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Aug 17, 2018

Salad causing loose output - normal or concerning?

This topic is about experiencing loose or watery output after eating salad greens, which is a common concern for people with an ostomy. The person sharing their experience is happy to enjoy salads again but notices that meals with lettuce, spinach, avocado, or other fresh vegetables lead to very loose output in their pouch. They are curious if this is a typical experience for others with an ostomy.

Here are some helpful insights and advice:

1. Loose output with salads is common due to the high water content in raw fruits and vegetables, especially iceberg lettuce, which can thin the stool.

2. Be cautious with foods that might thicken or obstruct:
- Foods with seeds or thick skins like apples, grapes, berries, pineapples, tomato skins, potato skins, corn, spinach stems, and nuts can be problematic if you have strictures or adhesions.
- Some people find spinach can be difficult to pass, and Boston or red lettuce might also be harder to handle.

3. Safer or easier-to-handle salad options include:
- Iceberg lettuce, which is mostly water.
- Tomatoes without skin, very thinly sliced seedless cucumbers, and heartier greens like romaine, kale, or spinach, if well-chewed and tolerated.

4. Chew your food thoroughly and introduce new salad ingredients one at a time to identify any that might cause issues.

5. Stay well-hydrated to help keep things moving smoothly and prevent thick blockages when consuming higher-fiber foods.

6. Consider medications to manage stool consistency or frequency:
- Imodium (loperamide) can be taken with meals to slow transit and thicken output, but adjust the dose as needed.
- An ostomy nurse might recommend stool softeners for consistently thick output.

7. Make dietary adjustments:
- Avoid butter, oils, and salad dressings if they seem to loosen output. Request food to be cooked without added fats.
- If you are on Warfarin, limit intake of vitamin-K-rich dark green vegetables.

8. Practical tips:
- Slice oranges instead of peeling to avoid swallowing large membrane pieces.
- Expect quicker output after eating salads and plan your outings accordingly.
- Experiment with new foods at home before trying unfamiliar buffet items or multiple new ingredients at once.
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