Reintroducing Foods After a Colostomy or Ileostomy: A Comprehensive Guide

The Importance of Fibre After Stoma Surgery

Fibre is essential for digestive health, regular bowel movements, and the prevention of constipation. It also aids in weight management, helps control blood sugar levels, improves gut bacteria balance and supports heart health.

Some people may need to adapt the fibre in their diet after bowel surgery.

Eating After a Colostomy or Ileostomy

You may have been advised after your operation to follow a bland low fibre or low residue diet. However, once your stoma is working well, there is no need to stay on this diet.

How to Reintroduce Foods After a Colostomy or Ileostomy

Introduce One Food at a Time

When reintroducing foods, introduce one new food at a time. This makes it easier to identify any foods that cause problems or changes to your stoma output.

Start Slowly With Soluble Fibre

Begin by introducing small amounts of soluble fibre, which is easier to digest.

Foods such as oats, bananas, peeled soft fruits and cooked vegetables are good choices.

Gradually increase the fibre content as your body adapts. It may take several weeks to get back to your normal diet.

Gradually Introduce Insoluble Fibre

Insoluble fibre adds bulk to the stool and can be introduced gradually as your digestive system adjusts.

Foods like whole grains, raw vegetables and salad contain insoluble fibre. Insoluble fibre also includes skins, pith, pips, seed husks and stringy, hard parts of foods.

Add small portions of one new thing at a time. Around a cupped handful of a new food on the first day can be a good starting point, followed by a handful at each meal. Gradually increase the volume if you are tolerating it.

Aim for as much variety as you can.

If you get a problem with anything in particular, stop for a bit but do retry it again to make sure it was the food or drink and not a coincidence.

Keep a Food and Symptom Diary

Track your dietary choices and their impact on your digestive health. This can help you identify trigger foods and make informed decisions about your diet.

Monitor Your Stool or Stoma Output

Pay close attention to stool output and consistency. Gradually adding fibre-rich foods, such as wholegrains, fruits and vegetables, can help regulate bowel movements and prevent constipation or sluggish stoma action.

Stay Hydrated

Adequate hydration is essential for maintaining digestive health as well as reducing fatigue. Consuming enough water helps soften stool and promotes regular bowel movements, preventing complications such as constipation.

Most adults need around 8–10 mugs or glasses a day. Try to keep most of your drinks caffeine and fizz free.

Include Lean Protein

Incorporate lean proteins such as chicken, fish, eggs and tofu. These are easily digestible and provide essential nutrients for overall health and recovery.

High-protein yoghurts such as natural Greek yoghurt are particularly good for your bowel health, unless you have a lactose intolerance.

Tips for Eating With a Stoma

Chew Your Food Thoroughly

Chewing food thoroughly aids digestion and reduces the risk of blockages. Take time to enjoy meals and practise mindful eating.

We generally need to chew 15–30 times per mouthful. The aim is to avoid swallowing big, hard lumps.

Follow a Regular Meal Pattern

Follow a regular meal pattern throughout the day.

Be Mindful of Portion Sizes

Be mindful of portion sizes, especially when reintroducing new foods. Small, frequent meals can be easier on the digestive system.

Avoid Heavy Meals, Alcohol and Caffeine Before Bed

Try to avoid heavy meals, alcohol and caffeine before bed.

Foods and Drinks That May Cause Wind With a Stoma

If you get excess wind from your stoma, remember that some foods may increase wind.

Keep a food and symptom diary and test each food to see how you respond.

It is never good to be overly restrictive, especially with foods you enjoy. A varied, balanced diet is important for your future health and wellbeing.

Tolerance to specific foods can vary from person to person. Here are some foods and drinks that may cause wind with a stoma.

Foods That May Increase Gas

Cruciferous vegetables — Broccoli, cauliflower, cabbage, Brussels sprouts and kale can produce gas during digestion. It can depend on the amount eaten and the cooking method used.

Beans and lentils — Legumes, such as beans and lentils, are known for causing gas.

Onions and garlic — These vegetables contain fructans, which can contribute to gas production. Try eating smaller amounts of these if gas is a problem.

Artificial sweeteners — Sugar alcohols such as sorbitol and mannitol, often found in sugar-free products, can cause gas.

Chewing gum — Chewing too much chewing gum can introduce swallowed air.

Drinks That May Increase Gas

Carbonated drinks — including fizzy drinks and sparkling water, can introduce air into the digestive system, leading to gas.

Caffeinated beverages — Coffee, tea and certain energy drinks may stimulate the digestive system, leading to increased gas.

Alcohol — Alcoholic drinks can cause bloating and gas in some people.

Fruit juices — Some fruit juices, especially those high in sorbitol, can contribute to gas.

High-sugar drinks — particularly those with added fructose, may cause gas.

Are There Any Foods You Should Avoid With a Stoma?

The only foods people tend to get problems with are eating too many nuts at once. These may cause stoma blockages.

Eating one nut in a chocolate is unlikely to cause a problem. Chewing well and drinking plenty will help.

If you like nuts, try having smooth nut butter or ground nuts instead.

Otherwise, aim to eat everything you normally would or work up to a healthy diet. Often, you can choose to eat differently when you are at home, where you can manage your stoma better.

Alternatively, some people use medications such as Imodium (Loperamide) to increase their food variety. You should seek support from a healthcare professional, such as your stoma nurse or a specialist dietitian, if you think this option may be right for you.

When to Seek Support With Your Stoma or Diet

It can take several months for your stoma to settle, including your wind and odour symptoms.

Starting chemotherapy or other cancer treatments, medication changes or starting antibiotics may alter your stoma function.

Further diet or medication management may be needed to prevent dehydration and unpleasant symptoms which may affect your treatment or wellbeing.

After your stoma reversal, you can get altered bowel habits or symptoms similar to IBS.

Reintroducing Foods After a Stoma: Summary

Reintroducing foods after a stoma may require patience and careful observation. By following a gradual and personalised approach, individuals can adapt their diet to promote optimal digestion, overall health and wellbeing.

Remember, every person's journey is unique, and adjustments may be necessary based on individual responses and preferences.