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Colostomies

A colostomy is a surgery to divert the large intestine through an opening in the stomach and the placement of a bag that collects your stools. In colostomies, the stool will be thick or even solid and will generally be discharged only at certain times of the day. Once the colostomy has been placed and is well adapted and tolerated, the aim is to follow a balanced and varied diet without any added special dietary restrictions.

WHAT DO WE RECOMMEND?

Eat in a relaxed environment, keeping your mouth closed, and chewing well, to avoid an excessive formation of gas and large pieces of food coming out of the ostomy (chewing too little increases the risk of obstruction).

Fasting or skipping meals increases the elimination of liquid stools and gas.

It may interfere with the correct adaptation of the colostomy equipment.

After the colostomy, fibre-rich foods should be introduced into the diet according to personal tolerance, until a varied and balanced diet is possible. The time of adaptation may vary for each person. Start with a low-fibre diet and use simple cooking methods, whilst gradually incorporating new foods and forms of preparation and cooking methods.

Recommended foods and foods to avoid in a low-fibre diet
Food group Allowed foods Unadvised foods
Refined cereals and derivatives
White rice, rice noodles, rice semolina, wheat pasta (noodles, macaroni, couscous, semolina…), tapioca, polenta, white bread, toast… Maria or butter cookies, gingerbread, muffins, fiber-free breakfast cereals, etc.
All whole grains (with fiber).
Legumes none
Sometimes, if there is a good tolerance, they can be eaten without the skin, passed through a puree. 		All (beans, lentils, chickpeas, fava beans, peas…).
Dried fruit or dried fruit none All (walnuts, hazelnuts, almonds, prunes, dried figs…).
Vegetables and tubers Without skin or seeds and very cooked: potato, carrot, pumpkin, courgette and grated onion.
Sifted tomato.
Strained vegetable broths.
liquefied 		The remaining.
fruits Raw, ripe, without skin or seeds: apple, pear, melon, watermelon, banana, avocado and grapes.
Liquid: all.
Cooked: apple, pear and peach. 		The remaining.
Meat, fish and eggs Everything well cooked: meat, fish, egg, seafood, surimi. Avoid eating meat with tender and/or strong parts.
Milk and derivatives Milk, natural or flavored yogurts, cheeses, custards, custard, curds, ice creams. Milk with fiber, yogurt with pieces of fruit or muesli.
fats All: extra virgin olive oil, sunflower oil, margarine, butter…
Drinks Water, liquefied fruit juices, instant coffee, infusions, soft drinks, isotonic drinks. Natural ground coffee, juice with pulp.
sweets Sugar, honey, jams without peel or chunks, caramels, cocoa powder, chocolate without chunks. Jams and preserves with pieces and peel.
Dressings Salt, vinegar, lemon juice, mild spices and aromatic herbs (chopped and in small quantities), mayonnaise, ketchup, mustard. Strong and spicy spices.

Lactose tolerance should also be checked and it may be necessary to limit milk for the first few days, or use lactose-free versions.

Example of three-day progression menu
Low-fibre, easily digestible diet menu Moderate fibre diet menu Unrestricted diet menu
To have breakfast Decaffeinated tea/infusion/coffee with milk (lactose-free milk). White bread toasts with salt and virgin olive oil and turkey. Tea/infusion/decaffeinated coffee with milk. Bread sandwich with tomato (seedless and skinless), virgin olive oil and turkey sausage. Tea/infusion/coffee with milk. Bread sandwich with tomato and turkey.
Midday Apple in the microwave with cinnamon. Apple in the microwave with cinnamon. Fresh apple or fruit.
To have breakfast Boiled white rice with carrot and cod. Baked banana. Vegetable and cod risotto. Macedon of banana, pear and strained natural orange juice. Fish pan Seasonal fruit macedonia.
have a snack Two Maria type cookies. Two Maria type cookies. A handful of dried fruit.
Dinner Mashed potato and carrot. Grilled chicken breast. Natural yogurt (with or without lactose, depending on tolerance). Cream of potato, onion and courgette. Grilled chicken breast. Cup of yogurt and mint. Vegetable’s soup. Grilled chicken breast with salad garnish. Cup of yogurt with mint.

When having an ostomy, the ingestion of certain types of foods can lead to changes in the consistency of the stool, the appearance of gases, etc. It is important to incorporate foods and preparations little by little to assess their effect and tolerance. The acceptance of each type of food can be very different for each individual. Symptoms that indicate poor tolerance to a specific food are nausea, vomiting, bloating or an increase in the number of more liquid bowel movements through the ostomy. A good alternative is to use a food diary.

Situations and foods to keep an eye on when having an ostomy
Situation/Symptom Food recommendation
DIARRHEA Foods that can cause diarrhea:

  • Spicy foods or spices (chili, curry, pepper, garlic…).
  • Foods rich in fiber or stimulants of peristalsis:
    legumes (peas, fava beans, lentils, beans, chickpeas).
    Bread, pasta or whole grains.
    Raw fruits and citrus juices.
    Raw vegetables and cooked green leafy vegetables (spinach, Swiss chard, cabbage, cauliflower, broccoli…).
    Milk and fresh cheese (due to the lactose content).
    Dry and dessicated fruit.
    Alcoholic drinks, with caffeine or theine.
  • Foods rich in simple sugars: candy or sweets, fruit nectar, simple sugar or honey, chocolate, sugary drinks.
Foods that can help with diarrhea:
bread, toast, non-fiber breakfast cereals, pasta or semolina, oatmeal, rice (all non-wholegrain).
Potatoes/sweet potatoes, boiled carrot.
Ripe banana, baked apple, peach in syrup, quince.
Lactose-free dairy products.
STINK Foods that intensify the smell of stool: fish, eggs, garlic and onion, vegetables (cabbage, cauliflower, pumpkin, broccoli, asparagus), legumes, fermented cheeses. Foods that help reduce the smell of stool: butter, yogurt, lemon juice, orange, blueberries, parsley, mint.
CHANGE IN THE COLOR OF THE FACES Foods that can change the color of the stool: beets, red fruits, iron supplements, tomato sauce, food dyes, licorice. Tip: If the color of the stool appears reddish and none of the above foods have been consumed, you should consult your referring doctor or nursing staff.
GASES Foods that can generate gas:

  • Legumes (peas, fava beans, lentils, beans, chickpeas).
  • Vegetables: cabbage, cauliflower, broccoli, pumpkin, onion, leek, asparagus, radishes, cucumbers, spinach.
  • Nuts and dried fruit.
  • Whole foods
  • Fruit peels.
  • eggs
  • Carbonated drinks
  • Rocafort type cheese.
 Tip: Tolerance to certain foods varies between patients, so it is recommended to avoid only foods that cause gas repeatedly.
OBSTRUCTION OF THE OSTOMY Foods that can cause obstruction:

  • Legumes
  • Nuts and dried fruit.
  • Fruit and vegetables: celery, mushrooms, corn, sprouts, peels and seeds of fruits and vegetables, green salad, raw pineapple, coconut.
  • Popcorn corn.