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Cashews, peanuts and pistachios- good or bad to eat?


I have been told different things by nurses, Drs, etc regarding eating nuts, pistachios,  cashews. I have refrained from them for the entire 2+ yrs I've had my illeostomy.  I been told that if I eat any of them my stoma has a strong possibility of getting a blockage.  I was wondering what the real people who have stomas have to say regarding this. Needless to say, pistachios and cashews are my favs and I miss eating them. So, I'm eagerly wondering what others do....

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I avoid nuts cause they come out as nut pieces. I’d say it’s ok to eat small amounts, chew really well, and drink plenty of fluids. 


the only way to find out is to have some.  have a small amount and chew well & then see how it goes. 


Yeah, drink lots of fluid. My personal choice with peanuts is beer. And lots of it. Seems to work for me. 


Hello Jalrein.

My problem with nuts is that they tend to get stuck in my esophagus and I had to manually massage them back up in order to chew them again. With that in mind, I used to cut them up into very small pieces (almost dust) with the blender. Unfortunately, I found that one of the pleasures of eating nuts is the process of chewing them. I Therefore gave up the blending and went back to chewing. Almonds, cashews and occasional pistachios are a regular part of my everyday breakfast and I have no problems. In fact, they help push down the pills, which are a real pain when and if they get stuck in my throat.
As others have already said, the appropriate technique is to chew-chew-chew and chew again, until the nuts are so masticated that they are barely different from a purely liquid in form. 
Thanks so much for this post as I feel a rhyme coming on.

Best Wishes



I love cashews, peanuts, and pistachios.  I don't eat them frequently, but I have never hesitated to enjoy them IN MODERATION, and chew 'em up, of course.  I have avoided almonds, since they seem harder and riskier, which may or may not make sense.  Always with fluids, naturally, it should go without saying.  I've had an ileostomy my entire adult life and nuts have never given me a problem.  I particularly like to eat nut bars like PayDay.  


Hello Jalrein.

Thanks again for this post which has prompted me to pen a poem. I have posted it in the 'Blog' section because that way I can keep track of what I've put on here. However, to save you searching for it. I'll post it below as well

Best wishes



I admit I’m nuts about nuts,
but not without some ifs and buts’,
as nuts will pose me problems and
I’ll tell you, so you understand.

Nuts tend to be just the right size
to take the unwary by surprise,
for even though nuts are scrumptious 
they’ll stick in the oesophagus.
Experience tells me not to gloat,
when pesky nuts stick in my throat,
for they will tend to make me choke 
and I can tell you, it’s no joke.

I found that massaging each side
of my neck the nuts might slide
back to my mouth where I just knew
that I could masticate anew.

The nuts aren’t quite as bad as pills,
which tend to get stuck fast until
I swill them down with water but 
they’re hard to shift into my gut.

But nuts, when in this gut of mine 
cannot be trusted to be fine
because I have a stoma there,
now, I will briefly try to share. 

A stoma sits upon my tum,
replacing my malfunctioned bum,
so, I don’t want it blocked by nuts 
compacting in my reformed guts.

The answer’s what I always knew,
which is the fact I need to chew,
and chew, and chew, and chew again,
so food won’t block and cause me pain.

                                                B. Withers  2022


I eat nuts  regularly, salted, roasted almonds are the current favourite.


Good for me can't say if there are for you, as with all foods just try in small amounts the first time then if they was a problem it won't be to bad 


It all comes down to how much you eat. A couple of years ago I overdid it with almonds and had to spend two days in the hospital with a blockage.



I can eat all kinds of nuts with no issues, I think I'm one of the few ileo's that doesn't chew more than usual or drink a lot, sometimes a cashew or peanut may come out intact but that's the same with a lot of fruit and veg too, no problems for me, if it tastes OK I'll eat it.  Salted roasted macadamias are my favourite (and chocolate covered almonds a close second!)


