I was fortunate to have received quite a bit of information about what foods to eat (and avoid) following my ileostomy surgery. The information was quite important because it was aimed to not only prevent dehydration but also to avoid potential blockages.
Because our stoma swells up after surgery, we can’t eat meals that would be hard to pass through that swollen stoma.
Knowing how to reduce the risk of blockages is important (saving you a trip from the ER!).
Disclaimer: Your doctor or stoma nurse should be able to provide recommendations during this initial healing period. The usual time on this post-op diet is 6 weeks, but your surgeon may require you to be on it longer (or shorter) depending on your progress. This post focuses on ileostomy post-operative care based on my own experience. Many of the foods and suggestions that are given would apply to colostomies too.
Dietary Goals for the First 6 Weeks
- Maintain adequate hydration and electrolyte balance.
- Avoid foods that are likely to cause blockages. These are often high-fiber or high-residue foods.
- Avoid food/beverages that increase output too much.
- Learn to chew! Practice mindful eating.
- Eat smaller meals throughout the day.
- Keep nutrition high. Vitamins, minerals, and protein will help you heal.
- Eat enough to maintain a healthy weight (or to increase it if you’re underweight).
Food to Eat and Avoid
Here’s a list of common foods that are deemed “safe” to eat following surgery, as well as common foods that should be avoided during the healing phase. I’ve compiled this list from various sources, but I’ve tailored it in a way that substitutes animal products; this means that anyone will be able to make use if this list.
- When it comes to avoiding blockages, just about every beverage is “safe”.
- A guide to keeping hydrated can be found HERE.
Beverages to AVOID:
- Some drinks may increase output (alcohol, certain fruit juices, coffee, cola, etc.) or produce more gas (carbonated drinks). Keep track of the ones that do, and avoid them.
- Alcohol should be avoided during this period, not only to help avoid dehydration but also because you may be taking pain meds which may interact negatively with alcoholic beverages.
Grain products to INCLUDE:
- Bread, including pita bread, flatbread, and wraps
- Pasta, noodles, vermicelli, couscous
- White rice
- Cereal (not whole grain), including oatmeal.
- Cookies, oatmeal cookies
Grain products to AVOID:
- Any products that have whole grains, seeds, dried fruit, bran or added fiber.
- Brown and wild rice
Fruits and Vegetables
Fruits and vegetables to INCLUDE:
- Vegetable juice (like V8) are excellent. Carrot juice and tomato juice on their own are great too.
- Apple sauce, well-cooked apples (without the skin).
- Canned fruits and veg (I found canned peaches, canned carrots, canned green beans and canned beets worked really well).
- Most smooth baby food (don’t laugh, this one can help a lot!).
- Bananas, plantains.
- Cooked veg are usually fine as long as they are soft (no skins, no seeds).
- Tomato sauce (without seeds).
- Potatoes without the skin (mashed, boiled, microwaved, steamed, baked).
- Sweet potatoes (without skin) and squash.
- Soups made from blended veg or broths.
- Avocados. Great to add over potatoes or as a spread.
- Fruit jelly.
Fruits and vegetables to AVOID:
Generally speaking, harder to digest fruits and veg are to be avoided during this stage:
- Asparagus, raw beans, raw carrots, broccoli, cabbage (incl. sauerkraut, tomatoes, celery, etc.)
- Corn and corn products.
- Mushrooms (all types, even if they are canned)
- Grapes, whole apple, pineapple, whole mango, etc.
- Dried fruits.
- Fruit jam (with seeds).
- Greens (spinach, lettuce, bok choy, kale).
- Skins of fruits and vegetables.
- Seeds in fruits and vegetables.
- Coconuts (even shredded).
- Non-dairy milk (soy, almond, hemp, coconut, rice, etc.).
- Non-dairy yogurt.
- Non-dairy cheese.
- Sorbet or non-dairy ice cream.
Protein-rich foods to INCLUDE:
- Seitan (wheat gluten); ease into this one if you haven’t had it before.
- Most mock meat products are safe, high in protein, fortified with vitamins and minerals and taste great.
- Smooth nut and seed butter (almond, peanut, sunflower seed, cashew, etc.).
- Hummus (avoid whole chickpeas).
- Many of the non-dairy products are high in protein.
Protein-rich foods to AVOID:
- Chunky nut/seed butter, whole nuts, and seeds.
- Legumes including Adzuki beans, black beans, chickpeas (garbanzo beans), kidney beans, lentils, lima beans, mung beans, whole soybeans (including edamame).
Fats and Oils
While these are usually foods to avoid for optimal health, they can be a source of much-needed calories during recovery and can help make bland foods more palatable.
- Vegan margarine.
- Vegan mayo.
- Oils are considered “safe” for new ileostomates, but olive and flax oil are the healthiest of the bunch.
- Coconut oil can be used to cook with, or as a spread on bread.
Other Foods and Supplements
Other foods and supplements that may be INCLUDED:
- Protein powder may offer some benefits if you aren’t able to eat enough during the day. For my recovery, I went with THIS product.
- Your doctor may recommend a multivitamin during the recovery phase; when choosing one, be sure that it’s not a slow-release version, or it may pass through your system without being fully absorbed. More info HERE.
- Most condiments, like ketchup, vinegar or mustard are safe.
- While candies are generally safe, they are empty calories.
- Potato chips are usually well tolerated and can provide both sodium and calories, but will also help slow down your output.
Other foods and supplements to AVOID:
- Avoid condiments and garnishes with seeds or chunks (certain mustard, relish, olives, some salsa, etc.)
- Popcorn and corn chips should be avoided.
- Artificial sweeteners may increase output, so keep an eye out when consuming “sugar-free” or “low-calorie” products.
- If you have access to a Registered Dietitian that understands the challenges of having an ostomy (or IBD), you’ll be able to get a personalized meal plan through them. Here is an article I wrote about how to find a dietitian HERE.
- Try to have a variety of foods to make sure that you’re balancing nutrients.
- Keep a food diary to monitor effects of certain food or drink, then adjust your diet accordingly.
- Keep snack foods close by if you aren’t feeling well enough to cook or you don’t have any help following surgery.
- Log your food intake so you can track calories and nutrients. I’ve used and still recommend CRON-o-meter.
- If pouch odor is a concern for you, I’ve put together a handy guide on controlling it HERE.
- When you’ve received the OK to start a normal diet, try new foods slowly so you can test to make sure they are passing through your stoma without trouble. Most people will be able to continue eating healthfully with only a few (if any) limitations.
- The following foods and beverages can cause a dramatic change in your output’s consistency. You’ll likely be able to catch the culprit within hours of consuming them:
- Coffee or tea
- Sport drinks
- Soda/Pop/Soft drinks (both diet and regular )
- Fruit juices
- Certain fruits (for me it’s cherries)
- Artificial sweeteners
- Alcoholic beverages (especially wine)
- Fried foods
- Hot/spicy foods
- Non-vegan foods like dairy (or other lactose-containing food, if lactose intolerant)
- Done your recovery? See what’s on the menu past your initial six weeks HERE.
- To see what I was eating shortly after my surgery (along with nutritional profiles of those meals), please refer to THIS from approx. 2 weeks post-op, and THIS post from approx. 3.5 weeks post-op.
- For more ideas on what foods to eat when eating is difficult, check out THIS article.
- For ways to enhance nutrient absorption, consider reading THIS article.
QUESTION: Do you have any tips to share?