Diet Guidelines for People With a Colostomy

This information describes dietary (eating and drinking) guidelines to follow while your colon is healing. It also explains how to manage common side effects of having a colostomy.

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General Eating and Drinking Guidelines

Follow these guidelines for the first few weeks after your surgery. This will help keep you comfortable while your colon heals.

  • Eat small meals often. Try to have 6 small meals throughout the day instead of 3 large ones.
  • Eat slowly and chew your food well.
  • Drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids every day.
  • Eat mostly bland, low-fiber foods. For more information, read the “Recommended foods” section.
  • When you add foods back into your diet, introduce them one at a time. For more information, read the “Adding foods to your diet” section.

Before you’re discharged (released) from the hospital, a clinical dietitian nutritionist will talk with you about these guidelines. After you leave the hospital, your doctor and an outpatient clinical dietitian nutritionist will help you as you go back to following your usual diet.

Recommended foods

It’s best to eat mostly bland, low-fiber foods for the first few weeks after your surgery. Bland foods are cooked, easy-to-digest foods that aren’t spicy, heavy, or fried. Eating bland foods will help you avoid uncomfortable symptoms, such as:

  • Diarrhea (loose or watery bowel movements)
  • Bloating
  • Gas

The following tables include examples of bland, low-fiber foods. If you have questions about foods not listed in these tables, call 212-639-7312 to talk with an outpatient clinical dietitian nutritionist. You can reach a staff member Monday through Friday, from 9:00 am to 5:00 pm.

Milk and dairy

Foods to include in your diet

  • Non-fat (skim) or low-fat (1% or 2%) milk*
  • Powdered milk*
  • Non-dairy milks (such as soy milk and almond milk)
  • Lactose-free dairy products (such as Lactaid® products)
  • Yogurt*
  • Cheese*
  • Low-fat ice cream or sherbet
  • Eggs**

Foods to limit

  • High-fat milk and dairy products, such as:
    • Whole milk
    • Regular ice cream or sherbet
  • Milk and dairy products with lactose, if you have diarrhea after having them

* If you have diarrhea after having these products, try non-dairy milks, lactose-free cheese, or lactose-free yogurt instead.

** When trying eggs, start with a small amount (such as 1 egg). Eggs may cause a bad odor (smell) when you open your pouch.

 

Meats and proteins

Foods to include in your diet

  • Lean animal proteins, such as:
    • Meat without visible fat
    • Skinless poultry (such as chicken and turkey)
    • Fish*
  • Smooth nut butters (such as creamy peanut butter)*

Foods to limit

  • High-fat foods, such as fried meat, poultry, or fish
  • High-fiber foods, such as dried or canned legumes (beans, peas, and lentils)

* When trying fish and nut butters, start with small amounts. These foods may cause a bad odor when you open your pouch.

Grains

Foods to include in your diet

Low-fiber foods, such as:

  • White bread, pasta, and rice
  • Bagels, rolls, and crackers made from white or refined flour
  • Cereals made from white or refined flour (such as Cream of Wheat®, Rice Chex, and Rice Krispies®)

Foods to limit

High-fiber foods, such as whole grains (whole wheat bread, brown rice, bran cereal, quinoa, and buckwheat)

Vegetables

Foods to include in your diet

Low-fiber foods, such as:

  • Well-cooked vegetables without skins or seeds (such as peeled potatoes, peeled zucchini with the seeds removed, and peeled tomatoes with the seeds removed)
  • Lettuce
  • Strained vegetable juice

Foods to limit

High-fiber foods, such as raw vegetables (except lettuce)

Some vegetables may cause gas or a bad odor for some people. If a certain vegetable causes you to have gas or a bad odor, don’t eat it. For more information, read the “Guidelines for Managing Common Problems” section.

