In this article you will find the following:

• What You Need To Know About Colostomy Diet After Surgery
• Introduction to the Four Types of Colostomy
  • What is Ascending colostomy? 
  • What is Transverse colostomy?
  • What is Descending colostomy?
  • What is Sigmoid colostomy?
• Guidelines for healthy nutrition for patients with ascending and transverse colostomy
  • Low-fiber diet
  • Foods low in fat and cholesterol
  • Drinks rich in vitamins and minerals
  • Diet low in uric acid and oxalates
• Guidelines for healthy nutrition for patients with descending and sigmoid colostomy
• Low-fiber foods
  • Low-fat animal proteins
  • Foods to avoid for colon health
  • Hydration is the essence of well-being
• General rules of healthy eating for colostomy
• Colostomy diet: summary table of recommended and not recommended foods
• Colostomy: common problems and how to manage them
  • Constipation
  • Gas and bad smell
  • Dehydration
  • Diarrhea
• Final Thoughts: Foods to Avoid for Proper Colostomy Management

Introduction to the Four Types of Colostomy

Over time, you have also to learn how  to monitor your stool consistency, so you will know what fluids or foods will be beneficial or not for you.

However, the thickness of your stools doesn’t only depend on the food and beverage intake.

It can also be dependent on the placement of your stoma in your large intestine. When the stoma is higher up in the GI tract, the stools tend to be looser. If most of the colon is intact, you might have more formed outputs.

Below are the four types of colostomy to be aware of what to expect in your outputs:

What is Ascending colostomy?

Most of the ascending part of the colon which is located in the low to middle right side of the abdomen is removed or bypassed during the surgery.

You’ll have watery feces and gas is common. There’s decreased ability to absorb fluid and electrolytes and dehydration can occur with excessive sweating, diarrhea, and/or vomiting.

The thicker the output, you’ll know that you’re absorbing more nutrients and fluids.

What is Transverse colostomy?

The procedure is done in the transverse part of the colon or a large part of the large intestine usually located at the center of the abdomen above the navel. Your output is fluid to pasty or semi-formed feces and gas is common. You’ll experience decreased ability to absorb fluid and electrolytes as well.

What is Descending colostomy?

A portion of the large intestine which is located at the middle left-hand side of the abdomen is removed or bypassed leaving the GI tract intact. This helps your feces to be usually semi-formed to solid and for most, nutrients from food and beverages are well-absorbed.

What is Sigmoid colostomy?

The procedure is done in the sigmoid colon located at the lower left-hand side of the abdomen. Your outputs are semi-formed to solid and there’s a higher expectation that nutrients are absorbed well.

Helpful Diet for Colostomy Patients: Ascending and Transverse Colostomy

For ascending and transverse colostomy, a residue-free regimen is recommended, which includes preparations that do not stimulate intestinal transit or cause abdominal distension.

Low Fiber diet

Limit fiber for 2 weeks after your surgery to avoid any allergy reaction or triggers to other health conditions you may have. Don’t worry because you will be able to go back to your usual diet after 6 weeks or so with the advice of your physician. This depends on his overall assessment during your follow-up appointments based on your health conditions, stoma healing, etc. 

You’ll also find that this recommendation is highly beneficial in the long run as you’ll have lesser issues with your outputs.

Diet with Low-level Animal Fats and Cholesterol

Some dairy products and fats may cause loose stools, gas, or odor. Below are some examples of food to avoid or eat in moderation but keep in mind that every person is unique.

Along your journey, you’ll learn which foods cause problems repeatedly and you must totally avoid these.

Beverages Rich in Vitamins and Minerals

Daily fluid intake is very important so aim for 8-10 glasses each day. 

Some beverages may help to avoid constipation and some could cause diarrhoea. However, also consider that stress or medications may be causing your loose or watery output.

Lower Uric Acid and Less Oxalates Diet

To prevent any more bowel problems, it is recommended that you maintain a low uric acid level in your urine. 

Foods to avoid: 

• Cured meat
• Other processed meats (especially pork)
• Red meat
• Poultry
• Fish
• Alcohol 
• Sodas

Also, some are sensitive to oxalic acid derived from some food so talk to your physician to know if you are one of them.

Foods to avoid or limit:

• Spinach
• Cabbage
• Swiss chard
• Green tomatoes
• Rhubarb
• Legumes and beans
• Beets
• Pumpkin
• Cocoa & chocolate
• Parsley
• Chives
• Celery
• Dried fruit and Nuts
• Soy drinks

Nutrition Guidelines for Descending and Sigmoid Colostomy

For descending and sigmoid colostomy, a bland regimen should be followed, which includes easily digestible preparations and avoids foods that cause abdominal distention or irritation of the stoma.

Low-fiber foods

White bread, white pasta, and white rice could be added to your diet, just avoid whole grains, fresh and dried legumes such as broad beans, lentils, and chickpeas as these are high in fiber and may cause discomfort such as bloating.

Also avoid all kinds of nuts and vegetables that could cause you excessive flatulence. Below you will find a summary table of foods recommended and not recommended for a low-fiber diet: 

Make sure they are well cooked.

Low-Fat Animal Proteins

If you have descending or sigmoid colostomy, you may still be allowed to take in dairy products and derivatives with skim or low-fat milk including lactose free cheese and yogurt.

