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Mar 31, 2025

Weight Loss After Ileostomy: Can I Regain It?

The topic at hand is about weight loss after having an ileostomy, which is a surgical procedure that creates an opening in the abdomen to allow waste to exit the body. The person is concerned about losing over 30 pounds since the surgery and is curious if they will be able to regain the weight, especially since they are expecting a reversal in a few months.

Here are some helpful insights and advice from others who have been through similar experiences:

1. There is no one-size-fits-all answer. Many people with either permanent or temporary ileostomies do eventually regain the weight they lost. Some have reported gaining back all their lost pounds, and sometimes even more, within 3 to 12 months once their appetite returns.

2. The current weight loss could be due to several factors: reduced food intake after surgery, temporary malabsorption, fasting due to illness (like blockages), dehydration, loss of taste, or overall muscle loss.

3. Diet strategies that have helped others include:
- Eating a variety of foods during recovery, opting for full-fat versions, and including plenty of meat, poultry, eggs, dairy, and moderate sugar.
- Having multiple small meals (4 to 5 a day) instead of three large ones, and chewing well to aid digestion.
- Using calorie-dense oral supplements like Ensure.
- Gradually increasing portion sizes if appetite is low and keeping track of daily intake.

4. For fluids, aim to drink about 64 ounces (1.9 liters) per day, taking frequent sips to help with absorption and reduce the risk of dehydration from high output.

5. It's important to check micronutrient levels, such as B-12, and consider injections or oral replacements if needed.

6. Engaging in resistance or weight-bearing exercises can help build muscle and is often crucial for regaining a healthy weight.

7. Seeking professional help from a registered dietitian or a wound-ostomy-continence (WOC) nurse can provide personalized plans.

8. After reversal, some people have regained 15 to 20 pounds within months, but experiences vary. Some still face challenges with low weight or fluctuating output, so it's important to research the pros and cons thoroughly.

9. In the long term, the small intestine can still absorb calories efficiently. Some people even find themselves struggling with excess weight and need to monitor their calorie intake and exercise more.

10. For those with extensive resections, such as having only about 15 feet of small bowel left, absorption can be limited. Eating nutrient-dense foods more frequently and staying hydrated becomes even more crucial.

The product mentioned for calorie supplementation is Ensure, a high-calorie oral supplement by Abbott Nutrition.
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