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Jun 16, 2022

Questions about ileostomy bag/diet - Volume per meal? Caffeine? Gas management?

Preparing for an ileostomy can feel overwhelming, especially when you're trying to figure out how your diet and daily routine might change. If you're about to undergo a total colectomy with the creation of an ileostomy, here are some practical tips and insights to help you prepare:

1. **Food and Fluid Intake**
- After surgery, it's often recommended to have meals that are about 1 to 1½ cups in volume, six times a day. However, many people find that listening to their body works best.
- Staying hydrated is crucial. Many people drink a lot of water, sometimes with added salt, and have a full glass after every meal to prevent dehydration.

2. **Diet Adjustments**
- You don't necessarily have to give up coffee. Most people continue to enjoy 1–2 cups daily, though caffeine might affect output for some.
- Be cautious with carbonated drinks as they can cause the pouch to inflate, but this can be managed by "burping" the pouch.

3. **Gas and Odor Management**
- Gas can be managed by burping the pouch through the outlet or using a vent. Odor is usually contained if done correctly.
- Consider using pouches with carbon filters or stick-on vents to help with gas.
- Odor control products like M9 Odor Eliminator drops or hydrogen peroxide can help neutralize smells.

4. **Pouching Systems and Accessories**
- Experiment with one-piece and two-piece systems to find what works best for you. Barrier rings can help extend wear time.
- Keep an emergency kit handy, and consider high-waisted underwear or smaller bags for a discreet look under clothes.

5. **Stoma Construction and Care**
- Discuss with your surgeon to ensure the stoma protrudes slightly and is not placed in a skin crease or beltline to reduce leaks.

6. **Emptying and Blockage Prevention**
- For liquid output, start flushing the toilet as you empty the pouch to minimize splashing.
- Introduce foods like raw veggies or seeds cautiously to prevent blockages. Some people use Calcium Citrate tablets with extra water at the first sign of blockage.

7. **Clothing and Comfort**
- You can wear jeans and normal clothes, but give yourself time to heal. Protect your abdomen from tight clothing or pets jumping on you with a hand or cushion.

8. **Support and Resources**
- Stoma nurses are great for troubleshooting, and online communities can offer additional support and product reviews.

9. **Mindset**
- Keeping a sense of humor and staying positive can make a big difference. Many people find their quality of life improves after surgery.
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