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Patient Instructions

You had an injury or disease in your digestive system and needed an operation called an ileostomy. The operation changed the way your body gets rid of waste (stool, feces, or poop).

Now you have an opening called a stoma in your belly. Waste will pass through the stoma into a pouch that collects it. You will need to take care of the stoma and empty the pouch many times a day.

People who have had an ileostomy can usually eat a normal diet. But some foods may cause problems. Foods that may be fine for some people may cause trouble for others.

Your pouch should keep in any odor from your output. You may notice more odor when you empty your pouch after you eat certain foods. Some of these foods are onions, garlic, broccoli, asparagus, cabbage, fish, some cheeses, eggs, baked beans, Brussels sprouts, and alcohol.

Doing these things will keep down the odor:

• Eating parsley, yogurt, and buttermilk
• Keeping your ostomy devices clean
• Using special deodorants or adding vanilla oil or peppermint extract to your pouch before closing it. Ask your doctor or nurse about this.

Control gas, if it is a problem:

• Eat on a regular schedule.
• Eat slowly.
• Try not to swallow any air with your food.
• Do not chew gum or drink through a straw. Both will make you swallow air.
• Do not eat cucumbers, radishes, sweets, or melons.
• Do not drink beer or soda, or other carbonated drinks.

Try eating 5 or 6 small meals a day.

• This will help keep you from getting too hungry.
• Eat some solid foods before you drink anything if your stomach is empty. This may help decrease gurgling sounds.
• Drink 6 to 8 cups of fluids every day.
• Chew your food well.

It is OK to try new foods, but try only 1 at a time. That way, if you have any trouble, you will know which food caused the problem.

Unless you are underweight because of your surgery or any other illness, try not to gain weight. It is not healthy for you, and it may change how your ostomy works or fits.

When you feel sick to your stomach:

• Take small sips of water or tea.
• Eat a soda cracker or a saltine.

Some red foods may make you think you are bleeding.

• Tomato juice, cherry-flavored drinks, and cherry gelatin may make your stool reddish.
• Red peppers, pimientos, and beets may show up as small red pieces in your stool.
• If you have eaten these, you are most likely OK. But, call your doctor or nurse if the redness does not go away.

Call your doctor if

• Your stoma is swelling and is more than a half inch larger than normal.
• Your stoma is pulling in, below the skin level.
• Your stoma is bleeding more than normal.
• Your stoma has turned purple, black, or white.
• Your stoma is leaking often.
• Your stoma does not seem to fit as well as it did before.
• You have a skin rash, or the skin around your stoma is raw.
• You have a discharge from the stoma that smells bad.
• Your skin around your stoma is pushing out.
• You have any kind of sore on the skin around your stoma.
• You have any signs of being dehydrated (there is not enough water in your body). Some signs are dry mouth, urinating less often, and feeling lightheaded or weak.
• You have diarrhea that is not going away.

Standard ileostomy - diet; Brooke ileostomy - diet; Continent ileostomy - diet; Abdominal pouch - diet; End ileostomy - diet; Ostomy - diet

Cima RR. Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M. Friedman LS, Brandt LJ. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 110.

Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 50.

Khatri VP, Asensio JA, eds. Subtotal colectomy/panproctocolectomy and j-pouch reconstruction. Operative Surgery Manual. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2003:chap 35.

Scriver G, Hyman N. Ileostomy construction. Ileostomy construction. Operative Techniques in General Surgery. 2007 Mar;1: 43-49.

Updated by: George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.