Hi jal,

  Questions like this are very dependent on the individual and why they're an ostomate.  As such, it doesn't matter if others can eat them or not, as they're not you.  Dietary guidelines for ostomates vary significantly depending on your specific condition.  So there's no one diet for ostomates that applies to everyone.  Nuts are hard to digest, or maybe a better way of saying it is that they need more time in your bowels to be fully digested.  So whether they come out whole, partially digested or fully digested comes down to what parts of your bowel are still intact and functioning, and if your liver is producing the proper consistency and volume of bile.  Also, any underlying condition that is adversely affected by undigested diverticulitis, strictures, bowel narrowing, etc, needs to be considered before you eat things like nuts.  Most nuts now come in a butter, like almond butter, pistachio butter, etc.  Those are safe, and you can make your own easily enough.  If your bowels are mostly intact and you have no other should be able to eat anything.  Regardless, if you do try to eat nuts........chew the living daylights out of them before you swallow.  And don't eat them while you're doing something else.  Your concentration will lapse and you'll find yourself swallowing them partially which point it may be too late.  So the answer to your question is it depends on what's going on with your intestines and why you have an ostomy.  What I can eat really as no bearing on what you or anyone else can eat.........unless you're just like me medically.  So tread lightly and be careful.............and be smart. 




w30bob wrote:

Hi jal,

  Questions like this are very dependent on the individual and why they're an ostomate.  As such, it doesn't matter if others can eat them or not, as they're not you.  Dietary guideline...

Bob, your response is why I asked this question in the 1st place. Your answer helps me tremendously by giving me direction on how things work for you and that let's me know really, one way or the other regarding what you do. Chewing them to smithereens and then drinking afterwards is the way I'm gonna try and experiment....thanks again Bob


AlexT wrote:

I avoid nuts cause they come out as nut pieces. I’d say it’s ok to eat small amounts, chew really well, and drink plenty of fluids. 

I never stopped eating nuts I have no problem


I waited six months post=op and then went back to my usual diet, minus meat.  I suggest starting with nut butters (self made or store bought) so you have a sense of what the lumen of your stoma will tolerate.   Even pulverized in one's mouth with enthusiastic chewing, still there will be remnants especially from leguminous nuts.  And then introduce small amounts at a time.   As long as I don't over do it, eating most nuts is now pretty manageable.  Really fibrous fruits and veggies, like pineapple (which is hard to stop eating once one starts) are the only thing I find truly dangerous.

Good luck on this.  Stay hydrated and best wishes on normalizing your existence....whatever normal is these days.   Stay sane.


I didn’t worry at all what I ate and what I drank, I never had a problem with anything, except when I got the squits, projectile diarrhoea into a pouch, at the time was not good, then when the pouch started leaking because it was like a space hopper and during the operation of changing the bag the stoma squirted liquid forcefully everywhere in a public loo, it wasn’t good. I think that was down to drinking copious volumes of natural cider and being bladdered at the same time was not a great experience. As for eating nuts, I love them and was only initially worried because I thought it may have been nuts sticking in a diverticula that caused the punctured bowel, or maybe a coincidence but after the formation of the colostomy I eventually ate all and everything. Not sure all that helps but in short the stoma is your new arsehole and I never worried before, it adapts to whatever comes its way.


Hi ,  Welcome to t he site.   I'm Marsha, and have had my ileostomy for almost 60  years,  sin ce  I  was  a  teen of 15...    I always loved nuts,   so  once  I had my surgery,   I  began to eat them again , but with caution...   How much  fiber  one can digest  is really up to the individual..   For me, nuts were llike corn on the cob....  Need to CHEW , CHEW , and CHEW some more.    I find there is a real difference in texture of nuts...    Cashews and macadamians.... are easerier to " chew u ntil it's paste"..    Almonds,  and Peanuts....and my favorite...Pistachios need more chewing...   Over t he years,  my digestion has changed, and I'm having more difficulty  with digesting   I've cut down of eating nuts as well..    There's always  " peanut butter"...   Best thing is to try different nuts..... one type at a time ,  chew well, and dring fluids with them..   Best of luck to y ou..   Marsha..


