Which food or drink would the nurse instruct a client with a new colostomy to avoid because it produces large amounts of gas?

This information describes dietary (eating and drinking) guidelines to follow while your colon is healing. It also explains how to manage common side effects of having a colostomy.

General Eating and Drinking Guidelines

Follow these guidelines for the first few weeks after your surgery. This will help keep you comfortable while your colon heals.

• Eat small meals often. Try to have 6 small meals throughout the day instead of 3 large ones.
• Eat slowly and chew your food well.
• Drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids every day.
• Eat mostly bland, low-fiber foods. For more information, read the “Recommended foods” section.
• When you add foods back into your diet, introduce them 1 at a time. For more information, read the “Adding foods to your diet” section.

Before you’re discharged (released) from the hospital, a clinical dietitian nutritionist will talk with you about these guidelines. After you leave the hospital, your doctor and an outpatient clinical dietitian nutritionist will help you as you go back to following your usual diet.

Recommended foods

It’s best to eat mostly bland, low-fiber foods for the first few weeks after your surgery. Bland foods are cooked, easy-to-digest foods that aren’t spicy, heavy, or fried. Eating bland foods will help you avoid uncomfortable symptoms, such as:

• Diarrhea (loose or watery bowel movements)
• Bloating
• Gas

The following tables include examples of bland, low-fiber foods. If you have questions about foods not listed in these tables, call 212-639-7312 to talk with an outpatient clinical dietitian nutritionist. You can reach a staff member Monday through Friday, from 9:00 a.m. to 5:00 p.m.

* If you have diarrhea after having these products, try non-dairy milks, lactose-free cheese, or lactose-free yogurt instead.

** When trying eggs, start with a small amount (such as 1 egg). Eggs may cause a bad odor (smell) when you open your pouch.

* When trying fish and nut butters, start with small amounts. These foods may cause a bad odor when you open your pouch.

Some vegetables may cause gas or a bad odor for some people. If a certain vegetable causes you to have gas or a bad odor, don’t eat it. For more information, read the “Guidelines for Managing Common Problems” section.

Some fruits may cause discomfort for some people. If a certain fruit causes discomfort, don’t eat it. For more information, read the “Guidelines for Managing Common Problems” section.

When eating fats, start with a small amount. Fats may cause discomfort.

Reading Nutrition Facts labels

You can find the amount of fiber in your food by looking at the Nutrition Facts label (see Figure 1). Nutrition Facts labels can help you compare the nutritional information between different foods.

Figure 1. Fiber information on a Nutrition Facts label

Adding foods to your diet

After your surgery, you may have some food intolerances that you didn’t have before surgery. A food intolerance is when eating a certain type of food causes uncomfortable symptoms, such as diarrhea, bloating, gas, or bad odor. Sometimes, food intolerances go away as your colon heals.

When you add foods back into your diet, introduce them 1 at a time. If a certain food causes uncomfortable symptoms, don’t eat it for a few weeks. Then try it again. No 2 people will react the same way to food. You’ll learn through experience which foods, if any, you shouldn’t eat.

For more information, read the “Guidelines for Managing Common Problems” section.

High-fiber foods

Your first follow-up appointment will be about 2 weeks after your surgery. At this appointment, your doctor will tell you if you can start adding high-fiber foods back into your diet. Doing this will help make your bowel movements bulkier (more solid).

When you start adding high-fiber foods back into your diet, do it slowly. Only add 1 food at a time. Make sure you’re also drinking enough liquids. Aim to drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids every day.

Guidelines for Managing Common Problems

This section has guidelines for changing your diet to help manage common problems. You don’t need to follow these guidelines unless you’re having the problems listed.

If certain foods caused discomfort before your surgery, they’ll still cause discomfort after your surgery.

