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Information about what to eat with an ileostomy

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Who is this information for?

This information is on diet and lifestyle for patients who have an ileostomy (stoma). Stomas are surgically created openings made on the abdomen to divert bowel waste and are used as a treatment for a number of medical conditions including cancer, diverticulitis and inflammatory bowel disease. Approximately 1 in 500 people have a stoma in the UK .

Foods and fluids can have an impact on stoma output volume and consistency as well as symptoms. This diet page discusses strategies to resolve these issues as well as how to eat in the initial weeks following your surgery. It is also important to ensure you remain well nourished and hydrated without the function of your large bowel due to ileostomy formation.

If you have any further questions relating to your diet and ileostomy please speak with a dietitian or a stoma nurse.

General advice for eating with a new ileostomy

  • Eat little and often, with smaller meals with snacks between meals), if you can no longer tolerate a normal meal pattern.
  • Chew your food well.
  • Caffeine can increase the speed at which foods and fluids move through the bowel. Consider choosing decaffeinated drinks.
  • Fizzy drinks and artificially sweetened drinks may cause wind or bloating or diarrhoea.
  • Sip rather than gulp fluids as this can aid fluid absorption.
  • Add salt to your meals.
  • A healthy ileostomy output is between 700 to 1000 ml/day. If your stoma output is less than 1 litre in 24 hours drink freely but do not exceed 2 litres of fluid a day. Avoid drinking large amounts of plain water.
  • If you have a high stoma output, more than 1.5 litres per 24 hours you will need to speak with a healthcare professional. Also see section on fluid hydration

Dietary advice following your surgery

Following the formation of your ileostomy it is recommended to follow a low fibre diet initially (between 4 to 6 weeks). This allows your gut to heal and any swelling to settle. This advice is only to be followed for a short period of time following your surgery.

Fibre is a complex indigestible carbohydrate found in plant foods. The following tables identify foods lower in fibre (foods to choose column)

Food Groups.
 Examples of foods to choose Foods to avoid
Breads, crackers and flour products White bread and rolls.
English muffin.
Crumpets.
Waffles.
Pancakes.
Scones.
White crackers e.g. cream crackers, water biscuits or matzo crackers.		 Wholemeal, wholegrain, granary or seeded bread and rolls 50 50 bread.
Bread or bread products with nuts, seeds, or dried fruit.
Wholemeal crackers, e.g. Ryvita.

Breakfast cereals

Corn flakes.
Frosted flakes.
Rice krispies.
Puffed wheat.
Oat based cereals e.g. porridge.

 Bran based cereals e.g. All Bran, Branflakes.
Wholewheat cereals e.g. Shreddies,
Shredded Wheat, Weetabix.
Cereals containing dried fruit or nuts e.g. granola, muesli, crunchy nut flakes.
Carbohydrates White rice.
White pasta or noodles.
Potatoes without their skins e.g. boiled, mashed or sweet.
Cous cous or bulgar wheat.
Tapioca.
Cassava.
Polenta.		 Brown rice.
Wholemeal pasta or noodles.
Wholegrains e.g. quinoa, pearl barley
The skins of potatoes e.g. jacket potatoes, new potatoes.

Vegetables and salad

Aim for 2 portions per day

 Most well cooked, soft or mashable vegetables without the peel or seeds.
Passata (sieved tomato).
Vegetable based soups.
Florets of broccoli and cauliflower.
Root vegetables.		 Raw or lightly cooked vegetables.
Vegetables with seeds e.g. cucumber or tomato.
Vegetables with skins or husks e.g. peas, sweetcorn, celery.
High fibre vegetables e.g. mushrooms, spinach, cabbage.
Beans, pulses and legumes.

Fruit

Aim for 1 portions per day

 Soft, ripe, peeled fruit without seeds, pips and stalks e.g. banana, peach, plum or apple.
Most canned or cooked fruits e.g. fruit cocktail.		 Citrus fruits.
Berries e.g. blackberries or strawberries.
Prunes.
Dried fruit.
Fruit juice with bits.
Smoothies that contain whole blended fruits.
Nuts and seeds Smooth nut butters.
(e.g peanut, almond).		 All nuts and seeds.
Crunchy peanut butter.
Coconut.
Meat, fish and alternatives Poultry.
Fish.
Eggs.
Quorn.
Slow cooked and lean meats.
Tofu and tempeh.
Meat based soups.		 Tough, gristly meat.
Dairy products Milk.
Hard, soft or cream cheese.
Yoghurt.
Crème fraiche.
Cream.		 Yoghurt with pips, nuts, or seeds.
Cheese with fruit or nuts.
Desserts Custard.
Ice cream.
Sponge pudding.
Milk puddings e.g. mousse, rice pudding.
Crème caramel.
Jelly.
Stewed/tinned fruit.		 Puddings with dried fruit, nuts, seeds or coconut.
Snacks Plain biscuits.
Plain cake and scones.
Chocolate.
Confectionery e.g. fudge.
Sweets.
Crisps.

