Foods that thicken, foods that loosen

These are short lists of foods with a predictable effect, published for a stoma and for a pouch. They are starting points to experiment from, not rules: you will soon learn what is best for you.

Wind, odour and colour

• Wind: baked beans, cabbage and other green vegetables. Fizzy drinks may also increase the amount of wind.
• Odour: eggs and fish are the two usual culprits. Natural yoghurts may reduce both odour and wind, and fennel or peppermint tea may reduce wind.
• Colour: beetroot, tomato or red wine can make output appear blood-stained, which is not a reason to be alarmed.
• Anal irritation, for people with a pouch: coconut, spicy food, nuts, some fruit and food with pips.

Two tips about timing

With a pouch, two of the suggestions are about when rather than what: you may wish to avoid eating and drinking at the same time to cut down pouch activity, and it is worth experimenting with main meal times to regulate it. For a stoma and a pouch alike, start with small, appetising meals at regular intervals and introduce new items gradually — and if something upsets you, try it again after a week or so, and on further occasions, before finally deciding you cannot tolerate it.

Alcohol, and salt

You can continue to drink alcohol, but it may cause dehydration if taken to excess — and beer and red wine in particular may increase output. That puts alcohol on both lists at once: a laxative effect and a hydration cost.

Salt runs the other way. With an ileostomy, extra salt may be required, especially during hot weather or if you have diarrhoea, and two everyday ways to get it are beef extract and crisps. There is a figure attached: you can add up to one extra teaspoonful of salt per day, unless advised otherwise by your GP, because that is the average amount lost per day through a normally functioning ileostomy.

Why the thickening list reads like a beige menu

White bread, white rice, potatoes, tapioca, marshmallows, jelly babies, smooth peanut butter. Almost everything that may slow output down is low in fibre and starchy, and the same names turn up again in the advice on staying hydrated — as foods worth eating when you are losing more fluid than you are taking in. That is not a coincidence. Slower, thicker output is output you lose less water and salt through, which is why one list does two jobs.

It also explains why the other column is such a mixed bag. Beer, red wine and fruit juice are there for their effect on fluid; spicy food and chocolate for their effect on the gut; antibiotics, iron tablets and magnesium antacids because a medicine can loosen output as readily as a meal can. A bad afternoon after a curry and a beer has two candidates in it, not one.

How to actually use these lists

One change at a time, and give it more than one go. If something upsets you, try it again after a week or so — and on further occasions after that — before you finally decide you cannot tolerate it. Introduce new items gradually, in small amounts, alongside a meal rather than on their own.

None of these are prescriptions. They are things people have found useful, and everyone is different, which is the reason for going one at a time rather than rearranging a whole week of meals at once. Two changes on the same day tell you nothing about either.