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What’s the difference in nutrition advice for ileostomies and colostomies?

Have you wondered if everyone with a bowel stoma has to eat the same? We’ve put together the main differences in nutrition advice for those with ileostomies and colostomies. You can also read more in our Ostomates Kitchen Nutrition Guide.

Note: This advice doesn’t replace tailored diet advice from your healthcare professional.

Fruits, vegetables, and higher-fibre carbohydrate foods

If you have a colostomy, you’ll likely be better able to tolerate fibre from fruits, vegetables, and higher-fibre carbs, e.g. wholemeal pastas and couscous. Even with an ileostomy, it’s still recommended to aim for 5 portions of fruits and vegetables a day, alongside higher fibre ‘brown’ carbs, but to adjust this to your tolerance.

Fibre is important because it helps reduce constipation which can lead to excess wind, pain, and potential blockages. Alongside fibre, fruits, and vegetables also contain vitamins essential for our immune system and help us heal, e.g. from flare-ups of inflammatory bowel disease.

‘Trigger’ foods and drinks

Compared to an ileostomy, having a colostomy means you have the use of more of your bowel, which allows more time for digestion. Therefore, you’re less likely to be hypersensitive and need to reduce particular ‘trigger’ foods and drinks that cause symptoms (pain, higher water losses). Below are some dietary triggers you may wish to reduce. You might like our Ostomates Nutrition Guide for a larger list.

  • Nuts (not ground or nut butters)
  • Fibrous vegetables like broccoli stalks and cooked mushrooms
  • Greasy fried foods
  • Alcohol

Salt

The electrolytes sodium (salt), magnesium, and potassium help us remain hydrated, plus allow our muscles and nervous system to function. Without enough electrolytes you may become unwell and need to visit a hospital.

The more of our colon we have in use, the more electrolytes we can absorb, which is why not everyone with a colostomy needs to add salt to food. If you have an ileostomy, or an ‘ascending/right colostomy’, it’s advisable to choose saltier foods and/or add between 0.5-1tsp of salt across the day to your foods.

About the advice and opinions of our bloggers

We hope you enjoyed this article from our guest blogger. They are expressing their views or knowledge on a topic because of their experience & background. Some of the opinions expressed may not reflect the views of Fittleworth or your NHS professional.

It goes without saying, but this is not clinical advice. Each person will have an individual set of medical factors to consider. So please do not to make significant changes to your diet, exercise or treatments before consulting with an NHS professional.

Laura Coster

Laura Coster is a Registered Dietitian who is passionate about helping people feel confident in managing their health and find joy through what they eat.

She has worked in the NHS advising people at various stages of their stoma journey and continues to help promote gut health to all.