Ostomy Nutrition Guide

After your ostomy, you can return to your normal diet as soon as you are able to tolerate food.
Here are some general tips to help manage your ostomy:

● Slowly introduce new foods ​after your surgery. If a food seems to give you side effects
such as constipation, gas, loose stool, or odor, write down the food and symptoms you
experienced. Try eliminating the food for a few days and see if your symptoms improve.
Then try the food again at a later time to confirm you correctly identified the food
causing the symptoms. Be willing to experiment to find which foods are causing issues
before cutting them out completely!
● Thoroughly chew all of your foods​. This will help prevent any blockages from forming
● Eat regular meals. ​You should eat at least three times a day to help your ostomy work
best and produce less gas
● Drinks lots of fluids.​ You may lose more fluids than normal through your stoma,
especially if a lot of your large intestine was removed. This is because your large
intestine is responsible for reabsorbing a lot of your body’s fluid
● Maintain a healthy weight.​ Excess weight gain can cause further health problems.

Common Problems:

Blockages
Some patients, especially those with ileostomies, may experience blockages. The following
foods are more likely to cause blockages, so be sure to chew them well and eat them in smaller
amounts
● Nuts & seeds ● Coconut ● Salad greens
● Popcorn ● Apples with peels ● Coleslaw
● Dried fruits ● Grapes & raisins ● Raw pineapple
● Raw cabbage ● Peas ● Mushrooms
● Corn ● Chinese vegetables ● Relishes
● Celery ● Vegetable skins

Odor
Some foods are more likely to produce an odor. If you notice an odor after eating one of these
foods, try eliminating it and then trying a small amount again a few weeks later. You can also try
including yogurt, kefir, buttermilk, or parsley in your diet each day to help reduce any odors. If
you are still struggling with odors, talk to your doctor to see if any medications or vitamins you
are on may be the cause. Odor produce foods include:
 ● Asparagus ● Cauliflower ● Onion
● Broccoli ● Eggs ● Alcohol
● Brussel sprouts ● Fish ● Baked beans
● Cabbage ● Garlic ● Cheese

Gas

It is important to remember that some gas is normal. If excessive gas becomes a problem for you,
avoid activities that cause you to increase the amount of swallowed air such as smoking, chewing
gum, drinking through a straw, and consuming carbonated beverages such as soda, sparkling
water, or energy drinks. Be sure to take your time while eating and avoid talking with your
mouth full. Eating regularly also helps reduce gas.

Food associated with gas production include:

● Legumes (dried ● Garlic ● Nuts

peas & beans) ● Eggs ● Melons
● Broccoli ● Fish ● Cucumber
● Brussel sprouts ● Milk ● Cauliflower
● Cabbage ● Sweets ● Asparagus
● Onion ● Radishes ● Beer

Again, you can try experimenting with eliminating foods to which ones are causing you
problems. Sometimes just limiting yourself to only one of these foods during a meal may be
enough to avoid excess gas.

Constipation
While a blockage is undigested food blocking the stoma, constipation is having stools that are
small, dry, and/or hard to pass. Fiber is needed in your diet to add bulk to your stools and avoid
constipation. Mild constipation can be treated by:

● Drinking more liquids - water, coffee, tea, or juice

● Eat high fiber foods such as bran cereals, fruit, vegetables, whole wheat bread, and whole
grains
● Some people have found prune juice, lemon juice, licorice, or chocolate to help
● Exercise, such as walking

Food that have been reported to thicken stool include:

● Cheese
 ● White bread and ● Pasta ● Creamy peanut
rice ● Pretzels butter
● Marshmallows

If you continue to have problems with constipation, talk to your doctor to learn about options for
medications

Diarrhea

If your stoma is located higher in the GI tract, your stools will be naturally looser. If a food gave
you loose stools before your stoma, it will likely continue to do so. Loose stools can also be
caused by illnesses such as the flu, impure water, emotional distress, or traveling. Some foods
associated with loose stools include:
● Baked or dried ● Chocolate ● Hot beverages
beans ● Licorice ● Very large meals
● Beer or red wine ● Prune juice ● Heavily spiced
● Broccoli ● Soup foods

If you are experiencing loose stools, these foods may help:

● Applesauce ● Cream of rice ● Tapioca
● Bananas ● Peanut butter ● Weak tea
● Boiled milk ● Rice

If you are losing a lot of fluid through your ostomy, be sure to drink lots of fluids such as tea,
ginger ale, or bouillon broth to help replenish what is lost. Call your doctor if your diarrhea
persists for more than 24 hours.

Other Considerations
● You may need to follow a special diet to manage other health conditions, such as
diabetes, high blood pressure, or heart disease. Ask your dietitian about how to follow
these diets while managing your ostomy
● If you see red spots in your ostomy bag, it may be caused by certain foods such as red
peppers, beets, and pimientos. If you are unsure whether these spots are caused by food
or blood, call your doctor
● Before traveling abroad, talk to your doctor, dietitian, or enterostomal therapist for
special advice in case you encounter impure food or water
● Be sure to drink extra fluids when the weather is hot and during exercise to replace lost
fluids
Hydration for Ilestomy Patients
When you have diarrhea, you can quickly lose lots of water, vitamins, and minerals which can
lead to dehydration. When you are losing lots of fluids, drink beverages with electrolytes such as
Gatorade, Pedialyte, coconut water, V8, or other vegetables juices.

You can also use the following homemade solution:

● 1tsp salt
● 4tsp corn syrup
● 1tsp baking soda
● 1 6ox can of frozen orange juice
Mix ingredients together and add enough water to make 1 quart.

Eating foods with a high water content can help, such as smoothies, yogurt, pudding, Jell-O,
cucumbers, apples, and tomatoes.

Additionally, eating foods high in sodium and potassium will help replenish your electrolytes.

Food high in potassium include many fruits and vegetables, milk, poultry, fish, and meat. For
additional lists of foods high in potassium:
https://health.gov/dietaryguidelines/dga2005/document/pdf/Appendix_B.pdf
https://www.uofmhealth.org/health-library/abo9047

Foods high in sodium include processed meats (bacon, hot dogs, sausage, ham, cold cuts),
pickles, olives, relish, crackers, pretzels, salted popcorn, cheese, gravy, salad dressings, pickled
foods, soups, ketchup, and soy sauce.

Created by Rebecca Heming and Monica Hershey, RD

University of Virginia Health System October 2018