First Steps to a Normal Diet 3 Weeks After Ileostomy

May 25, 2023 5:29 pm

Hello: Just thought it might be helpful to some of you concerned about diet and healthy eating. I pretty much stuck to the all BLAND diet for 3 weeks after surgery. White rice, white bread, pasta, etc. and as much protein (salmon, peanut butter, chicken) as I could eat to regain strength. Then a couple of days ago, I had my first visit with the surgeon and was told I could start eating whatever I wanted. That is, being cautious with some of the vegetables in the cabbage family.

So today, I went to my vegetable garden and picked the first pea harvest for the year. I ate about 10-15 peas, just to be careful. Then I ate a fresh strawberry from our Amish neighbors and cooked some dried fruit in my cream of wheat. Such a thrill to be able to have some flavor and more well-rounded nutrition.

For any of you who felt the same sense of deprivation, I hope this gives you some hope for the future. I know everyone has different experiences and different maladies, so I certainly don't prescribe this new freedom, but I do want to offer some encouragement for those of you who are waiting for permission to eat more "normally." The time will come.

Mysterious Mose
May 25, 2023 7:39 pm

Thanks for your input on this subject. I am 5 months from having my colon removed and an ileostomy appliance installed. One of the issues I have had is finding information as to long-term diet. Everything I read online talks about the first 6-8 weeks following surgery, but very little exists about long-term diet. I have been gradually adding things that are a no-no in the short term and have had few problems as long as I keep things within reason. For instance, I find I can eat things with nuts in them as long as I chew the nuts very well. But, I am not sure I want to go back to eating nuts by the handful.

I am glad to hear that you had success with peas, as they are one of my favorite vegetables and I am about to give them a try. Gonna use fresh frozen, as we did not plant peas this year. :-)


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May 26, 2023 2:56 am
Reply to Mysterious Mose

Hi there,

So when I first got my ileo, I had been given the handbooks and the diet guidelines and what not, was following it to the T... Well, I was talking with my surgeon after he had to do another revision and diet. So, anything that you are before you had surgery, eat now. The only difference is instead of going to the bathroom from your back end, you're going out the front of you, eat small portions slowly and chew thoroughly. And as far as thickness and thinning out output, you find out what ends up working for you.

May 26, 2023 2:35 pm

Best advice I ever had on food after surgery was from a student ostomy nurse that had a stoma. He just overheard my ostomy nurse telling me what I could and couldn't eat and drink, and when she left, he said, "Bollocks, eat and drink whatever you like."

May 27, 2023 7:38 am

Eat whatever you like most, there is no need to punish yourself, just introduce things sensibly and chew things well that need to be chewed well. I eat anything and everything.

Living with Your Ostomy | Hollister
Mysterious Mose
May 27, 2023 4:24 pm
Reply to Axl

Thanks, Axl. I ate my peas yesterday and had no problems at all. Other than flushing the residue from my bag, that is. :-)

Bit by bit, I have been adding things back to my diet. However, I have yet to work up the courage to try my granola. The pepitas (pumpkin seeds) keep staring at me and asking if I am sure I want to do that. :-)


Mysterious Mose
May 27, 2023 4:31 pm
Reply to Beth22

Thanks, Beth. Step by step, I have been adding things back to my diet. So far, so good. --Daniel

Mysterious Mose
May 27, 2023 4:42 pm
Reply to Ben38

Thanks, Ben. I got the same talk from my wound/ostomy nurse while in the hospital. But, she stopped short of extending her advice beyond the first 6 weeks or so. I was on TPN for most of the first 4 months following my surgery. So, I started experimenting as soon as the PICC line was removed. So far, so good!


May 30, 2023 9:51 pm

When in doubt, chew like a rabbit.

I had a tough time initially with what I wanted to eat and what I should eat, and over time I have just gotten back to my normal diet prior to my Ileostomy. Only difference thus far, 10 months into this, I don't snack in the evenings like I used to to avoid bag ballooning in the middle of the night. I eat all the nuts and fruits and salads as before, just make sure to chew when in doubt.

May 30, 2023 10:35 pm
Reply to Mysterious Mose

Haha. I have the same sensation as you do when you look at the pumpkin seeds. I'm not even sure I've gotten all my taste buds back after my radiation/chemo treatments that ended way back in January.

