Ileostomy: Nutritional Management

Preventing digestive problems

You don’t have to eat a special diet just because you’ve had an ileostomy. Most foods, chewed well and eaten slowly, won’t give you problems—unless they did before. But you may need to be more aware of foods that make your stool more watery than normal and foods that cause gas or odor. You also need plenty of fluids and vitamins.

Choosing foods

Learning which foods cause gas or odor or make your stool too watery takes a little time. You may want to add foods back to your diet one at a time:

• Eat only small amounts at first to see how your body reacts.

• If a food causes a problem, wait and try it again in a few weeks. Once your system adjusts, you may find the food doesn’t give you trouble anymore.

Preventing fluid loss

When part of the intestine is removed, your body loses fluids and can become dehydrated more quickly. To prevent this, drink at least 8 to 12 cups (2 to 3 quarts) of fluids, such as water or juice, each day.

Taking supplements and medicines

Depending on how much small intestine is left when you have an ileostomy, some vitamins and medicines can't be absorbed:

• Your healthcare provider may prescribe vitamin supplements or have you eat more of some foods, like bananas.

• Time-release capsules and coated pills may not be absorbed in your remaining small intestine. Be sure all your healthcare providers know you have an ileostomy before they prescribe any medicines.

Causes of diarrhea

Stool that’s more watery than normal (diarrhea) can be a sign of an illness, such as the flu. Some foods and medicines can also cause more watery stool:

• After an ileostomy, your stool will be more watery than it was before, so drink plenty of fluids. This helps replace lost fluids and prevent dehydration.

• Limit foods that can make the stool loose, such as raw fruits and vegetables, garlic, onions, milk, beer, and iced drinks.

• Lactose intolerance can add to diarrhea. If you are lactose intolerant, choose dairy products that are lactose-free. 

• Check with your healthcare provider before you take any medicines for diarrhea.

Causes of gas and odor

Some gas is normal. But constant gas is not. Neither is constant odor from stool. What causes gas or odor can differ from person to person:

• Gas is often caused by swallowing air. To prevent this, eat slowly. Chew each bite well. Eating smaller amounts of food more often may help. Sip fluids, and don’t use a straw.

• If you have excess gas, you may want to go easy on beer, broccoli, Brussels sprouts, cabbage, cauliflower, corn, cucumbers, dried beans, milk, mushrooms, nuts, onions, peas, sodas, and spicy foods.

• If odor is a problem, you may want to eat less asparagus, broccoli, Brussels sprouts, cabbage, cheese, eggs, fish, garlic, horseradish, and spices, such as coriander, cumin, dill, and fennel.

Call your ostomy nurse or healthcare provider

Call your ostomy nurse or healthcare provider right away if:

• You have nausea, vomiting, pain, cramping, or bloating.

• You have a change in your normal bowel habits, such as little or no stool.

• Your stool is more watery than normal for more than 5 to 6 hours.

• Your stoma changes size, or the stool is black or bloody

• There is bleeding around your stoma.

• Your stoma appliance is not fitting well anymore, or there is leakage of stool.