An ileostomy is a surgical opening, or stoma, created to bypass the large intestine by attaching the end of the small intestine, or ileum, to the abdominal wall. As food makes its way down the digestive tract, it is excreted through this opening into a pouch rather than continuing on to the large intestine. Ileostomy nutrition therapy can vary depending on individual tolerances, and it includes an array of well-tolerated foods.
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In the Short Term (Up to Six Weeks Post-Surgery)
Immediately after surgery, the recommended diet is clear liquids -- broth, apple juice, tea -- with a progression to a solid, low-fiber diet. You should try solid foods one at a time to assess for tolerance and to avoid any food that may potentially cause odor, gas, diarrhea or a blockage. If a particular food causes gastrointestinal symptoms, stop eating it and try it again a couple of weeks later.
Recommended Foods While Healing
Well-cooked and seedless vegetables such as cooked carrots or squash, strained vegetable juice, and lettuce will help you avoid blockages as you heal.
Fruits with minimal fiber like avocados, soft melons and canned fruits except pineapple, pulp-free juices except prune juice, applesauce, ripe bananas, and oranges and grapefruits without the membrane will also give you fewer problems than high-fiber foods.
You should generally be able to tolerate foods made with refined grains such as white bread, white rice, crackers, pasta and rolls. Milk products are also acceptable to eat while healing. If you experience discomfort after eating them, you can try lactose-free versions instead.
Chicken, fish, pork and beef prepared without extra fat, along with smooth nut butters and eggs, are excellent sources of protein while healing. Fish, eggs and nut butters may cause odors, and you should try them in small amounts at first. Introduce fats slowly, as they may cause some discomfort.
In the Long Term
Patients are usually able to return to a normal diet within two to six weeks after surgery. Foods such as asparagus, broccoli, Brussels sprouts, cabbage, cauliflower, garlic, onions, eggs, fish, dried beans and peas, peanuts, and carbonated beverages may cause odor or gas in some individuals.
Drinking out of straws, eating too quickly and chewing gum can also increase gas. Foods such as kefir, yogurt, parsley, cranberry juice and buttermilk may help to reduce odors.
To reduce risk of blockages, eat foods such as corn, popcorn, raw cabbage, coleslaw, celery, dried fruit, coconut, unpeeled apples, grapes and nuts in small quantities and chew them thoroughly.
High-fat foods, fried foods, grape and prune juice, spicy foods, and foods with added sugar could potentially cause diarrhea in some individuals.
Eating small frequent meals and having your largest meal during the day can help lessen stool output at night. Foods such as bananas, applesauce, cheese, smooth peanut butter, pasta, potatoes, tapioca and rice may help to thicken stool.
To prevent dehydration, aim for eight to ten cups of liquid per day. In times of high diarrhea output, you may require extra potassium from tomato and orange juice, bananas, avocados and potatoes. If you need extra sodium during these times, you can get it from canned soups and broth and lunch meat.
An ileostomy decreases the absorptive surface area of the ileum and can potentially cause vitamin and mineral deficiencies in some individuals.
Consult your doctor or registered dietitian to help identify the need for increased potassium and sodium, along with any other nutrition-related deficiencies that may require additional supplementation.