I really miss nuts. Whole grain bread. Mixed salad greens from the garden. I look at these delicious meals on food networks and drool. So I have the desire to eat more, but then when I eat, nothing really has the same oomph. I used to really enjoy a gin and tonic, too, on Friday or Saturday nights with my husband, who makes them strong. I'm afraid they're just not going to be as refreshing as they were in the past.

Still, I'm alive and kicking and have a great prognosis, so I feel bad complaining.

May 31, 2023 2:23 pm

Anything with skin is hard to pass. Eat slowly, chew well. I steamed the heck out of broccoli, easy to pass. Not in the evening, gas. I peel all the fruits in my fruit salad, cut to small pieces. No problems. I add protein powder to my peanut butter, hot cereal, and coffee.

Mysterious Mose
May 31, 2023 5:10 pm
Reply to rlevineia

I've not had a problem with small white potatoes with skin. I have cooked them whole in my pot roast or standalone, cut in half. When it comes to russets, they always get peeled beforehand. :-)


Jun 01, 2023 9:02 am

I added foods one at a time to see what happened. I was extremely scared by the stoma nurse's cautionary tale of one patient who regularly goes into the hospital with a blockage. She loves peanuts and, they say, would probably be fine with a few. But around once a month she gorges on a whole bag and ends up in the hospital.
I tend to peel fruit and if I have cherries, I conscientiously chew and then spit out the skins. I've been avoiding bean sprouts as they seem to be immune to chewing and travel through whole. I guess the potential problem with them is that they could get entangled with other non-digested bits and clump together so the whole lot gets too big to get through the stoma. I love bean sprouts though and reading what people are eating here is encouraging me to be more adventurous.
I've been surprised at what can fit through the stoma. I love olive bread with big pieces of black kalamata olives. They pop through fine. Also, black beans often seem to travel through whole.
The thing that strikes me is that this must be happening to people who don't have an ostomy. So there must be a lot of food people are eating that never gets broken down and absorbed as nutrition.
I focused on trying to keep my output a good consistency to give the best chance of my body absorbing the nutrition. I do this with food rather than meds - a banana a day or some mashed potato.
The only time I had a blockage was when I got completely weary of having to be conscious of how I was preparing food. I'm an intuitive cook and make it up as I go along. I just wanted to cook the way I used to. I made a rice and mushroom dish, trying brown rice for the first time. I didn't chop the mushrooms up really small as I normally did with my new body. I tore the mushrooms - like I used to do. In the past, I've boiled brown rice in lots of water until it splits and sort of puffs, so it's soft. This time there was still quite a bit of bite in the rice. But I was hungry and went with it. Mistake.
I got a blockage, which is painful and I couldn't eat anything at all for a week. After that a week of tea and a plain biscuit (cookie). The stoma nurse said that the problem was that the rice would have continued to absorb water in the gut and swelled up. Also, mushrooms don't tend to chew down to small pieces. Though I don't know if they were the problem as they are soft and should squeeze through. I've got PTSD from my stay in the hospital so couldn't take myself off to the hospital, which is the normal way of dealing with a blockage because it can be serious. I think this is why I've been so cautious with introducing new foods.
I eat cashews because they're a soft nut and can be crunched down fine. I wouldn't risk something like hazelnuts. I have these other nuts in the form of raw nut butters. I eat any kind of bread including a pretty solid rye sourdough that has sunflower and linseeds in it. I love the crispy skin of a baked potato but end up in pain if I have 1/2 a spud - so I just have a little bit. Chewing well. Tomato skin could survive a nuclear war so I make sure I cut them up enough so that I can be sure the skin will pass through the same size it went in. Lettuce I tend to chop up (no rational explanation for that). Anything seems to be fine if it's chopped up small.
I had decaf coffee for a long time but now I have regular coffee with no problems.
I have curries, no problem - though I never liked them scorching. I love broccoli. No problem with wind. If I do get wind it turns up as a pain in my belly rather than a blown-up bag. I am no longer ladylike and if I feel pain in my belly I burp. And the pain goes. I have no idea how this works ...
The thing is that we have ileostomies for different reasons. If it came from a sensitive gut then it's an idea not to aggravate our gut. Something I'm aware of is that I didn't look after myself before this surgery. So the positive from it is that it has made me sit up and pay attention and take taking care of myself seriously.
It's really good to hear what people are eating without problems. It's making me think that maybe I might explore.