Can lettuce cause blockage? Best lettuce for ileostomy?

I have had my ileostomy for 4 months. I have always been a big salad lover, but keep being told lettuce, tomatoes, and cucumber can cause blockages. Is this true? If not, what's the best form of lettuce?

Hi Tmn86.  We're different in so many respects and if you're not having any problems with your salads causing any discomfort, continue to enjoy.  Others might have problems with an identical eating pattern so count your blessings.

Respectfully,

Mike

Sorry, I didn't offer a comment relative to the best lettuce.  Since I know almost nothing about this stuff I'll just offer "green".

Mike

Everyone is different as Mike says! Try everything you like in small quantities and chew really, really well! You should be fine. That goes for everything! Chewing it small is the key!
Puppyluv

Hi tmn,

I assume you've tried eating salad in the past 4 months, right? Lettuce, cucumber, and just about any veggie eaten without being cooked first will be very hard to digest, as it's all fiber. If you're eating salad now, just look in your bag and see if it's being digested. If you can still tell what it is when it's in your bag, you may be asking for trouble down the road if you continue. As suggested above, chewing will make a difference, as it makes the stomach's job of digesting all that roughage a bit easier. Bottom line is use common sense. If you don't digest something, you should probably try chewing it more, and if it still comes out undigested, consider either giving it up or putting it into a blender (yuk) first. The advice given to avoid such things is based on the frequent complications that ostomates often experience. If your ileostomy isn't complicated by other problems, then you shouldn't have any issues even if you don't digest something. But if you have any bowel narrowing, IBD, or diverticulitis, etc., then you will need to be more careful about undigested things.

Regards,

Bob

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

Hello tmn86.

I agree with your other respondees so I will restrict my reply to the question about lettuce. Surely, this is a matter of taste and preference. I used to prefer Iceburg or Cos lettuce, but then I realised that they caused an excessive amount of wind, which in my case was very painful apart from being inconvenient. 

Being vegetarian, I eat a lot of salads so I experimented with most of the other green stuff to see what seemed best for me.  What I found was that I can eat almost everything apart from lettuce without any adverse effects. However, my favorite now tends to be watercress, which has the added advantage of being high in iron.

We are all so different in the way our bodies process food and what we prefer or not  and I am a firm believer in eating what you like.   I hope this helps

Best wishes and happy eating!

Bill

No matter how much you like something, once you discover it doesn't work for you, you'll naturally eat it sparingly.

Pain is a wonderful teacher, but go into it being honest with yourself. You can't just make something work.

This isn't a battle of wills with your gut; if your gut loses, it'll take you with it!

Dave

Just eat it! Try everything you like in small amounts and see how it goes, it's the only way you will find out if it's right for you. Always try foods at least 3 times if you think they've caused a problem as it may have been nothing to do with the food. Some days you get loose watery output or a blockage for no apparent reason from something you've eaten many times before without any problems. I always put it down to an off day or adhesions.

The only thing that causes me a blockage is pineapple, but then it might not in you and many other members.

I always think the best place for those foods to avoid lists are in the bin!!! They do more harm than good and make people have a fear of eating foods.

You are awesome - love the attitude! Thank you!

Thank you!

I've been eating salads since about month 2 into my adventures in Ostomyland. I've never had a problem. I can't chew things very finely (dental issues), so some bits and pieces are poorly digested, but nothing has been complicating the passage of output through my intestinal tract. The only time I've had a problem from fibrous foods was when I ate beet greens (!) which definitely caused a significant blockage that had me pretty worried. So that's definitely off my list. (By the time I was eating those kinds of greens I'd forgotten the caution to try new foods in small quantities first and increase amount incrementally, to give self time to see how New Thing affects the digestive tract. I don't forget to do that any more!)

A long way around to saying, I agree with others here who've remarked that every body processes foods a little differently and you will need to experiment to see what works for you and what you can tolerate.

Regarding specifically what kind of lettuce: iceberg is mostly water, relatively little fiber, and is sparse on nutritional content. So if you want something that has good mouth feel (crunch), and is *easy* to digest, iceberg is actually the one to go for. Green and red-leaf lettuce and romaine are much more fibrous, also much more nutritious. They require somewhat more chewing, and you will need to see how that level of fiber agrees with you (or not). I notice when I do those more fibrous lettuces, that I end up passing more undigested bits in my output. Butter or bibb lettuce and various 'natural' greens like salad mix, dandelion leaves, watercress etc are more nutritious than iceberg and less fibrous than the three commonplace ones I mentioned above. So they might also be a good alternative.

