Eating Well with a Colostomy or Ileostomy

Bowel surgery – unlike surgeries and treatments for most other cancers – does call for extra care and attention with the diet and ways of eating. For some of you the stoma will be permanent. For others, it will be a temporary measure. Regardless of your situation there are many things you can do to ensure you can eat a wide range of nutritious, energising foods. Although there are some differences in how and what can be eaten depending on whether  you have a colostomy or an ileostomy eating healthily and enjoyably is achievable with both. 

The main ‘rules’ for both types of stoma are:

Chew your food well – digestion starts in the mouth
Drink plenty of fluids, around between 1.5 and 2 litres a day
Include salt in the diet
When you are able to, eat enough fibre to lessen risk of constipation
Eat regular meals to get a regular bowel pattern (less likely to be inconvenienced)

Ileostomies are surgical openings at the small bowel to let faeces bypass the large bowel. The main food complaint of those with ileostomies is that, because of the narrowness of the ileum, some foods can get stuck. This may be less of a problem for those with colostomies but it can be an issue for anyone with a stoma. It is advised to eat small mouthfuls, especially of fibre containing foods and meats, and to chew until the food is almost liquid in the mouth. In addition, the first few two months after your operation the area will be swollen and more prone to blockage. You will probably have to restrict the type and amount of foods you eat. After this time the swelling will subside and you will be encouraged to get back to a normal diet, including fibre containing foods, but still being mindful of thorough chewing. When you are ready to start eating a more varied diet, it is a good idea to keep a food diary, adding one food at a time to see how you feel. If you add more than one it can be difficult to know what may be causing a problem, or in fact be fine to eat. Everyone is individual about how they react to foods after a stoma, so it is a case of experimenting and recording your reactions. Over time you should find that you can include most things that you like.


Colostomies are lower down than ileostomies and have an opening at the large bowel to let faeces bypass the rectum. One of the main issues with colostomies is flatulence. In a way flatulence is good, it means the stoma is working well, but it is of course unpleasant. Most people have to figure out with trial and error which foods cause them excess wind. Foods that previously caused wind will probably continue to do so. It tends to settle down somewhat once surgical swelling subsides but it will still be an issue for many. To help avoid wind you should also chew your food well and not talk while eating. This prevents trapped air from causing wind. Keeping a food diary can help you identify foods that cause you problems. It is a good idea to give a suspect food a few ‘tries’ before deciding to cut it out of your diet, especially if it is very nutritious. If most foods in a food group cause you problems discuss this with your GP who may refer you to a dietitian. 


Foods That Can Cause Blockages (by incompletely digested food)

Because of swelling the following foods can cause difficulties just after either surgery, and may be more challenging for those living with an ileostomy. Those with either type of stoma should be encouraged to try small amounts of these foods a few months after surgery as any of them may be absolutely fine for you if thoroughly chewed in small amounts.

Celery, nuts, coconut, mushrooms, sweetcorn, cucumbers, oranges, fruit peels and skin, cabbage, pak choi and other Chinese leaves, nuts, seeds, pineapple, pickles, olives, dried fruit, some of the sturdier leafy greens such as kale and chard (young leaves should be okay).

Food and Drink That Increases Bag Odour

These foods have their own smell when digested matter enters the stoma.

Broccoli, cabbage, asparagus, onions, garlic, peanut butter, strong cheese, eggs, alcohol, cod liver oil, fish, seafood, some vitamins (B ones especially)

Food and Drink That Decreases Bag Odour 

Foods that neutralise odorous foods include: cranberry juice, tomato juice, parsley, fennel tea, buttermilk, live/bio yogurt, kefir

Gas Forming Foods

Any of these foods can cause flatulence but not all of them will for everyone. Try and introduce one of these foods at a time, using a food diary to track your reactions. 

Excess fruit, excess dairy, excess wheat products, nuts, soy, Quorn, carbonated drinks, Champagne, other alcohol but especially beer, beans, cucumbers, radishes, cabbages, onions, leeks, Brussels sprouts, cauliflower

Actions That Promote Wind

Lying down after meals
Swallowing air
Swallowing large amounts of food at once
Using a straw 
Chewing gum and smoking – gas forms with continued chewing and with the ‘style’ of breathing that occurs with smoking
Poorly fitting dentures (not an action of course!)

Foods to Help Constipation

Warm/hot drinks, coffee, fruit and freshly pressed/squeezed juices, vegetables, salad leaves

Foods to Help Diarrhoea

It is very important to replace lost fluids and electrolytes such as sodium and potassium, after a bout of diarrhoea. The colon normally absorbs water and electrolytes from the stool so when the bowel is gone you lose more water. With loose or watery stools it is even more important to keep a good fluid intake, including vegetable juice, strained soups, stock, sports drinks and coconut water (naturally high in potassium; Vita Coco recommended), as well as water. Tea and coffee may worsen diarrhoea.

