Remember that the stoma is smaller in diameter than is the colon. For ileostomies, this is not usually a problem, since the main content is liquid. However, blockage by large pieces of food can occur when food has been insufficiently chewed. Therefore, that old rule about chewing your food thoroughly really becomes important. In addition, since some very high fiber foods and meats with lots of connective tissue can pass through the intestine relatively unchanged, they may need to be eaten sparingly or not at all. Very high fiber foods are: corn on the cob, coleslaw, tough meats, pea pods, bean sprouts, bamboo shoots, orange pulp, coconut, raw pineapple, and other raw fruits, popcorn, raw celery, carrots and radishes, skins and seeds of fruits and vegetables.
Even if fluid and mineral balance is maintained, a large volume of effluent can be a real inconvenience. Some foods cause an increase in fluids, while others cause a decrease. Foods that tend to increase output are beans, broccoli, spinach, prune juice, raw fruits, juice, licorice, red wine, beef and highly spiced foods. Foods that tend to decrease volume are applesauce, bananas, boiled milk, rice and peanut butter.
Remember that effluent volume will not decrease by limiting fluid intake - you'll just get dehydrated. Keeping a diary of food intake and any accompanying problems is helpful, especially in the early stages.
Managing a colostomy: For persons with colostomies in the first section, or ascending colon, guidelines for eating and drinking are very similar to those for ileostomies. The closer the colostomy site is to the rectum, the fewer complications there are likely to be. Colostomies in the mid-range (in the transverse or upper portion of the descending colon) will require some individual experimentation with diet, but the stools should be soft and formed. There is less tendency to obstruct in colostomies, although a high fiber diet may increase fecal volume.
Constipation is the decreased ability to have comfortable elimination. Persons with colostomies need to ensure that they ingest adequate fluids and foods that provide a moderate amount of fiber. These include whole grain breads and cereal and soft fruits and vegetables.
Managing a urostomy: In most cases, people with urostomies enjoy a completely normal diet. Cranberry juice, yogurt or buttermilk will help combat urinary odours. Asparagus produces a strong odour in urine.
Odour and gas concerns: One of the biggest fears for persons with ostomies is that unpleasant odours will be noticeable. If odour is a problem, it may be helpful to limit foods that form gas or particularly strong odours. Foods that sometimes are found to be troublesome are cabbage, cabbage family vegetables, broccoli, onions, corn, carbonated beverages, whips and meringues. Certain habits such as chewing gum and sucking a straw result in the swallowing of air, which increases gas. On the other hand, some people find that yogurt and cranberry juice help to reduce odour. There are also tablets (available at a pharmacy or ostomy supply stores) that can be taken to reduce gas and odour.
Relax and enjoy: But not too much. After making the above adjustments, most people with ostomies learn that they can enjoy eating without too many problems. However, care should be taken not to gain too much weight, because obesity can sometimes create problems with a secure fit of the ostomy pouch. If youre having problems with weight gain, consider asking your physician to refer you to a registered dietician (R.D.) for nutrition counseling.
Besides being essential to life and health, food provides many pleasurable emotional and social experiences. By following the above guidelines, the person with an ostomy can continue to enjoy these experiences.