Personally, I tend to stick with the iceberg and natural leaves, though I'll do one of those more fibrous dense leaves (like romaine or green leaf) if I, say, want lettuce on my sandwich. But for just eating a bowl of salad, I've had the best luck with iceberg, which digests down to nothing very quickly.

Good luck, and happy salad experimentation!

I haven't tried it yet, I'll let you know how it goes.

I am worried now about tomatoes & cucumbers.  
Thank you so much!

Hi tmn86,

Sounds like you're getting some great advice, so I won't belabor the point.....just one thing no one has really mentioned......it's also important to think about what else you eat (and drink) when you're eating high fiber foods. Meaning if you just sat down and ate a head of lettuce all by itself you might be more prone to problems. Whereas if you ate that head of lettuce with some mayo or other concentrated fat, and a tall glass of water things might not be so bad. I'm exaggerating, of course, but you know what I mean. There's more to it than just the single food item you're focusing on.

Regards,

Bob

Thank you - I'll make sure, I drink lots of H2O

I was told that salads were not good for my stoma and could possibly cause a blockage. I only eat iceberg lettuce. I've never had any digestion problems or a blocked stoma. I followed what my ostomy nurse told me and for 4 years it has worked out great. Yes, I miss a good salad, nuts, and oranges but I'm alive and well.

It is iceberg lettuce for me also. A must-have lettuce, tomato (sliced thin), and cheese on every sandwich, burger, etc. Salads are okay with iceberg and cucumbers chopped fine, and tomato. I also enjoy coleslaw ground fine. The only problem I have is with corn on the cob (or off the cob). I started eating small amounts at first and now have no problem. I have a colostomy.

Everything is about chewing. Chew, chew, chew, lol. Permanent ileostomy since 2016. Also, rectal removal this year. I eat lettuce every single day at supper.. large portion too. Romaine and mixed organic arugula and occasional spinach plus dried cranberries and 1 small pickle..but I make sure I chew my food....Cucumber, I remove the skin just to be sure. Salad plus either chicken, fish, or shrimp...occasional rice or quinoa small servings...My worst blockage was popcorn...big mistake...was binge eating it and not drinking enough liquids...never eating popcorn again due to the kernels and kernel shells being so hard...I keep a close eye on how things come out. For example, eating nuts in small amounts come right back out generally...so chewing is crucial..I don't eat a lot of those but for an occasional small handful.

Count how many times you chew and pay attention to that until you know it's a habit.

Thank you so much, I have always been a salad fanatic! This helps a lot.  

Hello,

For me, it's not the kinds of things, but how I prepare them. If I peel and take the center out of cucumbers, peel tomatoes, and chop lettuce finely, I have no issues.

I have found that the only things I can't eat are several types of nuts (they come out like small daggers) and citrus. I can have the juice, but not the membranes.

Hope that helps. Good luck in the future.

Any food item that does not dissolve is a potential cause of a blockage. I eat everything, even peanuts and sweetcorn....BUT....I chew, chew, chew, so there's less chance of a big wedge causing a blockage (I've had 2 in 48 years). Typical blockage culprits are......raw or undercooked veg, "hard" salad, veg, nuts, sweetcorn, mushrooms, raw spring onions, coleslaw. As you can see from the aforementioned examples....all those food items do not dissolve. With an ileostomy, intestinal peristaltic action (the snake-like bowel movement) is not strong. There's no "straining" to help things move along.

For all of you looking for a treat and live near a CVS Pharmacy, I found an item like caramel corn that is wonderful but it is not popcorn in the sense. Gluten Free Salted Caramel Corn Puffs, 6.5oz bag by Gold Emblem in a brown bag in the chips etc section. It is a little expensive but well worth the price. They just melt in your mouth.

I have had an ileostomy now for 18 months. Oh, I eat everything under the sun and so far no blockages. I guess I have to count my blessings, which I do every day. Why some people can eat everything and other people cannot is a mystery to me. I eat lettuce, cucumbers, and tomatoes in a salad every day for lunch. I guess it's just the way your system works and why you have an ileostomy.

I'm glad you listed what operation you had.   I think it would be helpful if people said which type of surgery they had.   I had a partial colostomy, and when reading the comments, I often wonder who had what done.

I was told that iceberg lettuce is the only safe salad green. Tomatoes should be okay if you remove the skin. I have been told no on cucumbers even if you remove the skin, it still has seeds and seeds can cause blockages. Lee