Colostomy: Diet

In the first few weeks after having a colostomy operation, it is likely that a low-fibre diet will be recommended for you. This is because surgery causes your bowels to swell, making it difficult to digest fibre. Once the swelling has subsided (usually after eight weeks), you will be able to resume a normal diet. However, you may need to take vitamin supplements until you are ready to resume a normal diet.

It is a good idea for you to gradually introduce new foods to your diet, at a rate of one type of new food each day. This will enable you to judge the effects of the food on your digestive system. You may find it useful to keep a ‘food diary’ so that you can keep a record of the food that you have eaten and how you feel afterwards.

If you have a colostomy, the recommended dietary advice is similar to that for people without one. You should eat a healthy, balanced diet that includes plenty of fresh fruit and vegetables (five portions a day) and whole grains.

You may wish to avoid foods that result in excessive flatulence (wind). Food and drink that are known to cause excessive flatulence in people who have colostomies include:

• beans,
• peas,
• onions,
• leeks,
• potato salad,
• fizzy drinks, such as cola, and
  beer.

Changing your colostomy pouch

Most people find it useful to fix set times every day to change their colostomy bag. It is usually best to avoid changing the pouch when the output from your stoma is active, such as shortly after a meal.

Immediately after the operation the output from your stoma will be erratic and unpredictable. As your bowel heals, you should notice that the output from your stoma occurs at more regular times, which will give you more flexibility in what type of pouch you wear. For example, if you know that your stoma is going to be inactive for several hours, you could wear a small disposable pouch to protect against possible leakage.

Most people with a colostomy usually change their pouches when they are a third to a half full.
It is important to dispose of used colostomy pouches in a responsible way. You should seal the pouch in a plastic bag and place it in your dustbin.

An alternative is to use ‘flushable’ pouches, which are designed to be flushed down the toilet. Your stoma nurse will be able to provide you with more information about this type of pouch. You should never try to flush a ‘normal’ pouch down the toilet because it could cause a blockage.

Irrigation

Irrigation is an alternative to using a colostomy pouch. It involves washing out your colon with water, either every day, or every other day, usually after a meal when your bladder is full. Irrigation usually takes between 45-60 minutes to complete. Irrigation is not an effective method for everyone. It is usually more effective for people who have a permanent descending colostomy compared with those who have transverse colostomies.

Your stoma nurse will be able to advise you about whether irrigation is a suitable method for you. If it is, the nurse will be able to teach you how to perform irrigation and provide you with the equipment that you will need.

Smell

Many people worry that their pouch will give off a smell that other people will notice. However, this is unlikely if you use an odour-resistant pouch system and you empty it regularly. Special liquids and tablets that can be placed in your pouch to reduce any smell are also available. Eating yoghurt and buttermilk can also help to reduce smell.

Medication

Many medicines are designed to dissolve slowly in your digestive system. Therefore, if part of your colon is removed and you are taking medication, it may not be as effective because rather than staying in your system it could come straight out into your pouch. If you are taking medication, you should let your pharmacist know about your stoma so that they will can recommend an alternative type of medicine, such as an uncoated pill, powder, or liquid.

Exercise

In the weeks following surgery, it is usually recommended that you do some gentle exercises in order to strengthen the muscles around your stoma and colon. Your stoma nurse will be able to teach you a range of different exercises. Pelvic floor exercises are an example of the type of exercise that may be recommended for you. This exercise is described below.

• Sit, or lie, comfortably with your knees slightly apart.
• Squeeze, or lift, at the front as if you are trying to stop the passage of urine, and then at the back as if you are trying to stop the passage of wind.
• Hold this contraction for as long as you can (at least two seconds, increasing up to 10 seconds as you improve).
• Relax for the same amount of time before repeating.

Ideally, you should aim for 10 short, fast and strong contractions.

Work

Once your bowel has healed, there is no reason why you cannot return to work. If your job is particularly strenuous, and involves a lot of heavy lifting, you may need to wear a support belt, or a girdle. Your stoma nurse will be able to advise you about this. As it is likely that it will take several months before you are ready to return to work, it is a good idea for you to discuss potential options with your employer before you have your colostomy operation.

Some employers may be happy to provide a degree of flexibility, such as allowing you to work part-time until your strength improves, or allowing you to do some work at home. Your employer may also be able to offer you additional support, such as giving you access to changing facilities, or adjusting your responsibilities at work so that you do not have to do lots of heavy lifting.

There is no reason why you have to tell your work colleagues about your colostomy (unless you want to) but it is a good idea to tell at least one person in your workplace in case you should need any support or advice.

Travel

There is no reason why you cannot travel freely when you have a colostomy. You will just have to set aside some extra time when planning your journey. When travelling abroad, it is a good idea for you to bring plenty of supplies with you because you may have trouble obtaining colostomy equipment in another country.

Related Articles:

1. Introduction to Colostomy
2. The need for, and who requires Colostomy
3. How Colostomy is performed
4. Recovering from a Colostomy
5. Complications of a Colostomy
6. Ileostomy

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Related posts:

1. Recovering From A Colostomy
2. Colostomy
3. Who requires a colostomy?
4. How a colostomy is performed
5. Complications of bladder cancer