    Biscuit, cakes or scones made with wholemeal flour.
    Oat biscuits or flapjacks.
    Cereal bars.
    Biscuits, cakes and chocolate with nuts, seeds or dried fruit.

    Drinks

    Smooth fruit juice (no bits) (max 125ml per day).
    Squash.
    Tea, coffee or peppermint or fruit tea.

    Fruit juice with bits.
    Smoothies made with whole fruit.
    Fats All fats in moderation e.g. butter, margarine, oil and cream, Avocado.
    Miscellaneous Jelly jam.
    Shredless marmalade.
    Lemon curd.
    Honey or syrup.
    Gravy.
    Sauces e.g. Ketchup, brown sauce, mustard.
    Soy sauce.
    Salad dressings e.g. mayonnaise or vinaigrette.

    Jam with bits.
    Marmalade with shred.
    Pickles and chutneys.

    Moving on

    After 4 to 6 weeks start reintroducing some fibre back into your diet. Consider introducing small portions of higher fibre foods and increase gradually to tolerance.

    Occasionally high fibre foods can contribute to a high output stoma (more than 1.5 litres per day). This is associated with dehydration and salt deficiency. If this is an issue, continue the low fibre advice for longer and introduce higher fibre foods more gradually and one at a time to assess tolerance.

    Fluid and hydration

    Ileostomies can be associated with high fluid and salt losses and can lead to chronic dehydration. To avoid this aim for 8 to 10 cups of fluid per day (max 2 litres) and consider isotonic sports drinks (lucozade, powerade) or oral rehy-dration solutions (dioralyte) to improve hydration as they contain extra salts that water does not. If you are concerned that your stoma output may be high or have the symptoms below discuss with a healthcare professional including your GP, Dietitian or Stoma Nurse.

    Signs and symptoms of a high output stoma

    • Watery stoma output.
    • Changing your stoma bag more often than usual.
    • Possible leaking of stoma bags.
    • Becoming dizzy when standing up (related to low blood pressure).
    • Having a dry and sticky mouth.
    • Sunken eyes.
    • Passing a reduced volume of urine (that may be dark in colour and strong smelling).
    • Headache.
    • Lethargy, tiredness and feeling low in mood.
    • Cramps in your hands and feet.

    Promoting stoma health

    The following stoma issues have been associated with some foods. Consider eliminating the foods discussed below for a short while (around 1 week) and assess response. Reintroduce the eliminated foods if no difference is observed.

    Foods that can cause gas/bloating:

    • Asparagus.
    • Alcohol.
    • Broccoli.
    • Brussels sprouts.
    • Cabbage.
    • Carbonated drinks (such as soda).
    • Cauliflowe.
    • Corn.
    • Dried beans and pea.

    Foods that can prevent odour:

    • Buttermilk.
    • Kefir.
    • Parsley.
    • Yogurt.

    Foods that can cause loose stool:

    • Alcohol.
    • Bran.
    • Broccoli.
    • Brussels sprouts.
    • Cabbage.
    • Caffeinated drinks.
    • Spicy or fatty foods.
    • Artificial sweetener (sorbitol).

    Foods that can cause blockage or obstruction:

    • Apples skin.
    • Bean sprouts.
    • Cabbage.
    • Corn.
    • Green peppers.
    • Mushrooms
    • Peas.
    • Popcorn.
    • Seeds and nuts.

    Foods that can thicken stool output:

    • Applesauce.
    • Bananas.
    • Boiled white rice.
    • Creamy nut butter (such as peanut butter).
    • Oatmeal/porridge.
    • Gelatin containing foods (jelly babies, marshmallows).

    If you are diabetic you may wish to avoid some of the foods mentioned that are higher in simple sugars.

    Consider using a food diary if symptoms persist.

    Contact details

    Stoma Nurses: uhsussex.stomacaredepartment@nhs.net

    01273 696955: extension 64215.

    The Royal Sussex County Hospital:

    Dietitians: 01273 696955, extension 64290.

    The Princess Royal Hospital:

    Dietitians: 01444 441881, extension 68313.

    This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

    The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.

    Publication Date: April 2022

    Review Date: October 2024

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