Post-Surgery and Long-term Dietary Advice
This leaflet contains information about long-term dietary advice for those with a new ileostomy or colostomy. Please note the information in this booklet is not appropriate for those with jejunostomies and short bowel syndrome.
The information within this leaflet is a guide although it is important to remember that individuals may respond to foods differently.
For further information please liaise with your doctor, stoma nurse or dietitian.
Immediately after surgery
The bowel can take up to 12 months to adapt to its full absorption capacity .and tolerance after surgery.
The more bowel you have before your stoma, the more ‘space’ your bowel has available to do its job.
For the first 6-8 weeks after surgery, you will be asked to follow a low-fibre and low-irritant diet to help the bowel heal (see next pages).
It is important to eat well following surgery with a variety of foods, including sources of protein to help your body heal. If you are concerned about your diet or have noticed unintentional weight loss you can ask to be referred to a dietitian.
Eating tips
Digestion starts in the mouth where chewing and saliva breaks down food, which helps make it more easily digested and absorbed by your gut.
If we eat too quickly and do not chew our food well, the food requires more digestion lower in the gut. After surgery the bowel is shorter, leading to reduced digestion.
The following can help improve digestion and reduce loose stools, cramps, bloating and gas:
- Eat slowly and chew your food well
- Avoid talking with your mouth full
- Eat little and often (smaller meals with snacks in between meals)
- Try and relax during meal times.
Fibre
Fibre is a complex carbohydrate found in plant-based foods that cannot be easily digested. Too much fibre can increase the amount of time it takes for food to pass through your gut. This can lead to an increased and watery output from your stoma.
The following table gives examples of high fibre foods and suitable alternatives:
| High fibre foods (avoid) | Low fibre foods (recommended) |
| Wholemeal/seeded bread, rice, and pasta Potatoes with skin on | White bread, rice, and pasta Peeled potatoes |
| Wholegrain cereal (e.g., Weetabix, Shredders, Bran Flakes), porridge, muesli | Rice and corn-based cereal (e.g., Coco pops, Rice Krispies, Cornflakes) |
| Fruit with skin on, seeds, pith, and membrane e.g., berries, oranges, grapes, pineapple Under-ripe fruit e.g., green bananas/mango | Tinned, pureed, cooked fruit or fresh fruit without skin, pith, or seeds e.g., peeled apple, pear, peach, plums, melon, ripe bananas and mango |
| Raw vegetables e.g., lettuce, celery, peppers, tomatoes Vegetables with skin on and seeds Hard to digest vegetables e.g., sweetcorn, peas, mushrooms, spinach, kale, cabbage | Peeled and well-cooked vegetables without seeds e.g., onions, carrots, swede, butternut squash, broccoli, cauliflower, beetroot, parsnip, courgette, and aubergine. Cooked, de-skinned and non-seeded tomatoes e.g., sieved tinned tomatoes or passata |
| Pulses (e.g., lentils, kidney beans, chickpeas) | Cooked and pureed pulses |
| Dried fruit, nuts and seeds and any food containing these (e.g., cereal bars, crackers) | Smooth peanut butter in small amounts |
This table is not an exhaustive list, please ask your Dietitian if you have any queries.
Blockages
High fibre foods can also have increase the risk of causing a blockage, especially if eating in large quantities or not well-chewed.
Some common foods which can cause blockages include:
- Sweetcorn and peas
- Mushrooms
- Nuts, seeds and popcorn
- Orange and grapefruit pips
- Pineapple
- Raw or desiccated coconut
- Beans and lentils
- Celery and runner beans
- Thick broccoli or cauliflower stalks
Possible irritants
Shortly after surgery, you may experience an increase in stoma output when consuming the following irritants:
- Caffeine, switch to decaffeinated options when able.
- Alcohol, especially avoid binge-drinking.
- Fatty and greasy foods, including creamy sauces and high-fat meats (e.g., steak, bacon, sausages)
- Spicy foods, especially those containing chilli.
Long-term dietary advice
Following 6-8 weeks of stoma formation, it is important to reintroduce high fibre foods in small quantities, ensuring that they are well chewed.
In the long term, there are no specific foods that ileostomy or colostomy patients should avoid. However, as mentioned earlier, everyone is different and what works for one person might not for another.
Common issues and associated foods
Bloating and wind
- Foods such as beans, peas and lentils
- Brussel sprouts, cabbage and cauliflower
- Onions
- Spicy foods
- Rich, fatty foods
- Chewing gum
- Beer and fizzy drinks
Chewing well, and avoiding drinking and talking while you eat can help with these.
Loose stools
- Raw vegetables
- Nuts
- Onions
- Spicy foods
- Dried fruit
- Fruit juices
- Caffeinated drinks
Certain foods may help to thicken the stools, these include food containing gelatine such as jelly, marshmallows and jelly babies, over-ripe bananas, mash potato, and boiled white rice.
Unpleasant odour stoma output
- Asparagus and other green leafy vegetables
- Beans
- Cabbage, cauliflower and sprouts
- Eggs
- Fish
- Garlic
- Onions (especially raw)
- Spicy foods
- Cheese
Having plain yogurt or buttermilk may neutralise the unwanted odour.
Stoma output
Stoma output can change depending on your food and fluid intake. If your stoma output is over 1500ml daily (approximately 5-6 full stoma bags), you may have a high output stoma which could cause dehydration.
If your stoma output is high, you may be advised to restrict your intake of regular fluids by your doctor or dietitian. Regular fluids include water, juice, squash, tea, and coffee.
Sports drinks, such as Lucozade and Gatorade, are better choices as they don’t cause an increase in your stoma output. They also contain electrolytes, which are lost through your stoma.
To maximize fluid absorption, try to avoid drinking at mealtimes (leave a 20-minute gap) and sip rather than gulping fluids.
If this persists, please contact your stoma nurse, dietitian and medical team for further advice.
Contact Details
Nutrition and Dietetics
Address/based in the hospital: Agile Office, Queen Elizabeth hospital, Gateshead
Monday – Friday
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