You may need to alter your diet or take vitamin supplements when you have an ileostomy, a surgical diversion of stool to an opening in the abdominal wall. How an ileostomy affects your nutrition depends on how much of your small intestine is still available for digestion. If most of your small intestine is removed, a condition known as short bowel syndrome, you might have serious deficiencies. If you have most of the small intestine available, you might not need nutritional supplements or diet changes. Talk to your doctor about your nutritional needs after ileostomy.
The large intestine absorbs a large amount of fluid; when waste is diverted to the stoma rather than passing through the large intestine, you can become dehydrated. If you have a short amount of small intestine left, your stool will also be very watery, causing more fluid loss. Drink at least eight to 10 glasses of fluid per day, but don't drink while you eat. Watch for signs of dehydration, which include thirst, dry, loose skin, dry lips and mucous membranes, lightheadedness and darker than normal urine. Foods such as creamy peanut butter, bananas, pasta and potatoes help thicken loose stool and prevent fluid loss.
Foods high in fiber can cause problems when you have an ileostomy. High-fiber can lead to intestinal blockages. A low-residue diet also decreases stool output, a benefit if your ileostomy produces copious amounts of liquid stool. Peel fruits and vegetables and eat them cooked rather than raw, which breaks down the fiber. Avoid foods likely to cause intestinal blockage, which include corn, popcorn, celery, raw carrots, nuts, oranges and salads. Signs of blockage include abdominal pain and distention, decreased output, nausea, vomiting and stoma swelling.
Gas and Odor
Because foods are only partially digested when they pass through the stoma, the opening in the abdominal wall, odor and gas can both pose problems. Foods such as buttermilk, cranberry juice, parsley and yogurt can decrease odors, according to the American Dietetic Association. Foods that can cause increased odor and gas include asparagus, baked beans, broccoli, Brussels sprouts, cabbage, garlic, fish, some cheeses and eggs. Alcohol can also increase odor.
If you have less than 150 centimeters of small intestine left and have had your colon completely removed, you might need intravenous nutritional supplements to meet your needs for a period of time, according to a September 2007 article published in "Today's Dietitian." Over a one- to two-year period, you might transition to solid foods. If most of your small intestine is intact, you may need nothing more than a daily multivitamin to replace lost nutrients. You might need sodium or potassium supplements at times when you have high output of watery stool from the ileostomy, since you will lose these minerals in the stool.
- MedlinePlus: Ileostomy and your Diet
- American Dietetic Association: Ileostomy Nutrition Therapy
- Wound, Ostomy and Continence Nurse's Society: Discharge Planning for a Patient with a New Ostomy: Best Practice for Clinicians
- United Ostomy Associations of America, Inc: Ileostomy Fact Sheet
- Today's Dietitian: A Dietary Challenge: Maximizing Bowel Adaptation in Short Bowel Syndrome
A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.