Dietary advice following Ileostomy

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1 TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Dietary advice following Ileostomy An information guide

2 Dietary advice following Ileostomy Stoma nurse... Contact number... Dietician... Contact number... Ileostomy An Ileostomy is created by using a part of your small bowel. Your bowel needs to be diverted away from its usual route and out onto your abdomen. To allow faeces to leave the body, the surgeon makes a small opening on your abdomen and brings through the small intestine (ileum). This stoma is made using ileum and is therefore, called an ileostomy. This will mean that you will no longer sit on the toilet to open your bowels as your faeces and any wind will be diverted to a bag. The consistency of the faeces will be a mixture of liquid and semi-soiled faeces with some wind. However, you will still be able to pass urine in the normal way. 2

3 me wind. However, you will still be able to pass u rmal way. 2 3

4 Dietary advice following Ileostomy Your ileostomy will usually be on the right-hand side of your abdomen. It looks a bit like the inside of your mouth and is soft to touch. Its normal colour is pinkish-red, it should be moist, and it may stand out by a few centimetres. Your surgeon or specialist nurse will explain whether this will be an end or a loop ileostomy, as shown in the diagram below and will also explain the differences. At first the stoma will be swollen and will take a couple of months to reduce in size. It will take some time for your stoma to function normally. In the early postoperative stage your doctor will advise when to start oral fluids. When you are tolerating fluids, a light diet (low fibre) is normally recommended. The colon which may or may not have been removed is important for the reabsorption of water and salts. In the early postoperative period (up to 4 weeks), fluid intake must be increased to cups a day and you may be advised to also increase your salt intake. Gradually you will find that the remaining portion of the intestine will adapt, and fluid losses will decrease to around ml (emptying the bag 4-6 times per day). Provided that surgery has not also removed large sections of the small bowel, absorption of food should remain adequate and so nutrient deficiencies are unlikely. If you have been unwell for a prolonged period prior to surgery then this factor, together with a reduced food intake throughout your hospital admission, may have resulted in weight loss. If this is the case you can be referred to the dietician for advice. Occasionally a blockage may occur with undigested food residues. Remember to eat slowly, chew your food well and drink plenty of fluids after your meals. If you repeatedly experience obstruction you may be advised to reduce your fibre intake. However, for most patients thorough chewing of food is the most important factor in avoiding such obstruction. 4

5 If you repeatedly experience blockages, limit your intake of: peas celery popcorn sweetcorn bean sprouts all fruit skins nuts mushrooms coleslaw tomatoes wholegrain bread cereal citrus fruits coconut wholegrain products such as water chestnuts. In time you should be aiming towards a healthy and balanced diet, which may include spicy foods and alcohol in moderation. Foods that can cause wind Call it what you will, wind consists of the gases that are produced during the digestive process. These are responsible for all those wind noises that everyone makes at some time or another. Some people, with or without a stoma, produce a lot of wind and others do not. How and what you eat can make a difference: try not to swallow a lot of air while you eat, avoid gulping your food, instead chew it properly don t talk whilst eating fizzy drinks try shaking cans before opening them (gently!) or pouring them into a glass and letting them stand for 10 minutes before drinking to get rid of some of the bubbles ensure you have a regular meal pattern. These foods can increase wind: pulses such as beans, peas, lentils spicy food such as chilli, curry green leafy vegetables such as broccoli, cabbage banana chewing gum cucumber beer sprouts and cauliflower. 5

6 Foods that can cause odour With a well fitting bag, there should be no odour except when changing the bag. If odour is a problem, limit your intake of: pulses such as beans, peas, lentils sprouts onions particularly raw cabbage fish cauliflower asparagus eggs cucumber garlic broccoli curry. Find out what suits you and then decide whether you want to avoid any particular food that seems to produce an odour. However, there are many different deodorant powders, sprays and filters that can be used effectively. Ask your local stoma nurse. Some people find that some foods increase odour whilst others find no problem at all. There are a few things which some people say can help: peppermint oil capsules, peppermint tea, buttermilk, natural yoghurt and parsley. Foods which can cause your output to be loose When you have loose stools you lose more water and salts from your body, and are at more risk of dehydration. To avoid dehydration ensure you replace the fluids by drinking cups of fluid a day. Suitable fluids include: water, tea, isotonic still sports drinks; meat/ yeast extract drinks e.g. Oxo, Bovril, and Marmite The following foods can cause your output to be loose: chocolate and other foods and drinks fruit and fruit juice with a high sugar content fats, fatty or greasy food spicy foods 6

7 onions excess caffeine alcohol particularly beer and red wine wholegrain products such as wholegrain bread and cereals. You may find the following foods help to thicken / bulk up your stomal output: tapioca/rice pudding marshmallows bananas white pasta, noodles boiled white rice jelly babies white bread arrowroot eggs, particularly hard-boiled. If these dietary manipulations do not help then anti-diarrhoea drugs e.g. Imodium, are available on prescription or over the counter, which can help to reduce your output. If symptoms persists for hours contact your stoma nurse or GP. 7

8 If English is not your frst language and you need help, please contact the Ethnic Health Team on Jeżeli angielski nie jest twoim pierwszym językiem i potrzebujesz pomocy proszę skontaktować się z załogą Ethnic Health pod numerem telefonu For general enquiries please contact the Patient Advice and Liaison Service (PALS) on For enquiries regarding clinic appointments, clinical care and treatment please contact and the Switchboard Operator will put you through to the correct department / service Date of publication: May 2007 Date of review: January 2016 Date of next review: January 2019 Ref: PI_SU_351 The Pennine Acute Hospitals NHS Trust Wood pulp sourced from sustainable forests