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Sep 01, 2020

Ileostomy Diet - Realistic Expectations and Long-Term Adjustments?

This topic is about understanding what to expect with your diet after transitioning from a colostomy to a loop ileostomy. If you love cooking and have been enjoying a high-fiber, whole-food diet, you might be concerned about potential dietary restrictions. Here are some insights and advice to help you navigate this transition:

1. Many people with ileostomies eventually return to eating a wide variety of foods, but it can take some time. It's common to start reintroducing foods slowly, in small amounts, and to chew them thoroughly. Trying a food at least three times can help you decide if it works for you.

2. While many can eat almost everything, some foods are often more challenging. These include raw or very fibrous vegetables, lettuce, corn, peas, coconut, pineapple, mushrooms, berries, tomato skins and seeds, nuts, popcorn, large amounts of red meat, and dried or high-sugar fruits.

3. Preparing foods differently can make them easier to digest. Cooking, blending, or pureeing fibrous foods, and peeling or seeding items like Roma tomatoes, can help.

4. Some people avoid high-fiber foods in the evening to prevent slowed digestion or thick output overnight.

5. Staying hydrated is crucial. Drinking 2.5 to 3 liters (about 80 to 100 ounces) of water daily is often recommended. Adding electrolyte or citric-acid drinks like orange juice or lemonade can help reduce the risk of dehydration-related kidney stones. Remember, caffeine and alcohol require extra fluid replacement.

6. Pay attention to the consistency of your output. Extra fiber or foods like apples and mango can thicken it, which might be helpful for some but could increase the risk of leaks. Sugars and artificial sweeteners can thin the output and cause diarrhea.

7. Your individual dietary limits may be influenced more by underlying conditions like Crohn’s disease, strictures, bowel length, or medications than by the ileostomy itself. It's important to consult with your healthcare team.

8. If frequent emptying disrupts your work or sleep, some people find it helpful to have one or two solid meals a day and use protein drinks for other meals.

9. A FODMAP-style diet can help control gas and watery output caused by certain natural or artificial sugars.

10. To prevent blockages, chew your food well, avoid very fibrous skins and seeds, keep portions moderate, and drink fluids while eating.

11. Remember, diet is largely about trial and error. Don't let someone else's food issues stop you from trying foods you enjoy.
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