Life after your bowel surgery – reintroduction Food

Food choices after your bowel surgery
Small bowel: – it will continue to work and absorb and digest all the good things it needs after the formation of the ileostomy
Large bowel: – after the formation of the ileostomy the large bowel will absorb less salt and water and your output could be loose at first. In time your body will adapt and change and begin to absorb the water and salt so improving your consistency to a thicker output.
We all have different tolerances to food and drink, so base you diet on your own specific needs. The following information is guidance and for information purposes only.
If you are unsure about diet and nutrition always seek advice from your stoma care nurse, medical practitioner or a dietitian.

The start of your new food journey
You have just had your surgery and probably wondering what best to eat, hopefully we can give you some ideas, don’t rush into things, add food back slowly and best by starting with a soft diet and nutritious diet and is easy to digest and full of the good stuff your body needs. Try to avoid spicy foods and fried foods and high fibre and highly seasoned dishes, just have plain cooked food and chew and eat slowly.
After surgery you may be considering which food would suit your new life with a stoma.
Avoiding high fibre, heavily seasoned, spicy and fried foods would be a good start. A soft nutritious diet that is easy to digest helps, along with chewing slowly.
Best place to start
Protein rich foods help with wound healing
• Meat
• Fish
• Eggs
• Cheese
• Milk
Carbohydrates help with energy: – If you suffer with diabetes possibly substitute with the following
• White/brown bread
• Low fibre cereals like rice krispies or cornflakes
• Potatoes (no skins)
• White/brown rice/pasta
Poor appetite: – try smaller meals with snacks in between such as
• Cheese and crackers
• Yoghurts
• Milk
• Nutritious drinks
• Cereals
• Sandwiches
You may also be given supplements recommended to you by your health coach/dietitian
Fibrous foods: – for the first 6 – 8 weeks after your operation fibrous foods can cause a blockage, especially if they are not chewed properly or if too much fibre is consumed.
• Nuts
• Pith
• Raw vegetables
• Mushrooms
• Coconut
• Seeds
• Fruit or vegetable skins
• Salad
• Celery
• Pineapple
• Pips Peas
• Sweetcorn
• Dried fruit
• Mango
Once your ileostomy has settled (approximately six to eight weeks) you may reintroduce fibrous foods in small quantities, ensuring that they are all well chewed.

Hydration and salt/electrolyte replacement
Dehydration: – over the first weeks you maybe be losing more fluid and salt due to your loose, liquid output then you might do. This makes it a high risk of dehydration so to prevent it you need to increase your intake of fluid and salt. If you do become dehydrated you may be prescribed some oral rehydration solution, st marks electrolyte mix.
How much fluid and salt do you need?
You should ideally aim to achieve 1.5 – 2 litres of fluid per day (8-10 cups. These can include: –
• Water
• Tea
• Coffee
• Squashes
Approximately half to one teaspoon of salt added to food, spread throughout the day. Many foods already include salt so this should be taken into consideration. See link to NHS recommended salt intake:
As your ileostomy settles your output will become thicker. Continue monitoring your fluid and salt intake.
Ultimately seek medical advice from stoma nurses and medical practitioners and dietitians if unsure.
Eating healthy with your ileostomy

Getting used to normal function: – as you adapt you will gain in confidence and begin to experiment with food, resulting in a more enjoyable varied diet.
Healthy diet: – there isn’t one food that contains all the nutrients; therefore, you should include an adequate intake, and variety, of nutritious foods in your diet. Your diet can be modified if you are over or under weight or if you have diabetes.
Starchy Foods: – this food group helps to provide vitamins, fibre and energy they may also help to thicken your output. Try to various of the following
• Bread, breakfast cereals
• Oats, pasta
• Potatoes, sweet potatoes
• Noodles, green bananas
• Rice
Protein Foods: – help to provide the body with vitamins and minerals, repairing and keeping body tissues healthy. Try to include two proteins without including extra fat. Red meats, liver, kidney, oily fish, eggs and pulses are good sources of iron.
• Beef
• pork
• Bacon
• Lamb
• Liver
• kidney
• Chicken
• Turkey
Other foods
• Fish
• Eggs
• Beans
• Baked beans
• Peas
• Lentils
• Peanut butter (Smooth)
• Ground nuts
Meat alternatives
• Textured vegetable protein
• Quorn
• Tofu

Ultimately seek medical advice from stoma nurses and medical practitioners and dietitians if unsure.
Dairy Produce: – are good for healthy bones as they provide calcium. Some provide protein and vitamins. Daily recommendations are
• ½ to 1 pint (300-600ml) of milk per day (lowest fat possible)
• Yoghurt (5oz/ 150ml) (lowest fat possible)
• 1oz/ 30g of cheese (lowest fat possible)
Fruit and Vegetables: – provide an excellent source of vitamins, minerals and fibre to fuel your body throughout the day.
Try to eat a good selection of 5 fruit and vegetables each day. A good example would be 2x tablespoons of vegetables, a salad or some fruit and a glass of fruit juice (150ml).
If you some fruits and vegetables upset you, try peeled fruits, tinned fruits in natural juice, stewed baked or pureed fruits, fruit juices (unsweetened), well-cooked or pureed vegetables, vegetables in soup or casseroles, pureed if necessary.
Fats and Oils: – do provide a small number of vitamins but are mainly fats and energy they need to be used in moderation.
• Butter
• Low fat spreads
• Mayonnaise
• Oily salad dressings
• Cooking oils
• Margarine
Fats and Sugar: – are best enjoyed in moderation as a treats
• Crisps
• Sugar
• Sweetened drinks
• Cakes
• Biscuits
• Sweets
• Puddings
• Ice cream
• Chocolate

Ultimately seek medical advice from stoma nurses and medical practitioners and dietitians if unsure.
Alcohol: – can increase your output. It goes without saying that too much is not good for your health in the long run. If you do like alcohol the recommended units per are as follows
• Men – 3 to 4 units/day or less, with one or two alcohol free days each week
• Women – 2 to 3 units/day or less, with one or two alcohol free days each week
1 unit is equal to ½ pint of beer, a single pub measure of spirits, a small glass of sherry or a small glass of wine.

