Having an ileostomy means that stool does not travel the typical intestinal pathway. This affects how stool comes out as well as how the body absorbs important vitamins and minerals. As a result, doctors and nutritionists often recommend eating a special diet after having an ileostomy.
An ileostomy is a surgical procedure that involves making an opening in the abdominal wall. It means that the small intestine, or ileum, can get rid of waste products such as stool through this opening.
The procedure can be useful if a person’s intestines are damaged or inflamed, as it means that stool does not have to pass through the rectum.
After having an ileostomy, a person will need to wear an external pouch to collect these waste products. The pouch may be temporary or permanent.
While the person is still in the hospital, they will start with a clear liquid diet and then progress to foods based on a doctor’s recommendations.
This article recommends some dietary changes to make and some other tips to consider after having an ileostomy.
If a person has a specific nutritional question, they should ask a doctor to ensure that they are getting enough nutrients from their daily diet.
After having an ileostomy, some people may experience thin stool, or diarrhea, and high output.
As well as being inconvenient, uncomfortable, and potentially embarrassing, this can also be dangerous. A person with thin stool may experience low sodium levels or malnutrition. If this does happen, they may require intravenous fluids or nutrition.
To prevent this, a person can eat foods that thicken stool. These include:
- smooth peanut butter
Drinking electrolyte-replacing fluids can help a person who is experiencing dehydration due to diarrhea. However, they should not exceed two or three of these drinks per day, and they should avoid sugary drinks.
Some examples of electrolyte-replacing fluids include:
- sports drinks
- fruit juice
- vegetable juice
A person can also try to identify the cause of their diarrhea. For example, it could be due to:
- a viral infection
- a bacterial infection
- antibiotic use
- radiation therapy
- medication use
- food intolerance
People who are experiencing extremely high stool output should contact a doctor.
- taking certain pain medications
- taking certain anti-nausea medications
- not eating enough fiber
- not exercising enough
- not drinking enough fluids
A person should always ask a doctor if their fiber intake is adequate. If it is not, the doctor may recommend fiber supplements. A person should not take laxatives.
A person could eat foods such as:
- bran products
- cooked, peeled vegetables
- warm soups
Drinking certain fluids can help a person loosen their stools, including:
- hot water with lemon or lemon juice
- prune juice
Some people find that their ileostomy bag can cause bad smells when it is full.
The table below can help a person understand which foods can cause odor and which foods or eating methods can help prevent odor.
|probiotics such as yogurt||asparagus|
|smaller, more frequent meals||broccoli|
|fruits and vegetables||Brussels sprouts|
|odor eliminators to place in the bag, such as drops, gels, tablets, or sprays||eggs|
Oral nutritional supplements can provide calorie-rich nutrition for those who experience weight loss after having an ileostomy. Some examples of these supplements include:
- Carnation Instant Breakfast
- Glucerna, for those with diabetes
- Kate Farms Nutrition Shake
- Orgain Nutrition Shakes
These shakes and drinks have calories and nutrients for easier consumption. However, a person should consult a nutritionist regarding how much they should consume and how often.
Changing one’s eating habits can also help the body absorb nutrients better. For example, a person could eat smaller meals more regularly, such as every 2–3 hours.
Losing weight after having an ileostomy involves consuming fewer calories than one burns in a day.
However, cutting back on dietary intake can be difficult for a person who has had an ileostomy, as they have to be careful to ensure that they get enough vitamins and minerals.
A person who has had an ileostomy and wants to lose weight could consider eating low fat products, such as low fat dairy and lean proteins, and steamed or boiled fruits and vegetables, which should be peeled and deseeded.
With a doctor’s approval, a person can also exercise after having an ileostomy. They could take walks or try an online or in-person fitness class.
Adopting certain eating habits may also help a person lose weight. For example, they could:
- Avoid skipping meals.
- Serve their meals on a smaller plate.
- Avoid alcohol.
- Plan meals and snacks in advance.
Aiming for slow, steady weight loss by making dietary changes and incorporating an exercise routine as a doctor advises can help a person lose weight after having an ileostomy.
Although each person is different, many will find that certain foods result in higher output and gas after having an ileostomy. Some examples of these foods and some alternative ideas include:
|high fat milk and dairy products||fat-free or low fat dairy products, non-dairy milk, or lactose-free products|
|high fat meats, such as fried chicken or red meat with visible fat||lean animal protein, such as skinless poultry|
|high fiber beans and legumes||smooth nut butters, such as smooth peanut butter|
|high fiber grains, such as whole wheat bread, bran cereal, or brown rice||white bread and refined or white flour cereals|
|corn or high fiber vegetables||low fiber options, including well-cooked vegetables with the peels and seeds removed, such as zucchini, tomatoes, potatoes, or lettuce|
|raw fruits with skins||pulp-free fruit juice, cooked and peeled fruit, or canned fruit|
As a general rule, people should try to avoid fibrous skins and seeds after having an ileostomy. The body does not digest these, so they move through the intestine unchanged. As a result, they can potentially affect a person’s ileostomy.
Having an ileostomy means that food material does not reach the colon for nutrient absorption as it does with a colostomy.
As a result, a person may be more vulnerable to nutritional deficiencies. When this is the case, a doctor may recommend taking nutritional supplements.
Most supplements should be liquid or chewable but non-gummy to ensure that the body can break them down. Some examples include chewable multivitamins and liquid or chewable calcium supplements, such as calcium citrate.
Nutrient deficiencies of particular concern in people who have had an ileostomy can include:
There are also some general well-being tips that can help a person who has had an ileostomy feel better overall. These include:
- Eating several small meals at regular intervals on a daily basis: Eating at routine times can help a person better identify when they may need to change their ileostomy bag.
- Chewing food thoroughly: Doing this will make digestion easier.
- Not eating large meals or snacks at night: Eating a large meal could cause the ileostomy bag to become over-full and require changing during sleeping hours.
- Limiting alcohol intake: Alcohol can contribute to dehydration, bloating, and gas.
Following these tips can make for an easier and stress-free eating experience.
Every person is different in how they react to foods after having an ileostomy. Some people will start with a bland diet and gradually reintroduce different foods.
Making an effort to eat nutritious foods and drink plenty of water can help a person live well after having an ileostomy. If they are concerned about stool changes or nutrient deficiencies, they should talk with a doctor.