Bananas, applesauce, white rice, white toast, peanut butter

Foods That May Cause Diarrhoea

Fresh fruit, fruit juices (especially prune, apple and grape), spicy foods, sugar, chocolate, caffeine, sugar substitutes such as Xylitol and mannitol (in gums and sweets)

Other Tips

Regular eating encourages regular bowel patterns: 4-6 small meals may work better for you than 3 normal sized ones. Some people find that having their main meal at lunch and a smaller meal at dinner reduces night output.

Certain substances in food can colour output and bile that can’t be reabsorbed can cause yellow or green stools, especially when you have diarrhoea or rapid bowel action. Beets, broccoli, asparagus, spinach and some meds that settle the tummy can colour or darken the stool.

Don’t use bulking agents unless instructed, but anti-diarrhoeal meds are okay.

Exercise is great for constipation and is of course vital to keeping weight in check.
Last Updated:  September 1, 2013
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35 thoughts on “Eating Well with a Colostomy or Ileostomy

    • Basically things not on the list. With ileostomies it is a very individual thing, which is frustrating as a person with the ileostomy, as well as carers & loved ones. Keeping a food and symptom diary will help to identify the foods that are best. Most people find that they can eventually eat most anything, once the swelling has subsided and everything settles down internally. Chewing well and taking time to eat is often a big help.

    • Hi there. If its going against advice, no. But if the advice was to try gradually increasing fibre, then plain lettuce should be okay. It is always a good idea to try one ‘new’ thing at a time to gauge your reaction. Listen to your body. Different advice for different types of bowel surgery but it is often up to the individual to know when it’s right. If bowel calm with strict low fibre then adding one thing at a time should be okay, with medium fibre a first option. Things like beans and nuts would always be much later. Hope this helps. Best wishes.

  1. Kelly..I have had my ileostomy for 4months now and I’m really confused about vitamin supplements…is fish oil ok to take…also going on my first plane ride since operation..is Dramamine safe to take..thank you for your help

    • Hi Sue. Thanks for your questions.You may have difficulty absorbing any number of fat-soluble vitamins, as well as some minerals so it is best to seek advice from your doctor to make sure you are adequately covered. Here is a list of nutrients that may needed supplementation: http://bit.ly/11tpKHN Fish oil should be okay but eating oily fish twice a week is even better. Regarding dramamine, only the injected form seems potentially problematic but again, just double check with your doctor. Actually your pharmacist would probably have a better idea. Ask pharmacist about both queries. Bon voyage!

  2. Have had an ileostomy for 4 years and would love to have a spinach salad. Can eat nuts and tomatoes without any problem. Just nervous to try a salad. Thanks in advance for your answer.
    Barb

    • Barb, if you are able to handle nuts – and that would’ve been a big step, very daring! – you could think about trying spinach. But before you set your heart on it as a salad maybe see how you go with a small amount wilted down first. Good luck!

  3. Hello Kelly first your site was the only I came across with out front info I just got a colostomy I just got home my wife is doing her best to find simple recipe book to help her. The colostomy will be reversed in 4 months but I am so scared to eat anything but oatmeal and pot soup trying some apple sauce next can you recommend a book to purchase I did not see if you produce one if you do would love to get it, I miss my English muffins thanks for any help here in Virginia Steve

    • Hi Steve. I dont have a book out yet as I work full-time in my ‘all-cancers’ job (I am not a specialist dietitian in GI area), and I don’t know if there are any books. But most people I see find that, under hospital guidance for your own surgery, keeping a food diary and only adding in one new food a day can help keep track of what’s good and not good at present. Don’t be too frightened of the colostomy – it is a good thing! Look at the link to the food fibre list on either the page you commented on, or in low fibre recipes page (can’t remember which page links) to get an idea of what typical fibre counts are and go from there, using guidance from the eat well with… page. Unless you are at risk of a bowel blockage (which the colostomy eliminates pretty much) the amount of fibre you consume is flexible and purely based on your comfort level and allowing the surgery site to heal.Most doctors want patients to move onto fibre as soon as they are able, so please know that fibre is good, but just gently reintroducing at first. Have a look at the low fibre recipe page to give an idea of the range of choice. You may be pleasantly surprised.

  4. A friend of mine who has a loop ileostomy has asked me for help on her diet. I am a raw vegan and do detox juicing. Before I advise her I am doing a large research on the subject. Could you recommend links and people who have researched into this area. It goes without saying all my recommendation would go through her doctors approval

  5. :’) This blog is wonderful. I am 7 years post opt from a bowel reconstruction and I still have lots of issues with my digestive system :’(. For one I am very active and I refuse to not eat fruits and veggies. I want to be healthy. I have learned a lot through trial and error. I can tolerate whole wheat products and one serving of nuts. I ate a spinach salad the other day with grilled salmon. No diarrhea but very smelly gas. Is there something else I could add to my meal to balance things out while eating my slad. Or should I just give up on it?

