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Colostomy and Ileostomy patients

(Only) for Individuals with a Colostomy

Foods and beverages that may help constipation:

  • Extra fluids      

  • Fresh fruit and vegetables

  • Fruit juices

  • Wheat bran (e.g. bran cereal)

(Only) for Individuals with an Ileostomy

For individuals with an ileostomy, the colon has either been removed or bypassed. The function of the colon is to absorb water, salt and potassium. When the colon has been removed or bypassed some of these functions are lost. It is important to be aware of the signs, symptoms and treatment measures for dehydration and electrolyte imbalance.

Signs and Symptoms

Description

Treatment Measures

Dehydration

Increased thirst, dry mouth, dry skin, decreased urine output, fatigue, shortness of breath, stomach cramps.

Increase fluids of any kind.

Sodium Loss

Loss of appetite, stomach cramps, cold arms and/or legs, fatigue.

The highest sources of sodium are found in: bullion, instant power soup, canned soups, salted crackers, pretzels, pickles tomato juice, smoked meats, ham, wieners. Cottage cheese, cheeses, goat’s milk.  Drinks such as; Gastrolyte, club soda or Gatorade are lower sources of salt.

Potassium Loss

Fatigue, muscle weakness, shortness of breath, decreased sensation in arms and legs, a gassy bloated feeling. 

High sources in the vegetable family include: tomatoes, V-8 juice, potatoes, squash, carrots, vegetable and cream soups, salad greens.  High sources of potassium in fruits, include: oranges, grapefruits, bananas, melon and avocado.  Smooth peanut butter, nuts, butter, tea and coffee are also sources of potassium.

For Individuals with an Ileostomy or Colostomy

Foods that may cause gas

  • Carbonated Beverages / Pops

  • Cabbage / Sauerkraut

  • Beer

  • Brussels Sprouts

  • Cucumbers

  • Onions

  • Dried Beans / Peas / Legumes

  • Sweet Potatoes

  • Broccoli

  • Turkey

  • Cauliflower

  • Melons

Foods that may cause odor

  • Fish

  • Cauliflower

  • Eggs

  • Brussels Sprouts

  • Onions

  • Asparagus

  • Garlic

  • Broccoli

  • Spicy Foods

  • Turnip

  • Cabbage

  • Strong Cheese

Foods that may thicken stool

  • Apple Sauce

  • White Rice

  • Bananas

  • Tapioca

  • Cheese (particularly aged varieties)

  • Yoghurt

  • Marshmallows

  • Pretzels

  • Pasta

  • Potato Chips

  • Smooth Peanut Butter

  • Oat Products (Oatmeal / Oatbran)

  • Barley

Foods that may loosen stool

  • Alcohol

  • Spicy or Fried Foods

  • Raw Fruits

  • High Sugar Foods (e.g. Syrup)

  • Grape and Apple Juices

  • Spinach

  • Green Beans

  • Coffee

  • Prunes / Prune Juice

Management

There are differences in nutrition management for individuals with an Ileostomy and those with a Colostomy.

For Individuals with an Ileostomy

Some dietary changes are required for individuals with an ileostomy. Most of the changes are temporary, about 6 weeks after surgery (while the small bowel adapts after surgery), and some are more long term. If you had specific dietary restrictions before your surgery, you may want to discuss and review these with a dietician. Sometimes the restrictions are no longer required while at other times they should be maintained. If you need more long-term changes (e.g. ongoing difficulty with high outputs) a dietician can review your dietary needs and restrictions more specifically.

Short-term restrictions include limiting fibrous fruits and vegetables (particularly raw), as well as whole wheat and whole grain products as these may not readily pass through the stoma during the initial stages (due to post-operative swelling). Cooked vegetables and fruits (chewed well) in limited quantities are acceptable. Nuts and seeds (whole) should also be limited during this time. Gradual re-introduction of these food items can occur after 6 weeks, adding one restricted item at a time and monitoring your response to it (cramping, loose stools).

Long-term considerations can include adequately chewing foods before swallowing, separating solid foods from fluids during meals, and ensuring adequate fluid intake during the day. Fluid intake should be in the range of 8 to 10 glasses a day. Certain foods like popcorn can sometimes continue to be problematic, thus long-term avoidance is based on individual food tolerances.

Some foods may cause increased gas or odour when emptying. These foods do not necessarily need to be eliminated from the diet, but you may want to choose when you consume these items so that it best fits in with your lifestyle and environment. Remember that sucking through a straw, chewing gum, sucking on candies / lozenges, chewing food with your mouth open, and smoking will cause you to swallow more air and will increase the gas through your pouch.

For Individuals with a Colostomy

For the most part, dietary changes are not required for individuals with a colostomy. There may be some initial temporary changes, due to the effects of surgery, but otherwise, there are no restrictions or concerns. If you had specific dietary concerns before your surgery, you may want to discuss and review these with a dietician. Sometimes these restrictions are no longer required while at other times they should be maintained.

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