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?
Yikes. While it is true that colostomates might have an easier time with food (because the stoma opening is larger), it’s still not an open season without starting slowly and making sure that some foods aren’t going to be problematic.
I’m glad you had enough sense to be cautious about it!
Hi Ashley, After my colostomy in 2018 the doctor told me, cheerfully, “no restrictions” in my diet. Well .. I was very cautious about that and took things slowly, eating soft food at first and then adding new foods a little at a time. Glad I did that; there are some foods that really don’t work well at all and that was the way to find out. Everybody is different – I stay away from stringy things and most raw vegetables unless I cut them very small and chew them very well. Best of luck to you and your husband. LL
Thank you! My husband just went through surgery at Mass General Hospital (and they LOVE to claim they are a the best) and they said NOTHING about food. It’s shameful.
You’re welcome, Ashley. Your experience is more common than you’d think. I wish you and your husband all the best :)
Thanks for such a clear and helpful video and general info. It is really great to have a balanced approach to all the issues.
Keep up the excellent work!
With best wishes, Bob Harrop
Questions:
I enjoy miso soup and am not clear on where soya beans fit into the fibre spectrum. I assume because it has been fermented over a long period, it should have less insoluble fibre. But still, maybe best to have instant versions which are more liquid. Do you think that this will also help with balancing electrolytes?
I do like porridge, from fine cut oatmeal. As oats are also soluble fibres,I trust that a small bowl per day with added smooth nut butter and coconut oil, is a good part of the daily diet.
In the first video on this page, Eric is saying he was shocked that people were sent home after surgery, with no instructions as to what should they eat, or what to avoid for the first six weeks.
It was no shock to me to read it here, as I was one who got no instruction regarding what to eat, what not to eat, how to change my wafer and pouch, when to change them, how to release gas from the two piece unit I had on, and basically I went home with no idea about what should I do !!!
Before leaving the hospital, while waiting for my son to pick me up, I went to the nurse, and showed her the bag that was just about ready to explode from gas, and asked how do I take care of this bomb which is just about to explode, her answer was “a visiting nurse will see you tomorrow, and tell you all about it", and with that turned around and walked away.
Doctors and nurses in hospitals want nothing to do with Ostomy, and apparently know nothing about it, yes the Sergent knows how to put the bag on after surgery, wash his hands, and with that he did his job.
To make things worse, the Stoma nurse (the only one in this county) was on vacation, with no one to take her place.
If it was not for the home care nurse, who came the next morning, and showed me the basics, and answered my questions (about 100 of them) I would have been in deep poo.
For my parastomal hernia surgery 5 months after the original surgery, no one bothered letting me know they put on me a different size bag & wafer (2-3/4 instead of 2-1/4) due to the swelling of the Stoma after the surgery. I got home, had a leak over night, and had to plug it up any which way I could, till I went back next morning to the ER, and got a few pieces to hold me till my order came in.
If you are new to all this, and going to have an Ostomy, ask about a Stoma nurse, and get in touch with her before hand, maybe arrange for her to visit you in the hospital. Or ask here, and would all try and give you the best ideas from our experience.