Chapter 10: Problems with Diet
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"Problems? What problems?" The first mention of the word problems to a Colostomist-to-be may be worrying, but there is no need to worry. By problems I mean the common run of the mill conditions that effect everyone more regularly than we wish to admit to regardless of whether you have a Stoma or not. I refer to these as 'The Big Three'. Wind, diarrhoea and constipation.
The Big Three
1. Wind: As a general rule all the foods that caused you to suffer The Big Three before your Colostomy will still cause them in you after the Colostomy.
Wind is embarrassing at the best of times but whereas before you had muscular control over it's discharge, now you do not. Your stoma has no muscles in it whatsoever and despite your best efforts you will not be able to delicately deliver the wind quietly so no one notices. You'll feel it coming just like before but will be powerless to stop it.
For the first few days after the operation you'll be amazed at the quantity of wind you'll pass. Because your bag will be drainable it will have no integral filter so it will be trapped in the appliance until you open the clip and let it escape. I woke up the day after the operation, my bag was near bursting point and I was frankly amazed that I wasn't floating across the ceiling, out the window where a good gust would have blown me across the Atlantic faster than Richard Branson's latest trans-atlantic record bid!
Because of this lack of control and the inevitable embarrassment it will first cause it is best to try and quash the wind at the source.
Certain food causes wind - we've all heard the after effect of baked beans and peas for example. But there are other foods that can be rather windy too like chocolate or beer. It is best to experiment to find out any effects. If a certain food, like beans, does affect you it is best to eat that food in moderation. Don't feel you have to avoid it, just eat smaller amounts.
It is also helpful to eat slowly, making sure to chew food well with a closed mouth so that no air is gulped down with the food. Try to avoid fizzy drinks while eating and for about an hour after the meal. These are a major contributor to flatus.
2. Diahrroea: Spices, onions, fruits, greens, chocolate (especially dark) and beer are all foods that can bring on a bout of diahrroea if consumed in sufficent quantities.
This problem may not necessarily be caused by diet though. Anxiety and emotional stress can often have a softening effect on your motion. To try and combat it spend a little time on a low fibre diet, but not too long.
Once you've had a Colostomy your motion is automatically softer than before as it no longer passes though the rectum. The main function of the rectum is to absorb liquid from the stool to firm it up.
As a guide a Colostomist's motion will have a consistency similar to that of mushy peas out of a tin. However it may be softer or firmer than that depending on how much of your Colon has been by-passed in the operation. Your Surgeon will be able to advise you on this.
If you are suffering from a prolonged bout of diarrhoea it is best to switch to a drainable bag if possible, and the largest size you can get. This will help keep the stoma free of the stool.
If diarrhoea persists consult your GP to have it checked out, but do not take any shop bought remedies without his or her prior approval.
3. Constipation: Celery, sweetcorn, coconut and nuts all help to make stools firm. Eggs and boiled rice help the motion set like concrete.
If you are suffering from constipation try a little gentle exercise. Walking helps to get the bowels moving and with luck it will work the stool out of the system.
Failing that increasing your intake of fruit, or fresh fruit juice, will help to grease the wheels.
Make sure you chew your food properly too, as unchewed food can help firm things up. If you were an Ileostomist you'd be at risk of blocking the stoma if you didn't, that shows how important it is
Reading this you'll probably be wondering what you can eat! No chocolate, sproats, peas, cauliflower, baked beans, spices, alcohol! How can you live like that?
In all fairness I was warned about diet before I had the operation and although I was far from a healthy eater I found the food I was eating was perfectly fine for my Stoma. As far as I was concerned all this about diet was utter cobblers. The only thing that affected me badly was sweetcorn.
But, which foods affect you depends very much on your current diet and your own digestive system.
Until you have healed fully from your operation it is wise to stick to the post-operative diet to help your healing. After that time feel free to experiment as you wish with foods.
It takes anywhere from 16 to 22 hours for food to reach the stoma from being swallowed. So, it is a good idea to introduce new foods one at a time and monitor the effects the following day. If you think one particular food has affected you do not rule it out immediately. Give it up to three goes. If you are then certain it was affecting you try eating small amounts.
Your new dietry restraints are a matter of trial and error. We all have to go through this and hopefully at the end of it you'll have to boycott hardly any foods at all.
Whether foods upset your routine or not it is worthwhile trying to make sure you eat regularly at meal times, eating three meals a day.
You will not be able to stop your stoma working by stopping eating and in the long run you will upset the stoma from working to a regular time pattern, just like your bowels did before the operation.
Once you arrive home you'll undoubtedly feel hungry and dying for some proper food after the 'food' the hospitals have served up. Well, we may mock the food in hospitals for the quality but as far as dietry requirements go they are spot on, and designed to help your recovery.
Even if you are not hungry at meal times it is important that you at least try to eat something. You need many more calories than before the operation to help the healing process, and to build up your strength. Remember you've had a major operation.
Glucose drinks are very helpful in helping you to build up your strength. Try adding glucose to milk or fruit juice (use about 20g glucose per 400ml of liquid).
You do not have to eat full meals either. Ask your family to make the meal for you or if you are at home alone frozen or fresh ready meals from the supermarket are a Godsend, especially considering they are simply heated up. Even in your weakened state you'll be able to put a lasagne in the microwave.
Regardless of what you eat remember the golden rules. Always chew your food properly, avoid fizzy drinks at meal times and make sure your calorie intake is high.
During the first fortnight of your new Stoma it is best to eat a low fibre diet.
Once you've recovered from your Colostomy be adventurous but at the same time observant. Try to follow your normal diet routine and observe which foods upset your stoma routine. Which foods increased the smell in the bag etc.
Like I said, at the end of the day what effects you and what doesn't will be down to your individual digestive system. The items I've mentioned here are only guidelines. Experiment and enjoy!