Fruits

Foods to include in your diet

Low-fiber foods, such as:

  • Pulp-free fruit juice (except prune juice and grape juice)
  • Peeled fruits (such as a peeled apple)
  • Canned fruits (except pineapple)
  • Fruits with thick skins. Examples are:
    • Soft melons, such as watermelon and honeydew
    • Oranges without seeds or membrane (the thin clear or white part around each section)
    • Ripe bananas

Foods to limit

High-fiber foods, such as:

  • Raw fruits with the skin. Examples are:
    • Apples
    • Strawberries
    • Blueberries
    • Grapes
  • Prune juice
  • Grape juice

Some fruits may cause discomfort for some people. If a certain fruit causes discomfort, don’t eat it. For more information, read the “Guidelines for Managing Common Problems” section.

Fats

Foods to include in your diet

  • Foods cooked with a small amount of fat, such as olive oil and canola oil

Foods to limit

  • High-fat foods, such as fried foods

When eating fats, start with a small amount. Fats may cause discomfort.

 

Drinks

Drinks to include in your diet

  • Water
  • Decaffeinated coffee or tea
  • Drinks that aren’t carbonated
  • Sports drinks (such as Gatorade® and Powerade®)

Drinks to limit

  • Carbonated drinks (such as soda), because they may cause gas
  • Alcoholic drinks (such as beer and wine)

Reading Nutrition Facts labels

You can find the amount of fiber in your food by looking at the Nutrition Facts label (see Figure 1). Nutrition Facts labels can help you compare the nutritional information between different foods.

Figure 1. Fiber information on a Nutrition Facts label

Figure 1. Fiber information on a Nutrition Facts label

Adding foods to your diet

After your surgery, you may have some food intolerances that you didn’t have before surgery. A food intolerance is when eating a certain type of food causes uncomfortable symptoms, such as diarrhea, bloating, gas, or bad odor. Sometimes, food intolerances go away as your colon heals.

When you add foods back into your diet, introduce them one at a time. If a certain food causes uncomfortable symptoms, don’t eat it for a few weeks. Then try it again. No two people will react the same way to food. You’ll learn through experience which foods, if any, you shouldn’t eat.

For more information, read the “Guidelines for Managing Common Problems” section.

High-fiber foods

Your first follow-up appointment will be about 2 weeks after your surgery. At this appointment, your doctor will tell you if you can start adding high-fiber foods back into your diet. Doing this will help make your bowel movements bulkier (more solid).

When you start adding high-fiber foods back into your diet, do it slowly. Only add one food at a time. Make sure you’re also drinking enough liquids. Aim to drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids every day.

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Guidelines for Managing Common Problems

This section has guidelines for changing your diet to help manage common problems. You don’t need to follow these guidelines unless you’re having the problems listed.

If certain foods caused discomfort before your surgery, they’ll still cause discomfort after your surgery.

Diarrhea

Diarrhea is having loose or watery bowel movements, having more bowel movements than what’s normal for you, or both. Diarrhea can be caused by:

  • Certain foods
  • Skipping meals
  • Food poisoning
  • An infection in your intestine
  • Antibiotics (medicines to treat infections) and other prescription medications
  • A blockage in your intestine

If you’re having diarrhea, follow these guidelines:

  • Contact your doctor’s office. They may give you a medication to help.
  • Drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids throughout the day.
    • Drink sports drinks (such as Gatorade or Powerade) and oral rehydration solutions (such as Pedialyte®), if you can. These drinks will help keep you from becoming dehydrated.
    • If you don’t have these drinks, you can make your own using these ingredients:
      • 4 cups (32 ounces, which is about 1 liter) of water
      • 1 cup (8 ounces) of orange juice
      • 8 teaspoons (40 milliliters) of sugar
      • 1 teaspoon (4 milliliters) of salt
      Put all ingredients into a cup with a lid. Shake well so the sugar and salt dissolve (melt).
 
