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Aug 17, 2020

Can I make a toasted tomato sandwich with a peeled tomato? Ileostomy concerns.

This topic is about safely enjoying garden tomatoes and onions after having an ileostomy, which is a surgical procedure that creates an opening in the belly for waste to leave the body. The person sharing their experience is three months post-surgery for colon cancer and is eager to enjoy a toasted garden-tomato sandwich. They are cautious about potential blockages from tomato seeds and are also looking to reintroduce cooked onions and more vegetables into their diet.

Here are some helpful insights and advice:

1. General Recovery and Timing
- At three months post-surgery, your bowels are still adjusting. Introduce new foods slowly and in small amounts, paying attention to how your body reacts.
- If your entire small bowel is intact, you may eventually return to a "normal" diet. If parts are missing, be more cautious and consider consulting a dietitian familiar with stomas.

2. Tomatoes
- Many people with an ileostomy can eat garden tomatoes, whether peeled or unpeeled. The skins might appear in your pouch but usually pass without issue.
- Start with a small piece or a whole peeled tomato, chew it well, and monitor your output.
- Roma tomatoes are a good choice as they have fewer seeds.
- To avoid blockages, peel all fruit and vegetable skins and chop them finely before eating.
- Blending tomatoes, like in gazpacho, can help break down skins and seeds further.
- For easy peeling, scorch the tomato on a gas flame or dunk it in boiling water for a minute, then plunge it into ice water to slip the skin off.

3. Onions
- Finely chopped and cooked onions are generally well-tolerated but may cause gas. Keep an eye on how your body reacts.

4. Greens and Salad
- Raw greens like lettuce can be difficult for some people. Chew them well or avoid them until you are more healed.

5. Practical Eating Tips
- Chew your food thoroughly, or pre-chop it before serving to reduce the need for chewing.
- When trying new foods, start with about one tablespoon, observe how your body reacts, and gradually increase the amount if there are no adverse effects.
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