    • Oh, I wouldn’t give up but perhaps only have such foods that you enjoy but give you unpleasant side effects in the comfort of your own home. Some of us without your surgical issues will have foods that just don’t agree with us on some level but that we love them so much we sacrifice a bit of comfort (or dignity!) to enjoy them. As long as it goes through okay and you aren’t in any lasting distress then I would just suck up that experience. Me and chickpeas don’t really get on but I eat a little now and then because the two-day pain is worth it! Hope you are well otherwise and thanks for your kind opening line :D

  6. Thanks for posting. I just got a colostomy and appreciate the info here. However, I would like to add that its a good idea to take 2g/day of fish oil whether or not you have an ostomy. Fish is the main source of Omega-3 fat in the modern diet. Its very important to balance Omega-3/6 intake at 1:1-2. Most Americans eat 1:20 mostly due to rancid polyunsaturated fats in vegetable oils. No doubt its harder to absorb nutrients if your ostomy is in your small intestine, so it may be a good idea to consume even more.

    • I agree with you about omega 3 fatty acids. We prefer people to obtain it from oily fish rather than supplements as there are some who shouldn’t be advised to take it in supplement form. But yes, most of us have far too much 6 and not enough 3. Our processed diets and not enough fish are largely to blame.

  7. my mom just got her eliostomy,, not sure what she can eat that will give her energy.. she has no desire to eat.. she isn’t happy with her ostomy.. she has been battling chromes desiese sine 1995…

  8. Hi, I am 8 1/2 years post op after a total colonectomy and have an ileostomy. I find I can eat most foods, even rye bread and spelt pasta, but have trouble with quinoa, cous cous, buckwheat and brown rice. I can eat most vegetables, but notice more output when I have green veg, I don’t eat salad leaves apart from spinach (seems easier to chew right down when raw and can eat cooked too). I have the best health since I was 9 yrs old (diagnosed with U.C then) and my immune system is really healthy. So glad I had the op! I have been experimenting with raw foods, but have not found it easy to digest. I have a vitamix blender, so use that to make juices and smoothies and add in the foods that are hard to digest, such as flaxseeds, sunflower/pumpkin seeds, raw oats, nuts etc. I have found blending the easiest way to get those foods into my diet as I think I really need them. I also supplement with Vit B, D and C and iron and a few other trace elements all in liquid form so I know they can be easily assimilated. Good luck to anyone else in a similar position and thanks for this resource.

  9. Hi Kellie my husband just got his colostomy, doctor just told him that he can start having sips with coffee or juice, what juices is easy on him right now?

  10. Hello, my husband has just been given a stoma bag (he is still in hospital). I am very nervous about what food he can and cant eat, I feel I am having to hunt for any information and then its conflicting? for example, no fruit or vegetables for 3/6 months and then I am told to bring in tinned fruit? I feel totally confused and worried that I get it wrong, To add to the problems my husband is a very fussy eater – many foods he simply cant eat – strictly a meat and two veg man! I would appreciate any help at all. I have your blog very helpful. thank you

    • I am afraid I can’t – by law – give individual advice but I do hope you find the low-fibre pages helpful. Three – 6 months does sound quite a long time so I would double check this with the doctor as much of how to proceed with food is down to individual reactions. People vary greatly in when, what and how much they can introduce. We recommend one new thing at a time and keeping a food diary to track the successful and the not-so-successful. Do get clarification from your treatment team as to how rigid one must be with adding produce

  11. I just had an ileostomy on Jan 17! I am a private woman and this has tore my world upside down an I am an emotional basket case. I cant seem to get my bowels to straighten out. I have had a horrible time.

    • I know it doesn’t seem likely right now, but it will all settle down. Gradually. The vast majority of people eventually find that although it has been an invasive & unpleasant event, once it all settles in that they feel much better and can enjoy food once again. All best wishes, Kellie

  12. Just hang in there, I had a terrible time at the beginning too. Be good to yourself it is a huge adjustment. I am a very private person too. I have had my ileostomy since 2006. We are friends now, it took awhile. Don’t underestimate the power of prayer. I will send one up for you tonight.

  13. I had a colostomy six and a half years ago. I was of course warned to take things slowly and see how various foods etc., affect me. I have had absolutely no problems at all (except occasional but infrequent gas production!) and I hope that others can draw strength from my comments. Think positively, be sensible and try to carry on with your life as normally as possible. It has certainly worked for me.

    • That’s great news, Gordon. So many *newbies* are naturally concerned that things will never be normal for them, but your words happily prove otherwise. All best to you and thanks for commenting.

  14. hi kelly, im 3weeks post ileostomy (loop) which is a temporary one, i would like to say that for me its been like a miracle . the pain i was in for months beforehand was absolute agony, and the day after my op iv,e had none of the pain i had before it . some post op pain but thats been a doddle to what i suffered before. iv been eating pretty much what i like since the day after the op, but salad stuff im testing out in very small amounts at a time to see how i react, so far so good. it is so great to be able to eat again and not be in pain each time, i missed being able to eat well and im making up for it now.my stoma (hetty)is my best friend as she has given me the will to live back. i was so depressed and ill and in such pain before, now i feel like a new woman. so please anyone try not to be upset if you need this op, ok its not the most pleasant thing in the world to have but it really could change your life for the better.best wises to fellow ileostomyist.xx

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