Diarrhea

Diarrhea is having loose or watery bowel movements, having more bowel movements than what’s normal for you, or both. Diarrhea can be caused by:

• Certain foods
• Skipping meals
• Food poisoning
• An infection in your intestine
• Antibiotics (medicines to treat infections) and other prescription medications
• A blockage in your intestine

If you’re having diarrhea, follow these guidelines:

• Contact your doctor’s office. They may give you a medication to help.
• Drink 8 to 10 (8-ounce) glasses (about 2 liters) of liquids throughout the day.
  • Drink sports drinks (such as Gatorade or Powerade) and oral rehydration solutions (such as Pedialyte®), if you can. These drinks will help keep you from becoming dehydrated.
  • If you don’t have these drinks, you can make your own using these ingredients:
    • 4 cups (32 ounces, which is about 1 liter) of water
    • 1 cup (8 ounces) of orange juice
    • 8 teaspoons (40 milliliters) of sugar
    • 1 teaspoon (4 milliliters) of salt
    Put all ingredients into a cup with a lid. Shake well so the sugar and salt dissolve (melt).

• Don’t eat the following foods and drinks. They may cause diarrhea.

  Foods that may cause diarrhea
  Alcohol (such as beer and wine) Bran Broccoli Brussels sprouts Cabbage Caffeinated drinks, especially hot drinks Chocolate Corn Foods with artificial sweeteners (such as mannitol, sorbitol, and xylitol) Fried meats, fish, and poultry Fruit juice (such as prune, apple, grape, and orange juices) Green leafy vegetables High-fat foods	High-sugar foods Legumes (such as cooked or dried beans) Licorice Milk and dairy products with lactose, if you’re lactose intolerant Nuts and seeds Peas Spicy foods Stone fruits (such as apricots, peaches, plums, and prunes) “Sugar-free” canned or dried fruits Tomatoes Turnip greens Whole grains (such as wheat bread)

• Eat more of the following foods. They may help thicken your bowel movements.

  Foods that may help thicken bowel movements
  Applesauce Bananas Barley* Boiled white rice Cheese Creamy nut butters (such as peanut butter) Marshmallows	Oatmeal* Pasta Potatoes without the skin Pretzels Saltine crackers Tapioca White bread Yogurt

  * These foods are whole grains. You can eat them if you’re having diarrhea because they may help thicken your bowel movements.

Constipation

Constipation is having fewer than 3 bowel movements per week, having hard bowel movements, having a hard time passing bowel movements, or all 3. Constipation can be caused by:

• Certain pain medications
• Certain anti-nausea medications
• Not eating enough fiber
• Not exercising enough
• Not drinking enough liquids

If you’re constipated, follow these guidelines:

• Contact your doctor’s office. They may give you a medication to help.
• Drink hot water with lemon or lemon juice, coffee, or prune juice.
• Do light exercise (such as walking), if you can.
• Ask your doctor if eating high-fiber foods or taking a fiber supplement will help.

Gas and odor

For the first few weeks after your surgery, it’s common to have gas in your pouch and a bad odor when you open your pouch. You may have more gas if you had a robotic surgery.

If you’re having problems with gas or odor, talk with your wound, ostomy, and continence (WOC) nurse. You can also follow these guidelines:

• Don’t do these things. They can cause gas.
  • Chewing gum
  • Drinking with a straw
  • Smoking or chewing tobacco
  • Eating too fast
  • Skipping meals
• Ask your healthcare provider if you can take an over-the-counter medication (such as Beano® or simethicone) before meals to help prevent gas.
• Eat less of the following foods. They may cause gas, bad odor, or both.

  Foods that may cause gas, bad odor, or both
  Asparagus Alcohol, especially beer Broccoli Brussels sprouts Cabbage Carbonated drinks (such as soda) Cauliflower Corn Dried beans and peas Eggs	Fish Garlic Grapes Leeks Milk and dairy products with lactose, if you’re lactose intolerant Onions Peanuts Prunes

• Eat more of the following foods. They may help prevent gas, bad odor, or both.

  Foods that may prevent gas, bad odor, or both
  Buttermilk Cranberry juice Kefir	Parsley Yogurt

When to Call Your Healthcare Provider

Call your healthcare provider if you have any of the following:

• Diarrhea and a fever of 100.4 °F (38 °C) or higher
• Diarrhea and you’re vomiting (throwing up)
• Diarrhea that doesn’t stop after 24 hours
• Diarrhea and smelly discharge (fluid), or forceful liquid output from your stoma

If you have questions about your diet, call 212-639-7312 to talk with an outpatient clinical dietitian nutritionist. You can reach a staff member Monday through Friday, from 9:00 a.m. to 5:00 p.m.

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