4 Food-Related Issues – and How to Avoid Them

If you’ve had a colostomy or ileostomy, you may experience some common food-related issues. The good news is that you can avoid them with some small changes in your diet.

Avoid 4 food-related issues.

As your body adjusts to an ostomy, you may experience some diet-related challenges. If you’ve had an ileostomy (a stoma in the small intestine), food blockage is especially important to avoid and requires immediate medical attention. If you follow some simple guidelines and avoid certain foods, you can steer clear of any problems. Here’s what you need to know about four common issues.

Gas

Gas and odour can be embarrassing, but thankfully there are ways to minimise them. Here are some things you can do:

• Notice changes: As your bowel begins to function, you’ll notice a varying amount of gas in your pouch. But, if you had excessive gas before your surgery, you’ll likely still have that issue.
• Avoid swallowing air: Gas is not only caused by diet, but also by swallowed air. Avoid carbonated beverages, smoking, chewing gum and chewing with your mouth open. * Consider a pouch with a filter: The filter lets the gas out of the pouch, but not the odour. It also prevents gas from building up, so the pouch does not inflate like a balloon. Filters work best if your output is more formed.
• Avoid foods that can cause gas: Beans, beer, carbonated beverages, broccoli, Brussels sprouts, cabbage, onions and cucumbers
• Avoid foods that may increase odour: asparagus, broccoli, Brussels sprouts, cabbage, cauliflower, eggs, fish, garlic, onions and some spices

Diarrhoea

If your stool changes to mostly liquid and there is a marked increase in the volume, you may have diarrhoea. This could be related to food, medications or an intestinal flu. If you need to empty your pouch once or twice every hour, you may be losing far too much bodily fluid. If diarrhoea suddenly occurs and it lasts 24 hours or more, you should seek medical attention. Here are some ways to help resolve diarrhoea:

• Thicken your stoma output: Eat foods like applesauce, bananas, cheese, cooked noodles, pretzels, white rice, white toast and marshmallows
• Avoid foods that may increase output: Fibrous foods, raw fruits and vegetables, spicy foods, high fat foods, caffeine, nuts and corn
• Avoid dehydration: Drink more fluids and avoid foods and beverages that cause loose stools (see above). And empty your pouch more frequently. Replace electrolytes with sports drinks, bananas, broths, potatoes, tomatoes and crackers. 

Please remember that if these steps don’t resolve your diarrhoea within 24 hours, contact your healthcare professional.

Constipation

Constipation can be a common problem for those with and without stomas. A person with a colostomy (a stoma in the large intestine), not an ileostomy, is most likely to suffer from constipation. Here are a few tips:

• Find potential causes: Certain types of medications, infrequent exercise, stress or not enough fibre in your diet can cause or contribute to constipation
• Drink more water: Taking in more water will help resolve your constipation. However, disregard this tip if you’re on a fluid restriction diet
• Eat more of these foods: Bran, fresh fruits and vegetables, stone fruits – fresh and dried (e.g. peaches, plums, cherries) and whole grains
• Avoid certain foods: Constipation can be caused by foods low in fibre, many meats, dairy, refined sugars and processed or fast foods. Applesauce, bananas, cheese, cooked noodles, pretzels, white rice, white toast and marshmallows are known to thicken stool, so it’s best to stay away from them until the issue clears.

Food blockage 

If you have an ileostomy, cramping and abdominal pain, along with watery diarrhoea or no stool output may mean that you have a food blockage or bowel obstruction and need to seek medical attention. Minimise your risk of food blockage by:

• Avoiding high-fibre foods: High-fibre foods can have difficulty passing through the intestine and exiting the stoma. Don’t eat raw vegetables, coconut, corn, nuts, dried fruit, popcorn or other foods with lots of fibre.
• Avoiding other foods that can cause an obstruction: This would include celery, Chinese vegetables, grapes, raisins and mushrooms.
• Chewing foods thoroughly: The digestive process starts when you chew your food properly. Chewing releases digestive enzymes in the stomach that helps break down food.
• Drinking more fluids: Fluids help break down foods into smaller and smaller particles, aiding digestion. Eight cups of water a day is a good general guide.
• Following a fruit and vegetable diet: Your surgeon may have told you to eat only cooked (not raw) fruits and vegetables for six to eight weeks after surgery. This gives your body time to adjust to the changes in digestion.

Note: If you have no output and have vomiting, it is important that you see your healthcare professional immediately or seek care at a casualty department.

View or print the full PDF booklet: Living with an Ostomy: Healthy Eating