Help from the Lincoln Hospital
The Lincoln County Hospital’s Stoma Care Department is there to offer advice, support and counselling on any type of stoma e.g. ileostomy, colostomy and urostomy. It may be that you have had a stoma for some time but want to know what new products there are on the market. If that is the case then we are happy to arrange samples of different products for you to try. You are able to self refer, meaning you can contact us directly and do not have to be referred via your GP.
The Colorectal/Stoma Care Department is located in Clinic 6, Lincoln County Hospital. Working in the department are Sister Myfanwy (Miffy) Green, Sister Emma Taylor, Sister Alison Smith, Katie Goodman and Amy Lancaster. Their admin support is Janice McNamara. They are open Monday- Friday 8:30 – 16:00. Their telephone number is 01522 573776, this number is also a fax machine. If there is no-one in the office there is an answering machine so please feel free to leave a message and they will return your call as soon as possible. You can also contact us via e-mail, our address is StomaCare.Nurses@ulh.nhs.uk
If you are unable to get to Lincoln County Hospital they also run monthly clinics at Louth County Hospital – first Thursday of the month, and John Coupland Hospital – second Monday of the month. Contact the department at the Lincoln Hospital to arrange to see them at one of these clinics. Above all please remember that they are here to provide a service to you and will endeavour to help you wherever possible.
Diet and the Ileostomist
Diet is a very individual thing, and different foods affect different people in a variety of ways. The main advice is to eat sensibly, be aware of what you eat and the effect certain items have on your bowel specifically; what your ileostomist friend tells you doesn’t suit them may be OK for you. Initially after surgery your bowel and resulting ileostomy need a lot of TLC.
Don’t make it work too hard, too soon.
The surgeon has manhandled it during the op and it takes a while for the muscles to start working as normal (peristalsis). Fluids and diet will have been reintroduced gradually whilst in hospital, and it is best to continue in this gradual fashion once back at home.
Generally, try to eat little and often to begin with. If you eat a big meal, then nothing for 5 hours, then a big meal then nothing again for a few hours, your bowel has to do large bouts of activity, then lay dormant, then another large bout of activity. Far better to give your bowel a small amount of food to work on at more frequent intervals. It needs retraining to start resuming its normal levels of activity.
When you do eat in the early days post surgery, choose food that is easy to digest and does not produce too much wind. This is essentially low fibre food (white bread, past, chicken). Avoid the foods that create excess wind – high fibre foods, beans pulses, green leafy vegetables and the infamous onions. Avoiding these foods in the first few weeks is not to say that you can’t eat them again, but you need to give your bowel time to be able to process them comfortably again – you wouldn’t expect to run a marathon without putting in a bit of training first!!
When you start to reintroduce these food items, do so slowly. Add a different one to your diet each day, then if you do experience any associated problems you will know which food it is attributable too.
Some foods may produce wind in large quantities. It depends on your attitude to the wind and the discomfort you suffer as to how and when you eat those food items. If your desire for baked beans on toast outweighs the troublesome flatulence it produces, then eat the beans. If however the wind produces too much discomfort or embarrassment then avoid this food.
Some foods need to be eaten with caution and in moderation. Primarily these are nuts and sweetcorn. These aren’t digested and how you finish chewing them is how they come out in your stools. Not only can their bulk and sharp edges cause trauma to your ileostomy, but also they can clump together and cause a blockage or obstruction. If this occurs drink plenty of fluids and seek the advice of the stoma care nurse or your GP. When you do eat these foods in recipes etc, chew them thoroughly, and drink plenty of fluids at the same time.
As regards drinking fluids this is of at great importance with an ileostomy. The main function of the colon (large bowel) is to absorb water from the faeces. If your operation has removed or bypassed your colon, then your body is not taking on as much water as it would in somebody with a normal digestive tract. Try to drink on average 3 litres of water a day. Water and fruit juices are a good source of fluid. Caffeine based drinks can actually cause dehydration so do not class these as your main source of fluid. The ileostomist can drink alcohol as long as you are not on any medication contraindicating it. Fizzy drinks (beer, lemonade, lager) can create excess wind and again it is your preference as to which is more preferable – extra wind or a drink down the pub.
Salts are another food group not readily absorbed by the ileostomist. Again it is the role of the colon to absorb much of these salts, and for that reason you need to ensure you add extra salt into your diet. There is hidden salt in nearly all processed and takeaway foods, you can add salt onto your meal or eat a packet of salted crisp a day. All of these will help your body take on the necessary salts.
Above all the main watchword in all dietary advice is EXPERIMENT with food items. Try a different food item when you feel ready for it; see how you and your stoma react to it, and if it suits you keep it in your diet. If it does not agree with you leave it out of your menu, but in a few months try it again. Your bowel may have settled down and recovered more, such that it is now more accepting of this particular food. Individuality is also important – we are all different and no two bowels or their reaction to food is the same. If you don’t try something you won’t know. Variety is also important. Having an ileostomy can be very frightening with the possibility of wind, bags leaking and having to empty offensive faeces, but do try and eat a varied diet including all food groups. At the end of the day you need to be in charge of your stoma and not it in charge of you.
If you have any individual queries or concerns, then please feel free to contact your local stoma nurse or the Lincolnshire Ileostomy Association.