I just love peanuts and cashews. Chew Chew and then Chew some more. This is actually the joy of eating nuts. Turn them into paste. The temptation to swallow has to be resisted.

Nobody chews food enough anyway. It is actually a joy to prolong the taste, isn't that what most people enjoy more than the actual functional fuel need for consuming food.

Mastication.. ha

I sit next to people eating sometimes and I must admit, I am a bit of a table manners nerd..  but some people are like dogs. Wolf Wolf swallow.. and it turns my stomach. 

People have no time for nothing.

Enjoy your food. I actually haven't refraining from all them foods they told us to avoid. Just Chew the living daylights out of it.

A lifetime on the lips... A minute on the hips.

I understand it is so so better for your total fulfillment and nutrient uptake. You actually feel full sooner and understand that the whole process of preparing a table, sitting properly and eating slowly and mindfully is an exercise that should be trained for the better of not just our limited belly.

All the best to everyone.


WIGirl77 wrote:

the only way to find out is to have some.  have a small amount and chew well & then see how it goes. 

I probably eat more nuts than I should lately 😅 I love all types of nuts. I chew them well and I drink lots of water, and have had no problems. Enjoy your nuts and drink plenty of water and see how YOUR body reacts.


I was also told not to eat nuts. I understand why, cause i had a blockage one time when i ate alot and fast, quite painful and made me feel sick. But i can eat them if i eat slow and chew them long enough and drink a lot after. Never giving up on nuts 😄


If you have an ileostomy, Beware more than one handful of nuts like peanuts, cashews etc. Too many will clog up what's left of the small intestine.  The clog will eventually pass but the cramp may drive you to the ER where they will first suspect a blockage calling for surgery.   Might "backflush" through the Stoma to clear the clog.  Beware nuts

I love cashews too.  


Chew them well & you'll have no problem.

I've not in 46 years


I was told different things as well. I love cashews and I didn't eat them for about a year and then I decided to try it out. No problems so far. As others have said, I eat them in relatively small amounts and I chew them up very well and I always try to stay on top of my fluid intake.


Im an ileostomy 7 months....I have had cashews salted of course, no issues chew good have had peanut brittle again no issues, and peanuts no issues ...same as small seeds like on everything bagels or on buns no issues again chew well drink water and enjoy....


I've had my colostomy since 2019 and to be honest I still eat everything I always have. Agree its important to chew well, but if you try a little and see how you go, you will soon know if it disagrees with your gut.


Hello.  I've had an ileostomy for 30 years, and I eat a wide variety of nuts, including the ones you mention without a problem.  Sometimes I eat them in large quantities.  But since everyone is different, if you want to try, I would suggest by starting with small amounts and chew it down well into very small pieces.  If there is no problem, gradually increase the amount and if you want, swallow whatever size you're comfortable with.


I find that softer nuts like cashews and pecans are fine in small quantities, but peanuts and almonds can be very problematic.  Chew well, small amounts.


I find that softer nuts like cashews and pecans are fine in small quantities, but peanuts and almonds can be very problematic.  Chew well, small amounts.


I do not have any problems eating cashews, peanuts, popcorn or nuts of any kind.  Just make sure you eat them slowly and chew them up well.


3 days spent in hospital as a result of eating an apparent excess of peanuts and cashew nuts. Nuts and a beer on Saturday afternoon led to a temporary internal blockage in the area of my ileostomy scar. Went to see GP with lower abdomen pain on the following Monday morning. Doctor thought thought I may have appendicitis! Suggested I went to local A & E hospital where CT scan diagnosed blockage most probably caused by the nuts I had consumed on the Saturday.

Saline drip, a course of liquid Paracetamol & tube up my nose into stomach for 2 days was enough to discourage me from eating too many peanuts & cashews again! 

Lesson learnt! 


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