crisps. If your stoma output is high (more than 1 litre), or you are sweating (through exercise or hot weather) then you may need special additional fluids that contain salt. Speak to your dietitian or Stoma Care Nurse for advice on what you should take if you think these conditions will apply.
Blockages can sometimes occur from undigested food - especially if your ileostomy is tight. A food blockage results in minimal watery, or no, output from the stoma. In most cases it resolves spontaneously but, if symptoms persist, you should seek medical advice. For the first few weeks following surgery, and later if you experience repeated obstructions, you may be advised to modify how much fibre you eat in your post-procedure diet. For most ileostomates this is unnecessary and avoidance of a few foods most likely to cause blockage is sufficient to prevent problems (e.g. sweetcorn, fruit and vegetable skins and pips, nuts, seeds, coconut, muesli, wholegrains, dried fruits, fibrous fruits plus vegetables such as celery, bamboo shoots, pineapple and mango). It is also very important to chew all food thoroughly, especially meat and high fibre foods.
Ileostomy diet recipes
There are plenty of resources available to help you obtain a well-balanced and enjoyable ileostomy diet. SecuriCare produce a customer magazine called Hand in Hand, which contains regular recipes and diet advice for ostomates. It’s available online for free at https://www.securicaremedical.co.uk/advice-and-support/resources/hand-in-hand-magazine. Our Securicare bloggers are also on hand with their own experiences and tips for what to eat with an Ileostomy. Read long-term ileostomate Kath Holland’s guide to Winning the Battle with Beige food, https://www.securicaremedical.co.uk/blog/the-battle-with-beige-searching-for-colourful-food-i-can-eat-with-an-ileostomy