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Ileostomy and your diet

Description

You had an injury or disease in your digestive system and needed an operation called an ileostomy. The operation changed the way your body gets rid of waste (stool, feces, or poop).

Now you have an opening called a stoma in your belly. Waste will pass from the ileum (last part of the small intestine) through the stoma into a pouch that collects it. You will need to take care of the stoma and empty the pouch several times a day.

People who have had an ileostomy can most often eat a normal diet. But some foods may cause problems. Foods that may be fine for some people may cause trouble for others. Foods that caused you problems before the ileostomy may continue to cause problems.

Self-care

Your pouch should be sealed well enough to prevent any odor from leaking. You may notice more odor when you empty your pouch after you eat certain foods. Some of these foods are onions, garlic, broccoli, asparagus, cabbage, fish, certain cheeses, eggs, baked beans, Brussels sprouts, and alcohol.

Doing these things may keep down the odor:

• Eating parsley, yogurt, and buttermilk.

• Keeping your ostomy devices clean.

• Using special odor eliminators that are put into the ileostomy pouch. Ask your health care provider about this.

Control gas, if it is a problem:

• Eat on a regular schedule.

• Eat slowly.

• Try not to swallow any air with your food.

• Do not chew gum or drink through a straw. Both will make you swallow air.

• Do not eat gas producing foods such as cucumbers, radishes, sweets, or melons.

• Do not drink beer or soda, or other carbonated drinks.

Try eating 5 or 6 small meals a day.

• This will help keep you from getting too hungry.

• Eat some solid foods before you drink anything if your stomach is empty. This may help decrease gurgling sounds.

• Drink 6 to 8 cups (1.5 to 2 liters) of fluids every day. You can get dehydrated more easily if you have an ileostomy, so talk to your provider about the right amount of fluid for you.

• Chew your food well.

It is OK to try new foods, but try only one at a time. That way, if you have any trouble, you will know which food caused the problem.

Over-the-counter gas medicine can also help if you have too much gas.

Try not to gain weight unless you are underweight because of your surgery or any other illness. Excess weight is not healthy for you, and it may change how your ostomy works or fits.

When you feel sick to your stomach:

• Take small sips of water or tea.

• Eat a soda cracker or a saltine.

Some red foods may make you think you are bleeding.

• Tomato juice, cherry-flavored drinks, and cherry gelatin may make your stool reddish.

• Red peppers, beets, and pimientos may show up as small red pieces in your stool or make your stool look red.

• If you have eaten these, it is most likely OK if your stools look red. But, call your provider if the redness does not go away.

When to Call the Doctor

Contact your provider if:

• Your stoma is swollen and is more than a half inch (1 centimeter) larger than normal.

• Your stoma is pulling in, below the skin level.

• Your stoma is bleeding more than normal.

• Your stoma has turned purple, black, or white.

• Your stoma is leaking often.

• You have to change the appliance every day or two.

• Your stoma does not seem to fit as well as it did before.

• You have a skin rash, or the skin around your stoma is raw.

• You have a discharge from the stoma that smells bad.

• The skin around your stoma is bulging out.

• You have any kind of sore on the skin around your stoma.

• You have any signs of being dehydrated (there is not enough water in your body). Some signs are dry mouth, urinating less often, and feeling lightheaded or weak.

• You have diarrhea that is not going away.

• You are producing less stool than usual, or have belly swelling or pain. This may be a sign of a blockage.

References

American Cancer Society website. Caring for an ileostomy. www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/ostomies/ileostomy/management.html. Updated October 16, 2019. Accessed December 17, 2024.

Galandiuk S, Netz U, Morpurgo E, Tosato SM, Abu-Freha N, Ellis CT. Colon and rectum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 52.

Pham AK, McClave SA. Nutritional management. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 6.

Raza A, Araghizadeh F. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 117.

United Ostomy Association of America website. Food reference chart. www.ostomy.org/wp-content/uploads/2022/02/Food_Reference_Chart_2022-02.pdf. Accessed December 17, 2024.

Review Date: 10/30/2024

Reviewed By: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.