  • Don’t eat the following foods and drinks. They may cause diarrhea.
    Foods that may cause diarrhea
    • Alcohol (such as beer and wine)
    • Bran
    • Broccoli
    • Brussels sprouts
    • Cabbage
    • Caffeinated drinks, especially hot drinks
    • Chocolate
    • Corn
    • Foods with artificial sweeteners (such as mannitol, sorbitol, and xylitol)
    • Fried meats, fish, and poultry
    • Fruit juice (such as prune, apple, grape, and orange juices)
    • Green leafy vegetables
    • High-fat foods
    • High-sugar foods
    • Legumes (such as cooked or dried beans)
    • Licorice
    • Milk and dairy products with lactose, if you’re lactose intolerant
    • Nuts and seeds
    • Peas
    • Spicy foods
    • Stone fruits (such as apricots, peaches, plums, and prunes)
    • “Sugar-free” canned or dried fruits
    • Tomatoes
    • Turnip greens
    • Whole grains (such as wheat bread)
  • Eat more of the following foods. They may help thicken your bowel movements.
    Foods that may help thicken bowel movements
    • Applesauce
    • Bananas
    • Barley*
    • Boiled white rice
    • Cheese
    • Creamy nut butters (such as peanut butter)
    • Marshmallows
    • Oatmeal*
    • Pasta
    • Potatoes without the skin
    • Pretzels
    • Saltine crackers
    • Tapioca
    • White bread
    • Yogurt
    * These foods are whole grains. You can eat them if you’re having diarrhea because they may help thicken your bowel movements.

Constipation

Constipation is having fewer than 3 bowel movements per week, having hard bowel movements, having a hard time passing bowel movements, or all 3. Constipation can be caused by:

  • Certain pain medications
  • Certain anti-nausea medications
  • Not eating enough fiber
  • Not exercising enough
  • Not drinking enough liquids

If you’re constipated, follow these guidelines:

  • Contact your doctor’s office. They may give you a medication to help.
  • Drink hot water with lemon or lemon juice, coffee, or prune juice.
  • Do light exercise (such as walking), if you can.
  • Ask your doctor if eating high-fiber foods or taking a fiber supplement will help.
 

Gas and odor

For the first few weeks after your surgery, it’s common to have gas in your pouch and a bad odor when you open your pouch. You may have more gas if you had a robotic surgery.

If you’re having problems with gas or odor, talk with your wound, ostomy, and continence (WOC) nurse. You can also follow these guidelines:

  • Don’t do these things. They can cause gas.
    • Chewing gum
    • Drinking with a straw
    • Smoking or chewing tobacco
    • Eating too fast
    • Skipping meals
  • Ask your healthcare provider if you can take an over-the-counter medication (such as Beano® or simethicone) before meals to help prevent gas.
  • Eat less of the following foods. They may cause gas, bad odor, or both.
    Foods that may cause gas, bad odor, or both
    • Asparagus
    • Alcohol, especially beer
    • Broccoli
    • Brussels sprouts
    • Cabbage
    • Carbonated drinks (such as soda)
    • Cauliflower
    • Corn
    • Dried beans and peas
    • Eggs
    • Fish
    • Garlic
    • Grapes
    • Leeks
    • Milk and dairy products with lactose, if you’re lactose intolerant
    • Onions
    • Peanuts
    • Prunes
     
  • Eat more of the following foods. They may help prevent gas, bad odor, or both.
    Foods that may prevent gas, bad odor, or both
    • Buttermilk
    • Cranberry juice
    • Kefir
    • Parsley
    • Yogurt
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When to Call Your Healthcare Provider

Call your healthcare provider if you have any of the following:

  • Diarrhea and a fever of 100.4 °F (38 °C) or higher
  • Diarrhea and you’re vomiting (throwing up)
  • Diarrhea that doesn’t stop after 24 hours
  • Diarrhea and smelly discharge (fluid), or forceful liquid output from your stoma

If you have questions about your diet, call 212-639-7312 to talk with an outpatient clinical dietitian nutritionist. You can reach a staff member Monday through Friday, from 9:00 am to 5:00 pm.

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