Nutrition with an ileostomy

Hear from Sinead our Dietician and Nutritional Advisor

Hello, my name is Sinead McParland, I am a dietitian as well as nutritional advisor for the Eakin group. In this article I’m going to discuss the importance of nutrition with your ileostomy. Just before we start, I do want to highlight the fact that the advice is very general and it is very individual for each and every person. If you have any concerns then it’s important that you speak to your health care professional, either your stoma nurse, your GP, or your dietitian.

You’ve had your surgery, you’ve had your large bowel removed or your colon has been removed, but your colon never played a huge role in the absorption of nutrients in your body. It did, however, play a role in the absorption of fluid or liquids, as well as electrolytes, such as sodium or potassium into your body.

 So the general dietary advice would be to get back to as normal, varied diet as possible, ensuring that you’re following a well-balanced diet. And I will talk a bit about a balanced diet later in the article. But there are a few things I do want to focus on before we get to that. And as I mentioned, your colon is no longer there. It has been removed. So you’re not absorbing as much fluid or liquid as maybe you would be if you still had your colon, we want to reduce the risk of dehydration. So we need to replace some of that fluid. And what we would recommend is to add an extra one and a half to two litres of liquid/fluid into our diet on top of what we’re currently taking to reduce the risk of dehydration.

Dehydration

The signs of dehydration would be things like a dry mouth, dizziness, tiredness, maybe a low urine output. If you’re experiencing any of them, it is important to speak to a health care professional.

So I also did say that your colon absorbs your electrolytes.  We would recommend that you would add an extra teaspoon of salt into your diet. This can be done in cooking, at the table and introducing foods into your diet, such as sausages, hams, cheese, canned tuna, bacon, salted crisps or salted crackers. But it’s important to highlight that in time your body will start to adapt and start to absorb more liquid and more electrolytes. And therefore, you won’t have to add that extra fluid or extra salt into your into your diet.

High fibre foods

Other considerations when it comes to your ileostomy includes fibrous foods or high fibre foods. These are difficult to digest with or without having your colon. But in the colon, there are certain bacteria that helps ferment these foods, break these high fibre foods down. So they’re easier for us to pass. Again, we don’t have the use of that colon, so that fermentation isn’t happening. What happens is if you’re having high fibre foods, they might be difficult to pass, then be the cause of blockage. This is what we don’t want to happen, especially in the first few weeks after surgery. We want things to heal. You want things to settle down, but you want to give a healing process a chance. So for the first six to eight weeks, it’s very individual. Some people maybe less, some people may be more, but we recommend that you would reduce your high fibre foods for that length of time,  just to help with that healing process.

Foods that could cause a blockage

Certain high fibre foods could cause problems or cause blockages. It could be nuts, pips on your fruit, the skins on fruit and vegetables, mushrooms, seeds, things with pips in them, sweet corn or dried fruit. But after that healing period, we will be able to reintroduce these high fibre foods in smaller quantities as tolerated per each individual.

Other areas to highlight after your surgery is looking at your meal pattern. Some people may need to take small frequent meals as you mayb not able to tolerate three large meals in the day. So having small frequent meals throughout the day and maybe not having that late night meal then you don’t have that nocturnal stool production. or have to get up in the middle of the night and change your bag. Again, it’s very individual and it’s what you can tolerate.  Also, your appetite is another thing to consider. You maybe didn’t have a very good appetite pre your surgery, and this just doesn’t return just because you’ve now had your surgery, you will still maybe have a reduced appetite. So having things like a soft diet and things that are maybe a  bit easier to digest until your appetite is triggered and starts to come back. If you have any concerns, it is important to speak with your stoma nurse or your dietician, your doctor, your health care professional. But this is just general guidelines of what’s happening in the first few weeks after you have surgery and the things that maybe you need to focus on.