There is no ileostomy diet

The most common request the UK ileostomy and internal pouch charity receives is for details of a special diet. Why people ask is not hard to understand: after weeks, months or even years of diarrhoea, it is difficult to imagine normal eating being possible again.

The answer is that special diets are not usually necessary once the body has settled and re-adjusted after the operation. A study by Dr John H Cummings, Sheila Bingham and Dr Ian McNeil at the Dunn Clinical Nutrition Centre in Cambridge found that people with ileostomies can and do eat a normal diet similar to that of the general population.

What does change

Two things are different, and both are worth knowing in advance. Output from an ileostomy will never be as firm as a normal stool — normal for an ileostomy is described as a toothpaste-like consistency. And frequency varies from semi-continuous to four or five times a day. Eating a meal triggers the digestive system to make room for it, which is why output often follows a meal.

The mistake worth not making

Do not be too hasty. Many people who have an upset after eating a particular food immediately vow never to try it again, and deprive themselves unnecessarily of something they really enjoy — when trying a small quantity again a few weeks later often produces no adverse reaction at all. From there the amount can gradually increase, avoiding only excess.

The judgement call belongs to the person with the ileostomy and nobody else: provided they are prepared to deal with any liquidity or flatulence, and suffer no ill-effects such as dehydration, they are the only one who can decide whether the enjoyment of eating the offending item outweighs the inconvenience it causes later.

The exception: the first weeks

None of this applies on day one. During the period of post-operative adjustment, many people find that some foods and liquids — especially those with a high fibre content — may cause very liquid motions and may need to be avoided for a time. It is only sensible to add new foods to the diet a little cautiously in the weeks following surgery.

It is after that period that the majority find they can eat a full and varied menu, although some will still find certain items cause liquid motions and flatulence.

The position for a pouch is the same as for a stoma, and it fits in one sentence: neither should affect your digestive process, so try to eat as normally as possible. There may be some restrictions, or some items you prefer to avoid. There is no need for a special diet unless you are so advised by your doctor.