Dietary advice for people with colostomies Introduction During your surgery, you have had a colostomy formed. Colostomies are formed due to problems in the colon (large bowel). This leaflet is designed to provide you with advice regarding your diet, in the short and longer term. It includes information on Reintroduction of food following colostomy formation Healthy eating with a colostomy Managing problems with your colostomy output General Information The majority of nutrients are absorbed in your small bowel. The job of your colon is to absorb water and salts. Depending on the position of your colostomy, you may find your stools are more watery and loose than normal, particularly in the early stages. As your bowel adapts, this should settle. Now that you have a colostomy, you should aim to return to a healthy balanced diet as quickly as possible. Eating well will help your colostomy output to settle and help you recover. Reintroduction of food following colostomy formation New colostomies usually work within 2-5 days after your operation. The output is likely to be watery at first, settling to between 200-600ml daily of semi solid stool. For the first few weeks after surgery you may find your output is a little unpredictable while your bowel adapts. After your operation, you may be advised to follow a light diet for a few days.
The light diet will be food that is easy to digest, such as: Cornflakes/Rice Krispies White bread and toast Soup Omelette Scrambled egg Fish in sauce Chicken Mashed potato Milk puddings Custard Mousse Jelly Ice cream After this period, you should aim to introduce new foods and return to your normal diet as quickly as possible. Healthy eating with a colostomy As you are recovering from surgery, it is important that you eat a balanced varied diet that gives you all the nutrients you need. General advice Avoid missing meals Eat regularly Eat in a relaxed environment Take your time at mealtimes Some people find smaller, regular meals and snacks suit them best and prefer not to eat late at night If your appetite is poor, take smaller meals with snacks in-between, such as cereal, sandwiches, cheese and crackers, yoghurts or build up drinks If your wear dentures ensure they fit correctly Healthy eating with a colostomy Include a variety of foods from the following food groups: Cereal foods - for example, bread, potatoes, rice, pasta, breakfast cereal. These will provide you with energy. Try and have one of these foods with each meal and snack.
As your stoma output settles try and slowly include high fibre varieties such as wholemeal bread, high fibre breakfast cereal (Weetabix, Shredded Wheat, Branflakes ). When eating high fibre foods it is essential to have a good fluid intake, aim for at least 6 8 (1.5 2ltr) glasses of fluid a day, for example, water, tea, coffee, no added sugar squash, soft drinks. Protein foods - Such as meat, chicken, fish, cheese, eggs, beans and pulses, Quorn, soya, tofu, milk, yoghurt, fromage frais. These are needed to maintain and repair your body s tissues. Try to have 2 3 portions of these foods daily. Fruit and vegetables Aim for 5 portions of fruit and vegetables daily. Following your surgery, introduce fruit and vegetables gradually you should aim for 5 portions per day. You may wish to peel fruit and vegetables initially. What is a portion? 3 tablespoons of vegetables 1 medium fruit, such as apple, banana or orange 2 small fruits, such as plums or apricots 1 cup of grapes, cherries or berries 1 tablespoon of dried fruit Half a large fruit grapefruit or avocado 1 slice melon or papaya 3 tablespoons of fresh fruit salad, stewed or canned fruit. 1 small glass (150ml) of fruit juice 1 dessert bowl of salad Changes in weight If you experience problems with weight loss, or excessive weight gain please discuss this with your GP. Problem solving Some people may experience problems with their colostomy. This may be caused by food. There is very little scientific evidence; however, the following suggestions have been helpful for some people. It is important that you don t alter the output from your colostomy by reducing your fluid intake or missing meals, this may make you dehydrated. Your colostomy will work best if you eat regularly.
Only avoid foods if they are causing a problem, or if the consequences such as odour or wind, are bothering you. It is important that if you exclude some foods from your diet, that you try them again every couple of weeks, to see if you can re-introduce them. Remember the aim is to eat as wide a variety of foods as possible. Foods that may cause wind Certain vegetables - sweetcorn, peas, baked beans, green beans and other beans, lentils and pulses, seeds, cauliflower and broccoli (especially if the stalks are eaten), onions, garlic, cabbage, brussel sprouts, and other green vegetables, asparagus, radishes, mushrooms, unpeeled cucumbers Nuts Fruit especially dried fruit and under-ripe bananas Eggs Fatty foods Beer and cider Fizzy drinks Tips to help reduce wind Avoid smoking Avoid drinking at the same time as eating (but ensure that you have plenty of fluids throughout the day) Try peppermint oil in hot water or peppermint tea Cook all vegetables well Avoid chewing gum Swallowing too much air can cause wind. Sitting upright and chewing foods well will help reduce this. Foods that may cause odour Fish Eggs Fatty foods Baked beans Broccoli Brussel sprouts Cabbage Green leafy vegetables Asparagus Onions Garlic Spicy foods Beer and cider
Foods that may control odour Natural yoghurt Buttermilk Parsley Peppermint oil capsules (available from the chemist or health food stores) Colostomy deodorant sprays and drops can help mask or eliminate odours, ask your stoma care nurse for advice about these. Foods that may cause a loose stool Large amounts of fruit or fruit juice Prunes High fibre cereals and high fibre bread Bran Beans Leafy green vegetables Very fatty foods Highly spiced foods Caffeine, such as tea, coffee, cola, chocolate Sorbitol (artificial sweetener) Beer and other alcoholic drinks Foods that may control a loose stool Ripe bananas Marshmallows Rice White bread and toast Tapioca pudding Cheese Noodles Arrowroot biscuits Arrowroot powder Foods to alleviate constipation Constipation can be a problem for people with colostomies. Signs of this are hard pellet like stools or stool which collects at the top of the bag (known as pancaking) which can cause leaks, the following advice may help to alleviate these symptoms. Increasing your fluid intake approximately 2 litres per day (at least 8 large glasses) Increasing the fibre in your diet Increasing the intake of fruit and fruit juice to include natural laxatives such as prunes and figs Increase intake of vegetables Regular exercise If constipation continues to be a problem please contact you stoma nurse or GP for advice 23463 V1/Nutrition and Dietetics/TSDFT/09.16/Review Date 09.18