Food and drink after stoma surgery

Enjoying a meal at a restaurant is one of life's great joys - and there is absolutely no reason why you shouldn't be able to do that after your surgery, assuming your doctor has given the green light to resume a normal diet.

You might have already tried dining out again, but it is completely understandable if you do not feel quite ready yet.

No matter what, a good strategy is to start with a familiar restaurant and keep it simple when ordering. There is no need to be overly cautious, just be sensible.

In the beginning, however, you may want to order a type of food that you have already tried at home first so you know how you will be likely to react. As you gradually expand your diet, you will feel more confident when eating out as well.

Show restraint when drinking

Even if you are used to having a drink at home, it could well be best to 'start small'. For example, drink a small beer rather than a large one.

This will help your body build up your tolerance to alcohol again and help lessen – or completely avoid - any reactions.

Myth: Higher fibre foods cause blockage

This is not the case. While it is true that higher fibre foods like sweet corn, mushrooms and peas can increase your output or produce more wind, they will very rarely cause blockage.

What can cause problems, however, are large servings of high fibre foods combined with little or no fluid. The keyword here is moderation. If you take a careful approach to eating higher fibre foods, there is absolutely no reason to avoid them altogether.

Myth: Fish and sprouts cause more odour

It is true that some foods such as fish and sprouts produce more odour - but as the odour is concealed within your ostomy pouch, there is no reason to avoid eating things like fish or sprouts.

Keep in mind that you only experience the odour when you are alone, emptying your pouch. If you worry about leaving an unpleasant smell in the cubicle, it may be a good idea to carry an odour control spray.

Myth: Gluten makes you bloated

Gluten is a protein, which can be found within flour-based foods such as bread or pasta. Whilst gluten comes with a reputation of causing you to feel bloated or overweight, there is good reason not to consider this reputation to be true. Firstly, gluten is part of a balanced diet, and therefore it is not recommended that you cut it out of your diet unnecessarily.

Secondly, if you do in fact feel bloated or have excessive wind from eating gluten, it is probably not due to the gluten per se - but because you are one of the 20% of the population with irritable bowel syndrome. This is something that can be treated so do not hesitate to contact your general physician if you experience some of the symptoms above after eating foods containing gluten.

Myth: Dairy causes indigestion

This is not necessarily the case. When people with an ostomy find that dairy causes digestive problems, it is often because there has been some disruption to their bowel - perhaps due to an infection or inflammatory bowel disease.

These problems usually go away after a while, and thus it is a bad idea to cut dairy out of your diet, as it is a good source of calcium and protein. If you are not able to tolerate dairy, look for alternatives such as lactose free milk - or calcium-enriched foods.

A common fear in regards to certain foods is the fear of getting blockages, where the food gets stuck higher up in the larger bowl, thus causing the ostomy to stop working. Apart from the ostomy not working, other signs of blockage include Colic, bloating, nausea and vomiting.

First of all it is important to stress, that relatively few people with an ostomy experience blockage. And those who do only do so one or two times. If you do experience signs of blockage, do not hesitate to speak to your ostomy care nurse or consultant. Until you get help, you can relieve some of the pain by drinking lots of fluid, gently massaging your tummy or use a hot water bottle.

Trying to lose weight?

If you are trying to lose weight, it is important not to focus too much on making harsh sacrifices. You are not supposed to suffer, when you are on a diet. Small, achievable steps are often the way to go, when you are trying to achieve a sustainable weight loss.

You can start by reducing your portion size by 1/3. An easy way to do this is to use a smaller plate, as this will make the portion appear bigger. It is also a good idea to introduce more fruit and vegetables into your diet to make it healthier and more balanced.

You might have heard, that these foods will cause issues with your ostomy, but as long as you consume them in moderation, this will rarely be an issue. If this is a major concern for you, try low fibre fruits and vegetables such as carrots and courgettes.

Sometimes it can be difficult to eat if you have to. If you need to gain weight and do not have much of an appetite, there is a few tricks you can use.

Try to eat at least something every 2 hours between meals. It does not have to be a large meal - a couple of biscuits, a yogurt or some crackers with cheese will do. If this is difficult for you, think of it as medicine - something you take to feel better, not necessarily to enjoy. In time your body will adapt, and your appetite will return.
Looking to add something new to your diet?

Having an ostomy should not keep you from trying new foods - or foods that you have enjoyed in the past. However, it is a good idea to be cautious until you know how your body (and your ostomy) will react.

Try following these ground rules to make the transition go without too many unpleasant situations:

• Write a list of 5 foods you would like to try in order of preference.
• Make sure you do not have anything planned the day after you try new foods.
• Start out with a little portion and see how you feel.
• Keep a diary of your ostomy output after trying new foods.
• If there are no issues, you can continue to enjoy the food without worrying.
• If you do experience issues, make sure you retry the food a couple of times before you decide to stay away from it completely.

Need inspiration? Make a plan!

Writing down a diet plan for the week can be helpful, when you are trying to keep a balanced diet - and it is great way to introduce new foods at a sensible pace. Download the free One Week Diet Plan.

Diet tips before surgery

Good nutrition is essential in order to have a speedy recovery. Therefore you should try to follow a healthy and balanced diet in the time leading up to your surgery. That means:

• Eat a variety of fruit and vegetables.
• Base meals in starchy carbohydrates like potatoes, bread and rice.
• Include dairy or dairy alternatives (e.g. soya drinks) in your diet.
• Get protein from fish, eggs, meat or beans and pulses.
• Choose unsaturated oils and spreads and eat in small amounts.
• Drink 6-8 glasses of fluid a day.
• Cut down on foods and drinks, that are high on fat, sugar or salt.

Right after your surgery the area around the ostomy may be a little swollen. This means that certain foods will have a harder time passing through - especially high fibre foods and nuts.

In the first days after surgery it is a good idea to adopt a ‘little and often’ approach to meals in order to avoid blockages, which can be painful and uncomfortable. Start of with ‘soft foods’ such as fortified soups, runny porridge, rice pudding, yogurts and smoothies.

Until the swelling and discomfort around the ostomy wears out, it is a good idea to stick to a ‘light diet’. This means you should stick to plenty of protein based foods, low fibre fruits and vegetables along with pasta (not wholegrain) and white bread.

When you feel that the outside peristomal area starts to heal and you feel less sore, it is a sign that the inside is also starting to heal. Around that time you can start introducing some of the foods that are part of a balanced diet.

You should, however, do this little by little in order to avoid complications. This is especially important when you introduce more stodgy food like high fibre vegetables and nuts. Remember to drink lots of fluid to help the food move along the gut.