Below are some low-fat animal proteins to add to your diet :

• Lean meats (turkey, chicken and rabbit)
• White fish (cod, sole, hake, sea bass and octopus)
• Egg whites

Colon-friendly Diet

Avoid the following foods to keep your colon healthy:

• Raw vegetables
• Dried fruit
• Beer and other alcoholic beverages
• Cereals
  

Hydration is the Essence of Well-being

You will most likely lose a large amount of fluid through your stoma. For this reason, you will need to drink a lot and try to maintain proper hydration.

Water is always the best source of fluids for the body. Nevertheless, consider using oral rehydration solutions if needed.

Ultimate Rules for a Healthy Colostomy Diet

As an ostomate, what you really need to focus on is healing. Nutrition is one very important aspect in your journey.

Follow these general rules to achieve and maintain good health: 

1. Follow regular meal times

Eat small and frequent meals to facilitate digestion and avoid the formation of gas in the empty intestine.

You may divide your food into six meal times:

• Breakfast
• Morning snack
• Lunch
• Afternoon snack
• Dinner  
• After dinner snack

Doing this will also ensure that you get all the nutrients you need each day. To begin, start with a low volume of food and gradually increase the amount according to your tolerance.

Be aware that you might not feel full after eating smaller portions, however it will certainly help your digestion.

2. Chew well and eat slowly

Another way to prevent gas is chewing your food well and avoiding swallowing air. Chewing gum is also not recommended as it produces gases and some have a laxative effect.

3. Avoid previously not tolerated food

The introduction of new foods or textures, as well as the amount of food consumed, must be gradual and tailored to your unique needs.

It’s best to try new food at home, not in restaurants and public places since you still don’t know how your intestine will react. This will help you to avoid unpleasant situations.

4. Use healthy cooking or preparation techniques

• At the beginning of your healing process, boiled foods are preferred. You may gradually introduce other types of cooking such as grilling, steaming, baking and low-fat soups later on.
• Foods that are very hot or cold should be avoided. They could give you a feeling of fullness that will last very shortly.
• It is not recommended to use spices at first so consider using only salt.
• Use vegetable and raw fats like olive oil, when you are ready to introduce low-fat foods.

5. Limit the intake of sugar and sugary foods

Sugar can cause dumping syndrome – a condition that happens when fat or sugar is consumed suddenly and passes from the stomach to the intestine unexpectedly, resulting in hot flashes, nausea, stomach pain and diarrhea.

6. Rest for 15-30 minutes after main meals

Rest in a sitting position instead of lying down after eating. Proper posture helps you in the digestion process and prevents bloating, gas, and other discomfort.

7. Drink plenty of non-carbonated, non-frozen drinks after or before meals

Drink plenty of water 30 – 60 minutes before and after each meal – NOT during meals – so that your body absorbs nutrients from food properly.

Doing this will also aid in proper digestion because drinking too soon could dilute the digestive juices.

Common Colostomy Problems and How to Overcome Them

Above, we’ve shared a wide range of guidelines and colostomy diet that might help you in your healing and coping up journey.

However, please know that what worked for one patient doesn’t work for everyone. Below are some of the common problems you could also encounter which might be caused by your food and beverage intake.

Constipation

To solve constipation problems, increase your fluid intake (all the information you need is given in the section: beverages rich in vitamins and minerals).

If constipation persists despite fluid intake and proper nutrition, talk to your doctor.

Gas and Odor

Producing more gas is expected after ostomy and is also a part of bowel function.

However, there are foods that increase gas and odor such as cabbage, onions, cauliflower, broccoli, legumes, asparagus, peas, beans, artificial sweeteners and carbonated beverages.

These foods, on the other hand, reduce bad odor:

• Tomato juice
• Orange juice
• Yogurt (with probiotics)
• Parsley
• Mint water

Dehydration

Increase and monitor your fluid intake if you are actively exercising, having diarrhea, or sweating excessively because dehydration may cause problems with your stoma.

Some signs of dehydration include:

• Increased thirst
• Dry mouth
• Dizziness
• Palpitations
• Confusion, sluggishness, or even fainting
• Inability to sweat
• Reduced and / or darker urine production

If you have experienced any of these symptoms, electrolyte drinks or rehydration solutions can help you recover from dehydration. In any case, consult your physician for best advice depending on your current situation.

Diarrhea

If you are having watery and frequent outputs 4 times or more a day, it could be caused by foods such as:

• Raw/undercooked vegetables
• Spices
• Prunes/Figs
• Chocolate
• Dried Fruits
• Fresh fruit
• Salad dressing
• Pure Fruit Juice
• Highly spiced/Fatty Foods
• Bran
• Cereals
• Rhubarb
• Spinach

Other causes include:

• Skipping meals
• Food poisoning
• An infection in your intestine
• Antibiotics and other prescription medications
• A blockage in your intestine

You can drink sports drinks or oral rehydration solutions and avoid the foods listed above.

Don’t forget to contact your physician if you need medication help.

Final Thoughts: Foods to Avoid for Proper Colostomy Management

In general, what you cannot eat with a colostomy will be those foods and drinks that will cause you frequent issues such as constipation, diarrhea, gas and bad smell. Problems that you can avoid by following proper nutrition and the advice of your doctor. 

Finally, keep in mind again to focus on your healing first and not stress too much on thinking about your limitations. Just be mindful and conscious before taking in any kind of solid food or beverage. Furthermore, don’t forget about the hygiene of your stoma and use specific detergent with a self-balancing pH.