Patient education: Ileostomy diet (The Basics)

What is an ileostomy? — An ileostomy is an opening in the belly made by a doctor as a way for waste products from the intestines to leave the body (figure 1).

The hole in the skin is sometimes called a "stoma." This is the medical term for "opening." Waste products from the intestines come out through the stoma into a bag that is attached to the skin.

Why do I need an ileostomy diet? — If you have an ileostomy:

●Your body doesn't always absorb water, vitamins, and salts normally. Because of this, it's important to drink plenty of fluids to avoid getting dehydrated.

●You should avoid eating foods that could block your intestine or stoma.

●The foods you eat can affect the odor of your bowel movements, and how solid or loose they are.

●Certain foods can also make you have more gas.

What can I eat and drink on an ileostomy diet? — How your body tolerates foods depends on how much small intestine you have and how long it has been since your surgery. The food you eat and what you drink can affect your ostomy "output." (Output means the waste products from your intestines.)

●If your ostomy output is small, dry, and hard to pass (but there is not a blockage), check with your doctor or nurse. If you have had your stoma for at least 4 to 6 weeks, the doctor might want you to get more fiber. Foods with fiber include:

•Grains – Bran cereal, whole-wheat breads and pastas, whole grains, brown rice.

•Fruits – Fresh juice.

•Vegetables – Cooked vegetables.

•Meats, poultry, seafood, and other proteins – Dried or canned beans.

Ask your doctor or pharmacist if any of your medicines can cause hard stools. You should also drink extra water and other fluids like coffee, tea, or juice.

●If you have a lot of ostomy output or it is loose (watery), your doctor might suggest taking a fiber supplement or medicine to slow down food as it moves through your intestines. Some foods can help thicken your ostomy output. Examples include:

•Grains – White rice, oatmeal, tapioca, pretzels, saltine crackers, barley, white bread.

•Fruits – Applesauce, bananas.

•Vegetables – Potatoes without skin.

•Dairy products – Cheese, yogurt.

•Meats, poultry, seafood, and other proteins – Creamy nut butter.

•Other food – Marshmallows.

Ask your doctor or pharmacist if any of your medicines can cause loose stools (diarrhea). You should drink plenty of fluids because your body loses more fluid through your ileostomy.

●If you have a lot of gas or your ostomy output has a strong odor, it might be because of the foods you are eating. It usually takes 2 to 4 hours after you eat a food until you notice extra gas. Ask your doctor or pharmacist if any of your medicines could be causing the odor. These foods can help with gas or strong odors in your ostomy output:

•Fruits – Cranberry juice.

•Vegetables – Parsley.

•Dairy products– Buttermilk, yogurt with live active cultures, kefir.

What foods and drinks should I limit or avoid on an ileostomy diet? — If you have an ileostomy, you are more likely to have problems with food blockages. This is when the intestine or stoma gets blocked, so waste cannot get out.

You might need to limit or avoid certain foods if your ostomy output is very loose or watery. You can also limit or avoid foods that cause gas or odors.

●To lower your chance for a blockage, limit or avoid these foods:

•Grains to limit – Popcorn, whole grains.

•Fruits to limit – Apples and other fruits with skins, pineapple, coconut, grapes, dried fruit like raisins.

•Vegetables to limit – Salads, spinach, corn, celery, green peppers, peas, mushrooms, cabbage, bean sprouts, cucumbers, pickles, relishes, black olives, vegetables with skins.

•Meats, poultry, seafood, and other proteins to limit – Nuts, seeds, meats with a casing like sausage, meats that are tough or chewy like steak, dried meats like jerky.

●To help prevent loose, watery ostomy output, limit or avoid these foods:

•Grains to limit – Wheat, bran.

•Fruits to limit – Apricots, plums, peaches, prunes, other fresh fruits, prune juice and other fruit juices.

•Vegetables to limit – Broccoli, Brussels sprouts, cabbage, corn, peas, tomatoes, turnip greens, green leafy vegetables.

•Dairy products to limit – Milk or dairy products with lactose.

•Meats, poultry, seafood, and other proteins to limit – Baked beans, fried meats, fish, poultry, nuts, seeds.

•Other food or drinks to limit – Alcohol, caffeinated drinks, hot drinks, chocolate, licorice, sugar-free or artificial sweeteners, sugar-free gum and other sugar-free foods, foods that are high in fat or sugar, spicy foods.

●To decrease the amount of gas or odors, limit or avoid these foods:

•Fruits to limit – Grapes, prunes.

•Vegetables to limit – Cauliflower, broccoli, corn, asparagus, cabbage, Brussels sprouts, onions, garlic, leeks.

•Dairy to limit – Cheese.

•Meats, poultry, seafood, or other proteins to limit – Fish, peanuts, eggs, beans.

•Other food or drinks to limit – Fatty foods, alcohol, carbonated beverages.

What else should I know?

●Eat meals at regular times. You might want to eat 5 or 6 small meals a day instead of 3 larger meals. Don't skip meals.

●Have your larger meals in the middle of the day. Do not eat large amounts in the evening. This will help decrease ostomy output at night.

●Chew all of your food well. This will help prevent blockages.

●Try new foods 1 at a time. This will make it easier to know which foods cause you problems. If a new food gives you problems, avoid it for a few weeks and try it again later.

●Avoid drinking through straws, eating too fast, chewing gum, and smoking or chewing tobacco. These can cause gas.

●If your stomach is empty, eat solid foods before you drink liquids. This helps decrease gurgling sounds.

●Drink liquids 30 minutes after meals or snacks to avoid flushing foods through quickly.

●Dehydration (when the body loses too much water and salt) is a common problem for people with an ileostomy, especially during hot weather or when you are more active. Drink extra fluids like water, broth, or vegetable juice each day. You might also need an "oral rehydration solution" if you lose too much water and salt. Drink a pediatric electrolyte solution instead of a sports drink.

●If you do not feel well after drinking milk or eating dairy products, try lactose-free products.

●Tell your doctors and pharmacists about your ileostomy. Some medicines will move through your intestines too quickly and not work as they should.

More on this topic

Patient education: Living with an ileostomy (The Basics)
Patient education: How to care for an ostomy (The Basics)
Patient education: Colostomy or ileostomy surgery (The Basics)
Patient education: Colostomy or ileostomy reversal (The Basics)
Patient education: Gas and bloating (The Basics)

Patient education: Gas and bloating (Beyond the Basics)