Recommendations For Ileostomy

Diet

During the first few months after having an ileostomy, it is recommended that you eat a low-fibre diet. This is because the surgery causes your bowels to swell, making digesting fibre difficult.

Once the swelling has subsided (usually after eight weeks) you will be ready 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 to introduce new food to your diet slowly, at the rate of one type of food each day. This will allow 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.

Dietary advice for people with an ileostomy is similar to that for people without one. You should eat healthy, balanced diet that includes plenty of fresh fruit and vegetables (at least five portions a day) and whole grains. Many people with an ileostomy find it best to avoid eating nuts because they can cause irritation.

Fluid replacement

If you no longer have a colon, you are at greater risk from dehydration. This is because one of the functions of the colon is reabsorb water and minerals (sodium and potassium) back into the body. Therefore, it is important to drink at least 1.2 litres (6-8 glasses) of water a day. However, you will need to drink more in hot weather, or if you are more active than normal.

Sachets of fluid replacement solutions are available over-the-counter (OTC) from pharmacies, and can be taken when you feel dehydrated.

Flatulence (gas)

In the first few weeks after surgery, you may experience a lot of gas. This is harmless, but it can be embarrassing and uncomfortable. However, the gas should subside as your bowels become less inflamed (swollen). Not eating foods that cause gas can help. Foods that cause gas include beans, broccoli, brussel sprouts, cabbage, cauliflower, onions, and eggs. Fizzy drinks and beer will also cause gas. However, you should not skip meals to try to prevent gas because it will make the problem worse.

Some people find that eating six small meals a day, rather then three main meals, helps to reduce flatulence. If the problem persists, your doctor, or stoma nurse, should be able to recommend a medicine that can help to reduce gas.

Smell

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

Medication

Many medicines are now designed to dissolve slowly in your digestive system. Therefore, if 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.

You should let your pharmacist know about your stoma because they will be able to recommend an alternative type of medicine, such as an uncoated pill, powder, or liquid.

Anal soreness

Anal soreness, or itchiness, is quite common in people with an ileo-anal pouch. Having regular baths should help to relieve this. Using a skin protection cream is also recommended. Your doctor will be able to advise you about the best cream for you. You should use a small amount of cream every time you empty your pouch.

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