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The stoma emerges through the abdominal wall. The operation consists in creating an artificial connection of the lumen of the large intestine or the lumen of the ileum with the outside world. This route is then followed by the excretion of the intestinal contents. In general, it is then necessary to use stoma pouches on a permanent basis.
Immediately after stoma surgery, nutrition depends on the patient’s health and the extent of the surgery. Sometimes fat digestion may be disturbed in the initial period. It is related to the periodic limitation of their consumption. After a while, however, the rest of the gut takes over for the digestive function. After the operation, subsequent products and dishes should be introduced, one at a time and in small amounts. Observations of their individual intolerance should also be carried out (as evidenced by nausea, flatulence, bloating).
After the recovery period, the stoma is not an indication for a special diet or very strict dietary restrictions. Patients have to find out which products are well and less tolerated over time. However, it is worth following the rules of proper nutrition. Adequate diet affects regular bowel movements, their consistency and thus – the patient’s well-being. By proper nutrition, you can also avoid gastrointestinal ailments, such as constipation, diarrhea, flatulence.
Therefore, it is important to eat meals regularly, at the same time, no less than 3 a day. Meals should not be plentiful. It is very important to drink enough fluids during the day. Water has a beneficial effect on the regulation of the intestines and the formation of fecal matter. Therefore, you should drink about 2 liters of fluid every day. It is worth limiting the consumption of fatty products and dishes (fatty meats, cold cuts, fatty cheeses, lard) and sweets (chocolate, confectionery). Dishes should be prepared by cooking and baking in foil. Fried foods should be avoided. In addition, you should avoid products that excessively increase intestinal peristalsis and gas-forming, especially cabbage, peas, asparagus, beans, broad beans. Onions. It is inadvisable to drink alcohol and use hot spices.
In patients with a stoma, various gastrointestinal ailments may occur: diarrhea, constipation, excessive gas. Therefore, it is important to know which foods can be causing these problems and which can help alleviate them.
Products that can cause excessive amount of gases, are: legume seeds (beans, peas, broad beans), onions, cabbage, cauliflower, cucumbers, milk, nuts, radishes, carbonated drinks, alcohol. For products responsible for unpleasant smell of gases include: beans, asparagus, cabbage, onions, eggs, fish, garlic, sharp cheese. On the other hand, products that can reduce unpleasant odors are: cranberry juice and cranberry, parsley, tomato juice, yoghurt.
Some products and dishes can affect a change in the color of your stools. These are: beetroot, beetroot, dyes added to food, strawberries, tomato sauces, as well as some medications, e.g. iron preparations.
In the case of constipation it is worth including boiled vegetables and fruits, fresh fruit and vegetables without peel and seeds, fruit juices in the diet. Do not forget about the right amount of fluids, which also counteract constipation. The intestinal peristalsis is stimulated by, for example, water with honey or coffee. Boiled cabbage, alcohol, prunes, raw fruit, milk, spicy spices, bran have a strong defecation inducing effect. These types of products are generally avoided in the case of a stoma. Some of them may even block the stoma. These include: apple peel, raw cabbage, Chinese vegetables, celery, corn, dried fruit (e.g. plums), mushrooms, and nuts.
In the event of the appearance of diarrhea (you should always contact your doctor in this case) remember to replenish fluids. Diarrhea loses a lot of water and electrolytes, which can lead to dehydration. In the first stage of diarrhea, rice gruel, bananas containing a lot of potassium, followed by carrots and rusks have a soothing and stopping effect.
Not all diets are healthy and safe for our body. It is recommended that you consult your doctor before starting any diet, even if you do not have any health concerns. When choosing a diet, never follow the current fashion. Remember that some diets, incl. low in specific nutrients or strongly limiting calories, and mono-diets can be devastating for the body, carry a risk of eating disorders, and may also increase appetite, contributing to a quick return to the former weight.
Knowing the above rules, the patient must carefully observe his or her body and assess which products influenced the occurrence of particular ailments. It is important to ensure that the diet is as varied as possible and that it provides all the necessary nutrients.
Text: Dr. Katarzyna Wolnicka – dietitian
Food and Nutrition Institute in Warsaw