Ileostomy Diet: Avoiding Common Complications 

As an individual living with an ileostomy, it is important to focus your diet to ensure adequate nutrition while your colon heals and support your colon health in the future. Your diet will most likely be more restrictive in the first 4-6 weeks following surgery and then you may be able to reintroduce more foods. Always listen to your healthcare provider when it comes to deciding on what foods to include in your diet.

Ileostomy diet after surgery

1. Right after the surgery you might find the following recommendations useful:

   1. Drink a lot of water to avoid dehydration and constipation. An amount of water that would be considered sufficient depends on such factors as your activity level, the climate you live in, the medications you take, and more. Consult your doctor before deciding how much water to drink¹.
   2. Favor small regular meals over large sporadic meals. Don’t eat too much in the evening. This will help limit bowel movements at night¹.
   3. Eat a low-fiber diet. A low-fiber diet may help prevent cramping ,bloating and other digestive symptoms¹.
   4. Favor soft, bland foods¹.
   5. Cut food into small pieces and make sure to chew well before swallowing². 

Ileostomy diet after 6 weeks

Exercise caution when reintroducing foods intro your diet. Always consult a healthcare professional when considering any changes.

1. When you add foods back into your diet, reintroduce them one at a time and monitor your body’s reaction. The goal is eating the way you did before surgery. However, if some food items cause unpleasant digestive symptoms, you may need to eliminate them. For this reason, consider how you feel after reintroducing foods: watch out for gas, bloating and changes in output.
2. If a specific food causes discomfort, remove it from your diet for a few weeks, then try consuming it again.
3. It’s a good idea to keep a food diary and keep track of how you feel after meals.

Ileostomy diet and ensuring proper nutrition

People with ileostomies are believed to be at a higher risk of nutritional deficiencies, specifically iron, B vitamins, magnesium and folate². 

Taking a supplement may be beneficial if you have a deficiency. Talk to your healthcare provider about getting a blood test and establishing whether or not you need to supplement or adjust your diet (for example, to include more protein).

Recommended foods for people with ileostomy*

The following lists includes examples of foods that are considered bland and low-fiber*. This list in not exhaustive.

*Low-fiber options like idli, poha, upma, boiled arhar dal (strained), and khichdi (with minimal spices) can be good options initially.

Avoid raw salads, spicy achar, deep-fried snacks, high-fat gravies, and fibrous vegetables like bhindi (okra), mooli (radish), or baingan (eggplant) if they cause discomfort.

Roti made from refined flour (maida) or well-cooked suji (semolina) preparations may be easier to tolerate than whole wheat or millet-based items in the early stages.

**Always follow your doctor's recommendations first. Monitor how you feel after consuming different foods. No two people are alike and tolerance levels can vary. If you experience diarrhea, bloating, constipation or other unpleasant digestive symptoms after consuming certain foods, exclude them and see how you feel.

Avoiding common problems

Some of the common problems with ileostomies have been linked to certain foods. Note how you personally feel after consuming these and make decisions accordingly.

*Some traditional Indian remedies or herbal concoctions may not be suitable post-surgery. Always consult your healthcare professional before including them in your diet.

Odor

Potential dietary causes for odor include onions, garlic, brussels sprouts, broccoli, cabbage, cauliflower, various beans, asparagus, eggs and strong cheeses.

Wind

Foods that may cause wind include onion, garlic, legumes, e.g. beans, lentils and peas, soda and beer.

Loose stools

Diarrhea can be caused by spicy foods, high fiber foods, fried foods, alcohol, fruit juices.

FAQ:

What is the best diet for ileostomy?

Bland, low-fiber, and well-cooked foods (such as soft rice dishes, cooked vegetables, and lightly spiced meals) are usually recommended to people with ileostomy. Avoid raw foods and heavy spices initially.

What is the rationale for a low residue diet in the patient with an ileostomy?

A low-residue diet is designed to reduce the amount of undigested food—or “residue”—that remains in your digestive system. This residue contributes to fecal bulk (the solid material that makes up your stool). By minimizing residue, the diet helps lower the number and volume of bowel movements, which is especially helpful after ileostomy surgery. It includes easy-to-digest foods like eggs, white rice, refined flour, seafood, meat, and poultry. At the same time, it limits dairy, high-fiber foods such as raw vegetables, legumes, and whole grains, as these are harder to digest and can increase stool output.

References:

1. Memorial Sloan Kettering hospital. Diet Guidelines for People with an Ileostomy, 2022. Retrieved from: https://www.mskcc.org/cancer-care/patient-education/diet-guidelines-people-ileostomy

2. Alberta Health Services. Eating Well after Ileostomy Surgery, 2024. Retrieved from: https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-eating-well-after-ileostomy-surgery.pdf

3. E. Cunningham. Are low-residue diets still applicable? Journal of the Academy of Nutrition and Dietetics, 2012. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/22709819/