Eating with a new ileostomy

Eating with a new ileostomy Ladywell Building Dietetic Department 0161 206 4254 All Rights Reserved 2018. Document for issue as handout.

When your ileostomy is formed, food travels through your small bowel before passing into your stoma bag. Your small intestine will absorb nutrition from your food before it enters your bag. Digested food will not travel through your large bowel, where water and some electrolytes (such as sodium) are usually reabsorbed. This means your output will usually be a sloppy, porridgelike consistency. You may need to take special care to avoid becoming dehydrated. If you find you are losing weight, or have a poor appetite, contact your dietitian for advice. Eating behaviours Adopting good eating behaviours may help to relieve problems with wind and stoma output: Eat regular meals Long breaks between meals may increase stoma action after meals. Avoid overeating at any one meal. Eat slowly Digestion starts in your mouth! Sit down, take your time and chew well. You will need to follow a strict low-fibre diet for the first 6-8 weeks after your ileostomy is formed. High fibre foods (such as wholegrains, skins, pips and seeds) should be avoided as they are difficult to digest, may increase your output and can cause a blockage as they travel through your ileostomy. This becomes more likely if they have not been chewed or cooked properly. Stay hydrated Follow any fluid restriction your doctor has advised. Otherwise, aim for 1500ml-2000ml (about 10-12 cups) fluid per day, or more if you are particularly active. Stoma Ilesotomy bag Drink sensibly Try not to drink whilst eating. Instead, have a drink half an hour before or after your meal. Avoid drinking through a straw, as this may increase symptoms of wind. 1 2

Foods to choose and foods to avoid Food Group Starchy foods Fruit Vegetables Dairy Products Meat, fish and alternatives Low Fibre - eat freely Peeled potatoes eg. roast, boiled, mashed, chips Jacket potato without skin White pasta and rice White breads or crackers Cakes and pastry made with white flour Low-fibre breakfast cereal eg. Cornflakes, Rice Krispies, Frosties, Sugar puffs, Coco Pops Peeled fresh fruit eg. pears, peaches, apples, bananas, melon, mango Stewed peeled fruit eg. apples, plums Tinned fruit eg. peaches, pears, apricots, mandarins, pineapple Peeled and deseeded cucumbers and tomatoes Well-cooked florets of cauliflower and broccoli Passata or tomato puree Peeled and cooked vegetables eg. swede, carrot, parsnip, sweet potato, pumpkin, squash Milk Cheese Yogurt Meat Poultry Fish Eggs Cream Ice cream High Fibre - restrict these Jacket potato skin Boiled potato with skin Brown pasta and rice Brown/wholemeal/seeded breads or crackers Cakes and pastry made with brown flour Wholegrain cereals, muesli, porridge, oats Dried fruit Fruit skins eg. on apples, grapes, blueberries, plums Fruits with seeds eg. all berries, passionfruit Fruits with pith eg. oranges, satsumas, grapefruit Coconut Lettuce Pulses eg. peas, sweetcorn, lentils, green beans, chickpeas, baked beans Vegetables with skins eg. on carrots, tomatoes, cucumber, pepper Fibrous vegetables eg. onions, garlic, celery, mushrooms Seeds eg. tomato seeds, cucumber seeds Yogurt or ice cream with whole fruit or nuts added Beans and lentils Nuts After 6-8 weeks, you may wish to reintroduce small amounts of the foods in the High Fibre column. Be aware that these foods carry a risk of stoma blockage - and therefore should only ever be eaten well-cooked, well-chewed and in small amounts only. In the long-term, you can aim for a healthy, balanced diet with food from all groups of the Eatwell Plate. If you would like further information on healthy eating, please contact your dietitian or GP. 3 4

Common Problems You may find that certain foods cause problems such as wind, loose and watery output or excessive odour. This is different for different people, so it is best to adapt your own diet according to tolerance. Remember that stress, lifestyle changes and medications may affect your stoma too. You may find the following guidance useful: Problem Excessive odour Watery output Wind Potential Trigger Foods Cucumber, eggs, fish, onions Chocolate, excessive alcohol, fatty foods, fish, sugary foods, fruit or fruit juice, onions, spicy foods, caffeine Green leafy vegetables, onions, garlic, pulses, fizzy drinks, beer, chewing gum Foods That Can Help Buttermilk, parsley, natural yogurt, peppermint Banana, boiled rice, cheese, smooth peanut butter, potatoes, jelly babies*, marshmallows*, pasta, tapioca Peppermint *These foods are high in sugar, and should not be eaten in large amounts as they may increase your output Hot weather You lose salt in your ileostomy output. You need to replace this to avoid dehydration. On hot days, when exercising, or on holiday abroad, you may need to increase your fluid intake to avoid dehydration. Try to include extra high-salt foods in hot weather, to replace salt lost in sweat: Bacon, ham, sausages or tinned meat products Hard cheeses Marmite Bovril or OXO Tinned or cup soups Crisps High Output If your output is consistently greater than 1500ml daily, or you experience symptoms such as cramps, fatigue and excessive thirst, you should contact your doctor or stoma nurse for further advice. If you would like to further discuss any of the areas mentioned in this booklet, please contact your stoma nurse or dietitian. Notes Department of Nutrition and Dietetics Ladywell Building, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD 0161 206 4254 5 6

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