Living with an ostomy

Special diet considerations for:

Generally within 4-8 weeks after surgery patients can begin to eat a normal diet. Immediately after surgery their doctor may give them dietary guidelines to follow while their bowel is healing.

 

Colostomy patients can eat a normal diet by 4 weeks unless instructed otherwise. This group of patients can become constipated.. so teach them which foods can help alleviate this (these would include fluids, fruits and vegetables). Ileostomy patients may need to be careful of foods like nuts, seeds, popcorn, coconut, celery, cabbage, raw veggies, fruits  and some seafood (like lobster and shrimp) which may make them more prone to blockages.

Ileostomy patients need to drink 8-10 glasses of fluids/day to prevent dehydration.

 

There are foods which are effective for thickening ileostomy stools. These include rice, bananas, peanut butter, applesauce, tapioca and breads.

Whatever foods an ileostomy patient eats will be reflected in the color of their stool (tomato sauce will make it red, spinach will make it green, etc.)

 

Urostomy patients can eat a normal diet but should be reminded to drink 8 glasses of fluids/day. Also, they should be instructed regarding which foods may give an odor to their urine such as fish, eggs, asparagus and some vitamins.

Medications Bathing Managing Gas And Odor Traveling

Both colostomy and urostomy patients can take their medications as usual. For ileostomy patients some drugs will not be absorbed. They need to remind their doctor and pharmacist that they have an ileostomy. If they see their meds coming out whole in their bags, they need to inform their doctor so the med can be given in another form.

 

Patients with ostomies can shower either with their entire appliance on or off.  They should not remove the bag from the flange and shower with just the flange on, as water will get under the flange and allow for leaking. When they come out of the shower they should dry the bag off with a towel or a blow dryer on a cool setting. Patients may also take a bath with their bags on.

 

Managing gas and odor. Patients need to be instructed about foods that will cause gas and odor in their bags. These include beans, cabbage, turnips, onions, kale, garlic, cucumbers,  carbonate beverages, chewing gum, and alcohol.  

For colosotmy and ileostomy patients, yogurt may reduce gas in some instances.

For Urostomates, cranberry juice is good for odor control.

 

Of course, as we said earlier, there are odor eliminators for colostomy and ileostomy bags. There are bags with gas vents to help remove the gas without causing odor. For patients using a 2-piece appliance they can also vent the gas by pulling the tab at the top of the flange to open the bag and release the gas. Patients can also talk to their doctors about using products like Gas X and Beano to help with gas.

 

Traveling with an ostomy: When a patient wants to travel, make sure they take more supplies than they would usually use. They should be cautioned that they should never keep the supplies in a hot car or room. And they should be careful about diet and fluids if in a foreign country. Patients can get a form from the UOAA which identifies their need for an ostomy. And extremely important, make sure they take supplies with them on the plane.

 

 Activity and Intimacy

Generally speaking, a person with an ostomy is not limited from participating in any activities. For some activities they may want to wear a support belt (and there are specialized swimming belts, too). These are generally not covered by the patient’s insurance, but they are easy to find online.

 

Intimacy can be challenging for some patients. As a clinician, you need to be the one to bring it up with your patients. Generally after they have healed (6 weeks) they can return to intimacy. They might want to stay away from gas producing foods, empty their bags before they start and/or use abdominal binders. There are companies that make fancy intimacy underwear and belts to cover and support the bag (Ostomy Secrets). For colostomy patients whose stoma works on a somewhat regular schedule they could use a flange cap which is a small cap that fits on their barrier/flange. It’s important to note that the stoma cap may NOT be used for intercourse.