A colostomy is a surgical procedure in which a part of the colon is diverted to an artificial opening in the abdominal wall in order to bypass a damaged part of colon. An ileostomy is an artificial opening made in the abdomen due to a malfunctioned ileum or rectum. At the same time, a rectal pouch may be created when the rectum or colon is removed due to cancer. The opening itself is called a stoma.
Surgery is the last resort IN CERTAIN infectious diseases and colon cancer; however, the indication for surgery varies from region to region2. Surgery can be performed in two ways. The first way is that a reservoir pouch is created. Later a tube can be passed in the pocket to empty it. However, this procedure is not standard and is outdated. The other procedure involves removing all or part of the colon and directly connecting the small intestine to the rectum. An ileal-anal pouch is created and is connected directly to the rectum, and liquid feces can then pass through that pouch.
Important Diet Considerations
Consume diets that are easy to digest, produce no gas, and produce less odor.
- Take small meals 5-7 times a day to easily carry out digestion and absorption.
- Eat an average-sized breakfast and lunch, and eat smaller meals in the evening to avoidmore stool accumulation in the rectal pouch.
- Consider buttermilk, yogurt, and parsley to prevent increased gas odor.
- Avoid gas/flatulence by eating regular small meals, eating slowly, and chewing properly.
- Water intake should be 8-12 cups a day to soften the stool.
- Avoid cucumbers, radish, and melons.
- Eat solid food before drinking water to avoid leaking, which can be a common issue in ileostomy4.
- Avoid drinking soda, beers, alcohol, and carbonated drinks.
- Foods containing higher fiber should be avoided in the first 8 weeks after surgery.
- Maintain healthy body weight and avoid belly fat because obesity and belly fat may cause abnormal functioning of the stoma.
Nutrition Management
Since the colon is removed, care must be taken to manage the diet in order to control stool consistency. Well-balanced meals complete with necessary nutrients and minerals are a must. Your provider may also prescribe multivitamins or other supplements to meet the body's nutritional requirements.
Constipation can also be a common complication in stoma patients5, particularly after surgery. It is important to maintain proper water intake and to follow post-surgical dietary instructions.
Typically, if a diet plan is followed, no supplements are required.
Summary
If you have undergone a colostomy procedure, appropriate dietary management is a necessity. Foods that produce less odor and favor soft stools are preferred, especially during the first few weeks after surgery.
Nutrition Guidelines
The following diet plans and foods have shown beneficial results in colostomy, ileostomy, and rectal pouch patients:
Foods that are poorly or incompletely digested and may block a narrowed stoma
| Celery | Mushrooms |
| Coconut | Nuts |
| Corn | Olives |
| Cucumbers | Peas |
| Dried fruits | Pineapple |
Factors that cause excess swallowed air which can lead to gas:
- Jittery or stressed personality with excessive saliva swallowing
- Poorly fitting dentures, smoking pipes or cigarettes, and chewing gum or tobacco can cause increased salivation and swallowing
- Eating fast and swallowing large chunks of food or large amounts of beverages quickly
- Using straws or drinking from a bottle or can
- Inactivity and lying down after eating
Foods that tend to cause gas
| Vegetables | Cabbage, radishes, onions, broccoli, brussels sprouts, cauliflower, cucumbers, sauerkraut, kohlrabi, rutabaga, turnips, asparagus, onions |
| Fruits | Prunes, apples, raisins, bananas, excessive amounts of fruit |
| Cereals, bread | Excessive wheat products, including bread and cereals. Check labels for specific grains. |
| Milk, milk products | Excessive milk, ice cream, cheese |
| Fatty foods | Excessive pan-fried or deep-fried foods, fatty meats; rich cream sauces and gravies; pastries |
| Liquids | Carbonated beverages |
| Odor-Reducing Foods and Medications | |
|---|---|
| Buttermilk | Yogurt |
| Cranberry juice | Charcoal tablets (check with your provider first) |
| Parsley | |
| Liquids | |
| Odor-Producing Foods | |
|---|---|
| Asparagus | Garlic |
| Eggs | Onions |
| Fish | |
| Foods that Tend to Thicken Stool | |
|---|---|
| Applesauce | Pasta |
| Bananas | Creamy peanut butter |
| Bread | Starchy foods, such as potatoes |
| Cheeses | |
| Foods that Tend to Cause Diarrhea | |
|---|---|
| Apple juice | Prune juice |
| Grape juice | Highly seasoned foods, especially with hot peppers |
Sample Menu
|
canned peaches 1/2 cup skim milk 1/2 cup white toast 1 Slice margarine 1 tsp decaffeinated tea 1cup lemon juice 1 tsp sugar 2 tsp |
baked chicken breast 3 oz steamed white rice 1/2 cup cooked carrots 1/2 cup low-fat vanilla yogurt 1/2 cup margarine 1 tsp decaffeinated coffee 1 cup skim milk 1/2 cup sugar 1 tsp salt 1/8 tsp |
chicken noodle soup 1/2 cup saltines 2 sandwich 1/2 white bread 1 slice creamy peanut butter 1 Tbsp jelly 1 Tbsp applesauce 1/2 cup decaffeinated tea 1 cup lemon juice 1/2 cup |
This Sample Diet Provides the Following
| Protein | 54 gm | Sodium | 1,512 mg |
| Carbohydrates | 151 gm | Fiber | 9 gm |
References
- Maria A, Lieske B. Colostomy Care. MEDSURG Nurs. 2021;28(2):125-126. doi:10.5005/jp/books/11133_27
- Engida A, Ayelign T, Mahteme B, Aida T, Abraham B. Types and Indications of Colostomy and Determinants of Outcomes of Patients After Surgery. Ethiop J Health Sci. 2016;26(2):117. doi:10.4314/EJHS.V26I2.5
- Ng KS, Gonsalves SJ, Sagar PM. Ileal-anal pouches: A review of its history, indications, and complications. World J Gastroenterol. 2019;25(31):4320. doi:10.3748/WJG.V25.I31.4320
- do Egito ETBN, Medeiros A de Q, Moraes MMC, Barbosa JM. Estado nutricional de pacientes pediátricos ostomizados. Rev Paul Pediatr. 2013;31(1):58-64. doi:10.1590/S0103-05822013000100010
- Burch J. Constipation and flatulence management for stoma patients. Br J Community Nurs. 2007;12(10):449-452. doi:10.12968/BJCN.2007.12.10.27282
