Ostomy

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Diet

Patients who have had an ostomy may gradually resume eating a balanced diet, unless instructed otherwise by their physician. Foods and beverages that cause odor and gas and those that are hard to digest should be avoided. Examples of these include the following:

• Asparagus
• Beans
• Broccoli
• Cabbage
• Carbonated beverages
• Dairy products
  
  
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• Eggs
• Fish
• Onions
• Spices

Ostomy patients may experience constipation and diarrhea. Increasing fluid intake (i.e., 6 to 8 glasses a day) and adding fiber to the diet (e.g., fresh fruits, vegetables, whole grains) helps to alleviate constipation. To reduce diarrhea, limit the dietary intake of fiber and eat white rice, applesauce, bananas, peanut butter, and pasta. Abdominal cramping, prolonged diarrhea, nausea, and vomiting should be reported immediately to a physician.

A reduction in the absorption of fluids and electrolytes following an ostomy and prolonged diarrhea may lead to dehydration. Symptoms of dehydration include the following:

• Dark-colored urine
• Decreased urine output
• Dry mouth
• Muscle cramps
• Nausea and vomiting

Ileostomy patients must chew food thoroughly and avoid high fiber foods for 6 to 8 weeks. Foods that are high in fiber may cause blockages in the small intestine, especially after surgery, and should be added to the diet one at a time. High fiber foods include the following:

• Apple skins
• Celery
• Corn
• Dried fruit
• Nuts and seeds
• Popcorn
• Potato skins

Urostomy patients should drink plenty of water (64 ounces daily) to reduce the risk for urinary tract infections. Symptoms of infection include the following:

• Back pain
• Change in urine pH (i.e., from acidic to alkaline)
• Cloudy, strong-smelling urine
• Fever
• Loss of appetite
• Nausea and vomiting

Foods such as asparagus, fish, and spices increase urine odor, and cranberry juice, yogurt, and buttermilk decrease odor.

Various foods, beverages, and medications affect the color of stool and urine. Opaque pouches can be used, if this is a concern.

Medications Ostomy surgery affects the absorption of prescription and over-the-counter medications. A physician and a pharmacist should review all medications and adjust dosages and routes of administration, if necessary.

Activities Most ostomates are able to return to work and their other activities after recovery. The recovery period varies, and a physician should be consulted before activity is resumed. It may be helpful to return to work initially on a part-time basis. Ostomy patients may be more comfortable returning to work if relatively private restroom facilities are available and they are able to keep a change of clothes and spare pouches at work.

Sports and leisure activities can also be resumed, with a physician’s permission. Ostomates are not limited in their choices, but special protection for the stoma is necessary for heavy lifting and contact sports.

Patients who travel should keep the ostomy supplies in their hand luggage, store them in a cool location, and pack twice as many supplies as they anticipate needing. Seat belts should not be worn directly across the stoma.

Support

Because ostomy surgery affects many aspects of life, ostomates may have personal and social concerns. Patients are often unsure about informing casual friends, acquaintances, and co-workers about their surgery. Concerns about intimacy and sexual relationships are also common. Enterostomal therapists and ET nurses (specialize in care for ostomy patients) are valuable resources for all concerns following an ostomy. They can often recommend support groups for ostomates. The following organizations may also provide helpful information:

The United Ostomy Association (UAU) 36 Executive Park, Suite 120 Irvine, California 92714 Telephone: 1.800.826.0826

Wound Ostomy and Continence Nurses Society (WOCN) 1550 South Coast Highway, Suite 201 Laguna Beach, California 92651 Telephone: 1.714.497.9007 Toll-free: 1.888.224.9626

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