Colostomy, Ileostomy, Rectal pouch Diets

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.

colostomy 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 However, this procedure is not standard and is outdated.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
Buttermilk Yogurt
Cranberry juice Charcoal tablets (check with your provider first)
Parsley
Liquids
Asparagus Garlic
Eggs Onions
Fish
Applesauce Pasta
Bananas Creamy peanut butter
Bread Starchy foods, such as potatoes
Cheeses
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

  1. Maria A, Lieske B. Colostomy Care. MEDSURG Nurs. 2021;28(2):125-126. doi:10.5005/jp/books/11133_27
  2. 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
  3. 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
  4. 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
  5. 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

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