Fluid and Salt: – you should be taking in at least 1.5 to 2 litres of fluid per day. This is the normal amount for most, but having an ileostomy and having increased output you may need to increase the salt intake without increasing your fluid intake. There are many ways of adding salt into your diet if required and these are some of them.
• Adding extra salt to foods during cooking
• Adding salt to food after serving
• Eating more salty foods such as cheese, bacon, ham, sausages
• Smoked fish (kippers), shellfish, canned fish (tuna, sardines, salmon), meat and fish pastes
• Spaghetti and ravioli, meat extracts (Oxo, Bovril)
• Yeast extracts (Marmite)
• Salted crisps, savoury biscuits and crackers
Severe symptoms: – if you feel you are suffering from dehydration and the symptoms are prolonged consult your medical practitioner, who may recommend a rehydration solution, such as dioralyte which can be obtained from supermarkets (their own brand costs less), or St Mark’s electrolyte solution.
Meals times: – it’s a good idea to aim for a structured eating plan, which should help your ileostomy function. There may be a need for smaller sized meals, more frequently if you were undernourished. It also depends on your daily lifestyle and circumstances. Late meals could increase your overnight output. if this is the case, have smaller meals or eat earlier in the day.
One important factor is that you eat slowly and chew food well
Ultimately seek medical advice from stoma nurses and medical practitioners and dietitians if unsure.
Frequently asked questions.
What should I avoid? – –
Fibrous foods such as leafy greens ie; spinach, cabbage and salad leaves don’t break down quickly and can cause a blockage if they are eaten in large quantities or are not properly chewed. In the first month or two after your operation you should avoid fibrous foods such as nuts, seeds, pips, pith, fruit and vegetable skins, raw vegetables, salad, peas, sweetcorn, mushrooms, celery, dried fruit, coconut, pineapple and mango. Once your ileostomy has settled (after 6 to 8 weeks) you may reintroduce fibrous foods in small quantities, but ensure you chew them well.
How do I know if I have a blockage: – If you notice your output has stopped, stop eating but continue to drink? Try drinking 3 glasses of water, rest and gently massage your abdomen. If this does not work within an hour, repeat the process. If you have passed nothing for 6 hours, contact your GP as soon as possible.
Can I eat spicy food? chilli and curry may upset your ileostomy function so in the first 2 months choose mild food. After this time, you may introduce more spicy food if you wish.
Wind: – Wind is a normal by product of digestion, but it may be increased by swallowing air whilst eating or by eating fibrous foods. You may reduce wind caused by swallowed air by –
How to reduce wind: –
• Eating regular meals
• Eating slowly and chewing food carefully
• Don’t use straws
• Don’t chew gum
• Leave fizzy poured drinks to settle before drinking them
• Low fibre foods white bread, rice and pasta
• Cutting back on wind producing vegetables for example; cabbage, sprouts, onions, leeks
• Fruits nuts and seeds
My output is smelly: – Certain foods can cause your output to smell, these include such things as
• Fish
• Garlic
• Eggs
• Asparagus
• Baked beans
• Broccoli
• Cabbage
• Cod liver oil
• Onions
• Peanut butter
• Strong cheese
• Some vitamins
You could remove these from your diet and monitor the impact, or use deodorising vipoo sprays or drops such as nascent. These are available from your local supermarket. Some are available on prescription. Your stoma nurse will be able to advise.
No two people are the same and what affects you might not affect the next person. This is a general guide for information purposes only.
Ultimately seek medical advice from stoma nurses and medical practitioners and dietitians if unsure.

Frequent liquid output: – if you eat any of the following in large quantities try and reduce them to see if this slows down your output.
• Wholemeal bread
• Wholegrain cereals
• Pulses, various types of beans and lentils
• Leafy green vegetables
• Raw vegetables
• Fruits
• Nuts
• Spicy foods
• Alcohol
• Coffee, tea
• Fried foods
Stoma output colour changes: – drinks and certain foods can change the colour of your ileostomy output these might include blackcurrant or beetroot. If you have not eaten any of these consult your medical practitioner for advice.
Nightly output activity: – if your night-time output is causing interrupted sleep at night try eating earlier. Medication (Loperamide) may help. Speak to your medical practitioner.
Loose output: – if you are experiencing a very high output, you might want to consider increasing your fluid and salt intake. See above information on page 5, be mindful that if your diarrhoea persists for a few days seek medical help from your medical practitioner, because it can lead to dehydration.
Dehydration: – refer to the below symptoms if you believe you have dehydration
• Dry, sticky mouth, Increased thirst
• Light headedness, Tiredness
• Muscle cramps
• Headache
• Feeling dizzy
• Passing less urine which is dark or strong smelling

Always seek medical advice from stoma nurses and medical practitioners if you are unsure, or your symptoms continue

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