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.
Table of Contents
Video
Ostomy Diet Tips: The First Six Weeks
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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.
Beverages
| Beverages to Include | Beverages to Avoid |
|---|---|
| When it comes to avoiding blockages, just about every beverage is “safe”. | 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. |
| A guide to keeping hydrated can be found HERE. | 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. |
Grains
| Grain Products to Include | Grain Products to Avoid |
|---|---|
| Bread, including pita bread, flatbread, and wraps | Any products that have whole grains, seeds, dried fruit, bran or added fiber. |
| Pasta, noodles, vermicelli, couscous | Brown and wild rice |
| White rice | |
| Cereal (not whole grain), including oatmeal. | |
| Cookies, oatmeal cookies | |
| Crackers |
Fruits and Vegetables
| Fruits and Vegetables to Include | Fruits and Vegetables to Avoid |
|---|---|
| Vegetable juice (like V8) are excellent. Carrot juice and tomato juice on their own are great too. | Asparagus, raw beans, raw carrots, broccoli, cabbage (incl. sauerkraut, tomatoes, celery, etc.) |
| Apple sauce, well-cooked apples (without the skin). | Corn and corn products. |
| Canned fruits and veg (I found canned peaches, canned carrots, canned green beans and canned beets worked really well). | Mushrooms (all types, even if they are canned) |
| Most smooth baby food (don’t laugh, this one can help a lot!). | Grapes, whole apple, pineapple, whole mango, etc. |
| Bananas, plantains. | Dried fruits. |
| Cooked veg are usually fine as long as they are soft (no skins, no seeds). | Fruit jam (with seeds). |
| Tomato sauce (without seeds). | Greens (spinach, lettuce, bok choy, kale). |
| Potatoes without the skin (mashed, boiled, microwaved, steamed, baked). | Skins of fruits and vegetables. |
| Sweet potatoes (without skin) and squash. | Seeds in fruits and vegetables. |
| Soups made from blended veg or broths. | Coconuts (even shredded). |
| Avocados. Great to add over potatoes or as a spread. | |
| Fruit jelly. |
Non-Dairy Products
Dairy alternatives:
- Non-dairy milk (soy, almond, hemp, coconut, rice, etc.).
- Non-dairy yogurt.
- Non-dairy cheese.
- Sorbet or non-dairy ice cream.
Avoid any of these products if they have fruit pieces in them (i.e. in yogurt).
Protein-Rich Foods
| Protein-Rich Foods to Include | Protein-Rich Foods to Avoid |
|---|---|
| Tofu. | Chunky nut/seed butter, whole nuts, and seeds. |
| Seitan (wheat gluten); ease into this one if you haven’t had it before. | Legumes including Adzuki beans, black beans, chickpeas (garbanzo beans), kidney beans, lentils, lima beans, mung beans, whole soybeans (including edamame). |
| Most mock meat products are safe, high in protein, fortified with vitamins and minerals and taste great. | Tempeh. |
| 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. |
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 Food and Supplements that may be Included | Other Food and Supplements to Avoid |
|---|---|
| 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. | Avoid condiments and garnishes with seeds or chunks (certain mustard, relish, olives, some salsa, etc.) |
| 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. | Popcorn and corn chips should be avoided. |
| Most condiments, like ketchup, vinegar or mustard are safe. | Artificial sweeteners may increase output, so keep an eye out when consuming “sugar-free” or “low-calorie” products. |
| 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. |
Pro Tips
- 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
- Chocolate
- 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)
Further Reading
- 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?
Very helpfull and thank you very much for the videos! Yes indeed, right after surgery the doctor said eat whatever you want…quite not. The thing is that for many people ileostomy comes after a cancer surgery which means extra difficulties when combined with chemotherapy. We have been strugglying with the output especially on the days of therapy. One question i got is how did you manage to mantain your weight( in muscle mass) whithin the first months of ileostomy? I really want to start taking meat a little bit out of the diet but i am scared of the blockage issues. Also if you have any book to recomend that would be great!
Hi Sebastain,
My weight following surgery increased, as did my health and overall fitness. But understand that when I went in to have my surgery, I was frail from being so sick, so healing happened rapidly.
This might differ for someone going through cancer treatments, but gentle exercise (if possible) and working on flexibility will be helpful in both the short and long term recovery. Generally speaking, don’t do too many strenuous activities in the first month or so, especially those where your abdominal muscles need to be strained. This could cause a hernia.
I don’t have any ostomy-specific books to recommend, but for diet books related to improving health, anything from Dr. Michael Greger, MD (of nutritionfacts.org) would be well worth the read!
Protein, while you don’t need to go crazy, is important after surgery. If you can get adequate calories through a variety of food, chances are you’ll be getting enough protein. But I used protein supplements following my surgery until I was able to eat enough quantity and variety to get enough through food alone.
Best of luck!