Dietary Considerations considering the following situations:
Blockage is an obstruction of the digestive tract that may be caused by eating high fiber foods too quickly, or in large amounts, or not chewing thoroughly. Some foods, especially high fiber foods, may tend to clump together to form a mass that is difficult to pass through the intestines. The formation of scar tissue inside the abdomen following surgery can cause portions of the intestinal tract to become more narrow than normal. This can occur particularly with the small intestine and the area in which the stoma is created. If a large mass of fibrous food is passed into the bowel undigested, it could become lodged at a narrowed area in the bowel and result in a food blockage.
Blockage is characterized by cramping abdominal pain, thin watery output or the flow of waste may stop completely, increased odor of stool, abdominal or stomach area swelling, or vomiting.
Foods That May Cause Blockage (High Fiber Foods):
- Corn and popcorn
- Chinese vegetables
- Dried fruit
- Raw fruits
- Raw vegetables
- Seeds or kernels
- Foods with skins/peels
- Meats with casings/skins
- Shrimp, lobster
- Oysters, clams, mussels or other shellfish
Some Tips to Help Avoid Blockage:
- Omit high fiber foods for 6 - 8 weeks after surgery. During this time, the bowel is swollen and the opening is narrower than normal.
- Chew food well. Chewing well makes food easier to digest and move more readily through the intestine.
- When you begin to advance your diet, add fiber foods in small amounts and one at a time. This helps you see how you tolerate these foods. Be certain to chew well.
- Drink plenty of fluids to keep stool soft and easy to pass.
- When eating oranges or grapefruit, throw away the pulp and skin.
- Remove the skins of fruit if you are prone to blockage.
- Eat only the part of asparagus and broccoli that are easy to cut.
- Anything that is too tough to cut is probably too tough to eat.
- Avoid eating the gristle of meat.
- Remove sausage and potato skins if they cause a problem.
- When eating fibrous foods, intersperse with soft foods to help carry the fibrous food through the intestine.
- Corn kernels on the cob can be slit with a serrated knife before eating. Using the serrated edge of the knife, slit along the center of each row. (small plastic knives usually have a serrated cutting edge) As you eat the corn on the cob, you then get mostly the inner softer center of each kernel and the outer hard to digest portion remains on the cob.
What to Do If You Have a Blockage:
- Try taking a warm tub bath to relax abdominal muscles
- Gently massage the abdomen or around the stoma area
- Lie in a knee-chest position
- If stoma is swollen, remove pouch and replace it with a pouch that has a larger stoma opening.
- If able to tolerate liquids, increase fluid intake by sipping small amounts at a time. Gulping fluids too rapidly may push a food mass more tightly together. Sipping small amounts allows the fluid to intermingle with the food mass to help soften and liquefy it to move through.
- Warm to hot fluids tend to sooth and relax the intestine to help food mass move through.
- DO NOT TAKE A LAXATIVE if you have a food blockage.
- If the stoma is swollen or the wafer feels tight around the stoma, remove the pouch and replace it with one that has a larger opening.
Notify your physician if:
- Blockage symptoms persist.
- You are unable to tolerate or replace fluids.
- Signs and symptoms of fluid and electrolyte imbalance occur.
If the blockage persists or if you are nauseated and/or vomiting, go to the Emergency Room. Take your ostomy supplies with you.