Nutrition-wise blog

What is a good ileostomy diet?

By Jennifer K. Nelson, R.D., L.D. and Katherine Zeratsky, R.D., L.D. October 16, 2013

A reader recently asked a question that might be of interest to others as well: "What is a good ileostomy diet? I do not eat meat or poultry, and I am having constipation problems."

Before answering, a little background is needed. An ileostomy is when the part of the small intestine (called the ileum) is surgically connected to the abdominal wall to provide a way for stool to leave the body. This procedure is done when there is disease, blockage or other problems that don't allow stool to pass to the large intestine and exit as normal bowel movements.

The small intestine is about 21 feet long and is responsible for breaking down food and absorbing nutrients. Each part of the small intestine absorbs certain nutrients. After part of the small intestine is removed, the remaining intestine adapts somewhat over time to compensate for the section that was removed.

Why is this important? Your dietary needs and tolerances will depend on how much healthy small intestine remains and how much time has allowed it to adapt following surgery. In addition, the type of ileostomy will play a role — if your surgery created an ileostomy that is continent (no collection appliance is worn) or incontinent (an appliance is needed).

With these points in mind, here are some general guidelines:

  • Immediately after surgery (for about one month), you'll likely be advised to eat a diet that is low in roughage to allow the intestine time to heal and to prevent blockage due to swelling. Foods with roughage include whole grains, raw vegetables and fresh fruit. This is a temporary limitation.
  • Eat meals at regular times, eat more slowly and chew well. Also, avoid skipping meals or overeating. These efforts help your remaining intestine digest and absorb food, reduce gas, improve "regularity" and control output.
  • With time you will find that you can resume a more normal diet and you will learn which foods tend to be constipating, which may have more of a laxative effect, and which cause stool to change color, or cause gas or odor. This varies according to the individual and the length of small intestine remaining.
  • If your stool is very thick (constipated), some dietary changes may help. Stool-thinning foods may include grape juice, apple juice and prune juice. Be cautious with foods that are constipating. For some people that includes apple, banana, cheese, potato, pasta, rice and peanut butter.
  • Make sure to drink at least eight 8-ounce glasses a day. Water is best. Diluted electrolyte beverages, such Gatorade, Powerade or CeraLyte, contain sodium, are hydrating and are helpful immediately after surgery and during hot weather. Eating a lot of bread, especially whole grain bread, can increase your need for liquids.

As you can see, regularity will depend on many things and vary from person to person. When you're constipated, pay attention to the balance between constipating foods and the amount of beverages you drink. If these lifestyle changes don't help, check back with your surgeon or gastroenterologist. Talking with a dietitian also may be indicated.

Ileostomates, please share what works for you.

Jennifer

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Oct. 16, 2013