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Jul 31, 2013

Stoma Eating Issues - Need Help with Food Intake

This topic is about managing some challenging symptoms after getting a new ileostomy. The person is experiencing constant hunger, high-volume liquid output, and nausea, which can be quite overwhelming. Here are some helpful tips and advice shared by others who have been through similar experiences:

1. **Consult Professionals:**
- It's important to talk to a gastroenterologist, a wound, ostomy, and continence nurse (WOCN), and a dietitian. They can help create a personalized plan and assess any issues with vomiting.
- Ask about managing Short Bowel Syndrome and possible medications like loperamide (Imodium), tincture of opium, or cholestyramine.

2. **Slow and Thicken Output:**
- Try starchy foods like white rice, pasta, oatmeal, mashed or baked potatoes, crackers, bread, pretzels, and tapioca pudding.
- Other options include bananas, applesauce, marshmallows, cheese, milkshakes, and gummy candies.
- Consider using Metamucil capsules or powder, marshmallows, or small doses of Imodium.
- Avoid or limit coffee, drinks with sorbitol or artificial sweeteners, and highly processed deli meats.

3. **Hydration and Electrolytes:**
- Keep hydrated with water and oral rehydration solutions like Pedialyte, Gatorade, Powerade, or even pickle juice to replace lost sodium and potassium.
- Be mindful of dehydration and consider using sports drinks as athletes do.

4. **Meal Pattern and Calorie Strategy:**
- Eat several small meals or three balanced meals with 1–2 protein-rich snacks daily. Keeping a food journal can help avoid long gaps that trigger nausea.
- Smoothies with ingredients like banana, berries, spinach, flaxseed, yogurt, or protein powder can add calories and fiber.

5. **Identify Individual Intolerances:**
- Use trial and error to find what works for you and keep a food/output diary.
- Some people find that milk increases output, while cheese or yogurt is more tolerable.
- Processed foods and preservatives might cause acidic, high-volume output.

6. **Nausea Relief:**
- Peppermint or ginger tea and candy can help settle the stomach between meals.

7. **Skin and Appliance Care:**
- For acidic or watery output, consider using a Stoma Seal with an Eakin Cohesive Seal for better skin protection.
- Peppermint or ginger teas can also help reduce odor and nausea, and marshmallows may reduce pouch gas.

8. **Wound Healing and Nutrition:**
- Focus on high-quality protein from meat, dairy alternatives, or protein shakes, and ensure adequate calorie intake to support tissue repair.
- Liquid multivitamins might absorb better than tablets if you have a short bowel.

9. **Emotional Coping:**
- Try to replace negative thoughts like "I hate this bag" with a more positive mindset, seeing it as a "badge of survival." Adjustment can take time.
- Attend local ostomy-support meetings for shared strategies and encouragement.

10. **Long-term Reassurance:**
- Many people report that drastic hunger swings, food cravings, and erratic output usually decrease after several months as the digestive system adapts.
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