Constant Hunger Pains - Need Advice!

A question to everyone: I have had my stoma for 6/7 months now, but for a couple of years before that, I was ill and couldn't really eat without being sick and becoming unwell.

Now I am always hungry. I eat and 10/15 minutes later, I'm hungry again, and I mean stomach pain hungry. Am I eating the wrong foods? I try to have a balanced diet. Do I need supplements? Anyone have any ideas?

High protein, low carb diet... I'm going to edit this to mention "low residue" foods also. I personally avoid fiber if possible, others freak out when you mention this but I know in my situation it works very well.

Well, Loki, maybe it means you're getting better! If you have been ill and unable to eat for a few years, it might be hard for you to adjust to actually being able to eat again. And now, having a colostomy, it might be awhile until your bowels adjust, so you could well be paying close attention to your diet for a few years.

I agree with MMSH that protein is something you should try to incorporate into every meal, as it will keep the hunger pangs at bay. Protein doesn't always have to be meat; legumes like lentils and chickpeas are a good source of protein too. So is peanut butter. You will need some good fats as well, in small amounts (olive oil, avocados, nuts). Generally, the simple carbohydrates that don't give us much nutritional value (refined sugar and flour) don't do much for our hunger either. Best to keep those to a minimum. Complex carbohydrates, like whole grains, take longer to digest, so they keep you feeling full for longer. I have eaten oatmeal for breakfast most of my life, but I discovered farro, an ancient whole grain, a few years ago, and I find it keeps me full for longer than oatmeal does. So I am still learning too.

Loki, do you have access to a dietician? If you do, it would be worthwhile to spend some time with one. Learning how to eat properly, especially with an ostomy, can be frustrating at times. If you could consult with a professional, even for an hour, it might save you a lot of time and angst.

Laurie

Hi Laurie, thank you for your advice. I try really hard to have a variety of different foods in my diet. I must admit, it is nice to eat food again and actually enjoy eating rather than eating because I have to. I will definitely increase my protein intake.
As this is still fairly new, I have regular check-ups and I am seeing the surgeon (who will probably not be happy as I have put on a considerable amount of weight), so I will try and organize a few visits to the dietician.

Paul

Agreed that protein is a great way to keep the hunger away but do you have high output? Do you have a colostomy or ileostomy? You could not be absorbing the nutrient that you are consuming.
A dietitian is a great alternative to set you on the right track!
Pup

Hi pup, I have a colostomy and yes, I would say I have high output. Some days, I can change/empty my bag 5 or 6 times and through the night. I will definitely try for a dietitian appointment though.

Thanks for taking the time to help. nbsp

Paul

Hi Loki,

I'm a little confused (seems to be a natural state for me).........you mention diverticulitis and a keyhole (laparoscopic) surgery, and then a colostomy. I'm not seeing how those are connected.........can you give me a little more info? Is your small bowel still fully intact? Was part of your colon (if any) removed.......or was it just disconnected from your ass and stuck out your front for some reason? Why did they do the colostomy? Are you now cured of any bowel issues or are you still dealing with some?

As for the hunger..........after my "chop and yank" operation I was hungry ALL THE TIME. I mean ravenous hunger. And thirsty. Even more thirsty than hungry. For me, it was because anything I ate passed through me and out into my bag in minutes......if not sooner. Your intestines provide feedback to your stomach telling it when to release contents or not. The stomach also regulates what it lets flow into the small bowel by what it is you ate. Water and most liquids are released immediately. Fats are held in the stomach the longest, as they are harder to break down. So you can influence how long stuff stays in your stomach (and prevent your stomach from telling your brain it's empty and to eat more) by what you eat.

Anytime you have a bowel operation there's a shock to your bowels, such as in a colostomy, and they need time to adjust and adapt to the new normal. Our digestive system is a not-very well understood part of our bodies, despite what you read from the medical community. So don't be surprised if advice given to you regarding your digestive system is sometimes flat wrong.

The key indicator for how much to eat is what your body weight is doing. Are you gaining weight, staying the same, or losing? Are you maintaining hydration? And by that, I don't mean are you thirsty, I mean what your urine is telling you (frequency and color) and what a frequent skin-pull test is telling you. Before my operation, I was so sick I lost all appetite. I just couldn't eat no matter what it was you put in front of me. It's a hard feeling to describe, as normal folks just can't relate. Once you get that desire to eat back, your brain goes a bit nuts. Now that you're on the road to recovery (or already fully recovered), remember that your body is still adapting. Seeing a dietician (not a nutritionist) is key, as Laurie said above. You want to see one that specializes in IBD, not diabetes. Most dieticians work in the diabetic camp, as that's where all the work is at these days. Ask your gastroenterologist for a recommendation for a dietician specializing in bowel (gut) issues. They'll order up a full micronutrient panel on you and can then determine what's going on from a nutrition standpoint. But calories are calories........so you may just have some getting used to hunger pangs like the rest of the human race........unless you want to pork out and end up needing to see that dietician for diabetes as well (don't do that). Your body will always want more food than it needs.........it's what kept the cavemen out hunting all day instead of sitting in their caves playing with their Playstations and watching Netflix.

;0)

Bob

Hi Bob 

I will try and explain. So, I had diverticulitis for years and in the end, my sigmoid colon got so badly damaged it was solid scar tissue. So, I went in for keyhole surgery which went well. They cut out the large section of colon and reattached it. Great, swollen and bruised belly but all good. I went home after 4 days in the hospital. On day 2 of being at home, I started getting really bad pains all through my body, over my shoulders, and down my legs. I left it for a few hours but it just got worse. The mother-in-law called an ambulance but by this time, I was in and out of consciousness, laying on the floor. I actually died for a while on my living room floor. The ambulance arrived with blue lights to the hospital. The join had ruptured and all the waste was being pumped around my body. I had septicemia and peritonitis. I ended up having emergency surgery and a total internal washout. The colon was so badly shredded they could not reattach it again, so hence the colostomy. 7 days in ICU and another 15 in the ward, and home again .......god, that was hard to go through again.

Dietician doesn't always help. I had an ileostomy and next day splenectomy. The diets and totally different. She told me to figure it out.

Sorry that your situation is so confounding, even for a dietitian. However, Loki's situation is quite different from yours, and hopefully, he will be able to get some good advice.

Laurie

Well.....D makes a good point. Not all dietitians are good dietitians. The first one I ever met was a "new" one at my local hospital. She was a cute little old lady, so I figured she knew a lot. I was wrong. When we finished our first 45-minute appointment, I was getting up to leave and gathering my notes, and I asked her for a copy of her summary notes. She looked at me and said "no, you know more about this stuff than I do.......and I also can't charge you for the appointment". That's 45 minutes I never got back. So having a pretty degree framed on the wall doesn't really mean much. I've subsequently tried to contact a few other semi-local dietitians, but they all specialize in Diabetes and are booked solid for months. When I talked to their assistants on the phone and I mentioned IBD, I always radio silence. The best one I ever met worked for the home infusion company that supplied my TPN when I was on it. She restored my faith in dietitians.........but you have to find a good one.

Regards,

Bob