Nutritional Guidelines

Dietary Considerations to Patients of Specific Ostomy:

• An ostomy created in the large intestine, or colon, is called a colostomy. As stool moves through the colon, water is absorbed. Therefore stool consistency gets thicker the further along in the colon. A colostomy in the descending or sigmoid colon (the last part of the colon before the rectum), stool may be soft to hard-formed. Often it is possible to resume your normal diet as you advance foods after surgery. It is still important to chew foods well.
• If you have an ascending or transverse colostomy, the stool will have a tendency to be thin to thick liquid. This is because the ostomy is higher up in the intestinal tract and has not gone through the length of the colon to absorb as much water. You need to replace the fluid lost in your stool by drinking adequate non-caffeinated liquids.
• You may notice undigested foods that pass through your body into your pouch. Do not be concerned about these as they were always present in your stool prior to your surgery. It was just not as visible. (It does help you learn just how well you chew your foods.)
• For some people with a descending or sigmoid colostomy, eating certain foods can help the bowel move at a more convenient time. By monitoring what you eat and how much you eat, you may be able to predict when your pouch will fill with stool.
• Most medications are absorbed in the small intestine, so you will probably have no difficulty taking your usual prescriptions and over the counter medications. Always discuss any medications with your physician before using them.
• If you see a medication tablet or capsule in your ostomy pouch, you may not be getting the full benefit of the drug. Discuss this with your physician and pharmacist to see if there is a more easily absorbed alternative.
• Time release medications are not usually recommended for individuals with ascending or transverse colostomies. The shortened length of bowel may not allow complete absorption and decrease the effectiveness of the drug.

Constipation

Constipation can occur postoperatively just as it may have prior to your surgery. As a person grows older the slowing down process of the body can result in constipation. This is not a result of having a colostomy. Constipation occurs when bowel movements do no come as often as normal. Individuals each have their own normal bowel pattern that is affected by activity level, fiber intake, and fluid intake. Some people with a colostomy pass stool several times a day and others pass stool only once a day or every other day. If your stools are occurring less frequently than usual and the stools are hard to pass, then you are probably constipated.

It is important to include adequate fluids and fiber, well-chewed to avoid blockage, in your diet to keep stools soft and easy to pass. Before taking any type of laxative preparations, try increasing fluids and the fiber in your diet.

Foods That May Contribute to Constipation:

Dietary Measures to Help Relieve Constipation:

• Increase fluid intake (fruit juices and water).
• Increase fruits and vegetables (chew well to avoid blockage).
• Include whole grain breads and cereals in diet.
• Try moderate amounts of prune juice, lemon juice in water, or coffee. These foods do not contain fiber, but have been known to help people who are constipated.
• Adequate exercise can also help prevent constipation.
• If you feel the need to take a laxative, consult your physician first.