• Reference Number: HEY-1380-2023
• Departments: Dietetics, Nutrition Support
• Last Updated: 31 July 2023

Introduction

A colostomy is made by surgically bringing part of your large bowel (colon) through your abdominal wall, to form an opening on the surface of your skin.

The surgeons will advise you when you can start to eat and drink after your operation. Usually you will start with soft foods and should be able to progress to a normal, healthy diet.

There is generally no need to avoid foods with a colostomy unless you find they cause undesirable symptoms.

The aims of this diet sheet are:

• To advise on healthy eating habits with a colostomy
• To help you deal with common colostomy issues
• To provide dietary advice if your appetite is poor

What to do if your appetite is reduced post-operatively

Following your surgery, you may experience a reduction in your appetite.    If this is the case, the following measures may help:

• Eating small amounts more frequently
• Fortifying meals with foods high in calories such as full cream milk, cream, cheese, butter, jam, sugar.
• Ensuring protein rich foods are included at each meal to aid healing these include meat, fish, cheese, milk, yoghurts and vegetarian alternatives such as Quorn, Tofu and tempeh.
• Including high calorie snacks such as biscuits, cakes, crisps, cheese and biscuits, yoghurts, mousses, milk puddings.
• Including nourishing drinks such as milk and milkshakes.

If you are struggling to meet your requirements with food, alone your medical team/dietitian can prescribe nutritional drinks/products to increase your intake.

Eating following surgical recovery

Once your colostomy is working and you are confident with its function, you should be able to reintroduce food with the aim of a healthy balanced diet as outlined in The Eatwell Guide.

Fruit and vegetables (green section)

 Excellent source of vitamins and minerals

• Aim for five portions per day, 1 portion = 80g.
• If some fruit and vegetables upset you aim to stick to lower fibre varieties such as carrots, swede, squash, courgettes, cooked spinach, cauliflower, broccoli, tinned fruits, mango, melon, peeled apple or pear, stewed fruit.

Starchy foods (yellow section)

• Provide energy, vitamins and fibre.
• Includes breads, breakfast cereals, potatoes, rice, pasta and other grains.
• Should make up a third of what you eat and be the basis of each meal.
• Starchy foods are reported to help thicken stool and reduce bowel frequency.

 Beans, pulses, fish, eggs, meat and other proteins (pink section)

• A good source  of protein, vitamins and minerals.
• Aim for 2 portions of fish per week if eaten– 1 oily, 1 white.

Dairy and alternatives (blue section)

 Great source of calcium, protein and vitamins.

• Some conditions of the bowel increase the risk of bone thinning and as such a daily calcium intake of 700mg is recommended.
• If you are using dairy alternatives check they are fortified with calcium.

Oils and Fats (purple section)

• Try and choose healthier unsaturated fats usually from plant sources e.g. rapeseed oil, sunflower oil or olive oil.
• Use in sparing amounts.

Foods rich in fat, salt and sugar

• Includes foods such as cakes, biscuits, crisps, chocolate, confectionary, butter and ice cream.
• Enjoy as a treat in small amounts.

 Fluids

• Aim for 6-8 glasses/cups or mugs per day.

Foods and Associated Symptoms

Some foods can be associated with bowel symptoms.  Please be aware that this can be very individual and what affects one person may not affect another.  If you are unsure about a food try in small amounts to assess tolerance.

Symptom	Associated Foods
Loose motions	Spicy foods, fruit juices
Wind, bloating and gas	Brussel sprouts, cabbage, broccoli, cauliflower, beans and pulses, onions and garlic, leeks, chewing gum, fizzy soft drinks, beer, lager, sparkling wine
Excessive odour	Fish, onions, garlic, eggs, brussel sprouts, cabbage, broccoli and cauliflower

Constipation

If you experience constipation, try to increase fibre content by choosing:

• Wholemeal breads and pasta
• Wholegrain cereals e.g. wheat biscuits, porridge, bran flakes
• Increasing fruit and vegetable intake

Fibre acts by absorbing water to make the stools softer, so it is very important to drink plenty of fluids: at least 6-8 cups/glasses/mugs a day

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Dietetic Department on  tel no: Hull Royal 01482 674490 Castle Hill: 01482 461941, Queens Centre: 01482 461135

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.