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By Ellyn Mantell

From the time I can remember, constipation was always an issue for me. I assumed I was doing something wrong to cause it. It turns out that I was born, like so many, with a redundant foot of bowel, which in layman’s terms, means that my colon was not only oversized, but a portion of it went in the wrong direction. Here is what I mean…the colon or large intestine ascends on the right side (ascending colon) and goes across the abdomen (the transverse colon) and descends the left side (the descending colon.) That is exactly the path that stool takes in its journey to leave the body. My redundant foot of bowel meant that the transverse colon actually went up at the connection to the descending colon, for a foot, before heading downward, so stool had to travel against gravity before leaving my body.

My first barium enema was when I was 10 years-old, and although we didn’t know what the problem was, I was always told at that time, and every subsequent test, that my sluggish bowel would be an issue for me, (and it truly was, until my ileostomy 6 years ago). So, it came as no surprise that I was also told, each colonoscopy or c-t scan, that I had severe diverticulosis, which could become diverticulitis, a problem that often requires medical intervention.

The diverticula are small sacs that form along the mucosal lining of the colon, often due to straining to move stool through the intestinal tract, which puts pressure on the intestinal wall (which causes the bulging). This issue can worsen with age, medications and other causes of constipation. If the diverticula are inflamed or rupture, serious infection can result, which then is called diverticulitis.

While diverticulosis doesn’t cause discomfort, diverticulitis can be terribly painful, cause fever, constipation or diarrhea, nausea and fatigue. Several in our Ostomy Support Group have had resections of their colon and ostomies due to diverticulitis. Some choose to be reversed after the several weeks of healing necessary to allow the connection in the intestine to do its job. Others choose, instead, to live with their ostomy, which offers them freedom from constipation.

There are ways to avoid diverticulitis, and they are manageable for most. Eating a high-fiber diet rich with fruits and vegetables and whole grains is a great place to start. You may remember that I have also mentioned that is a smart way to enhance our immune system, which may help fight Covid-19. Add more fluids, and if possible, pitted watermelon, for an extra kick of fluid. These tips will soften waste and help it pass more quickly through your colon. That may reduce the risk of diverticula becoming inflamed. Also, exercise and maintaining a healthy weight are very helpful.

Many physicians recommend reducing red meat; some used to say avoid nuts and seeds, although that restriction seems to have changed. As I tell others with an ostomy especially those with an ileostomy, if you eat nuts and seeds and fresh fruits and vegetables, which are healthy and filling, please chew, chew, chew, since that is the best way to avoid inflammation or a blockage.

Many medications can impact motility of the bowels, so be mindful to changes when you add or delete medications, and please address with your physician any concerns. And most important, if you notice any changes, pain, distention, nausea, vomiting or generalized discomfort in your abdomen that has you concerned, do not wait. Speak with your physician and consult UOAA’s blockage card and don’t be hesitant to go to the Emergency Room if needed. Much can be done to not only make you feel better, but to prevent a manageable situation from becoming extremely serious!

Ellyn Mantell is a UOAA advocate and Affiliated Support Group leader from New Jersey. You can follow her personal blog at morethanmyostomy

Chances are you will be able to return to your normal diet not too long after your operation. It is good to keep in mind that foods that were good and healthy for your body before your operation are still good for you. A well-balanced diet is recommended for most individuals.

Although your ostomy nurse more than likely will give you tips and advise you on your health and diet, here are some alternative helpful suggestions for maintaining a proper diet after your surgery.

Follow the advice of your surgeon, dietitian, and/or WOC nurse regarding any dietary restrictions right after surgery or on a long-term basis.

Start Small

Ease your way back to proper nutrition with small quantities of food. It is recommended to eat 3 or more times per day in smaller quantities and portions. Try to eat these meals at the same time each day to help regulate bowel movements. Eating more frequently and in smaller quantities will help aid your body’s ability to process food and help with unnecessary gas.

For the first several weeks after your surgery, eating simple and bland soft foods will be easier to digest. Keep in mind that chewing your food well also adds to the ease of digestion – the more broken up it is, the easier it will be to process. Take your time with introducing high-fiber foods back into your diet as these will be harder to digest and can cause blockages. Ileostomates are often encouraged to avoid high-fiber foods to prevent risk of obstruction. Always follow the advice of your surgeon, dietitian, and/or WOC nurse regarding any dietary restrictions right after surgery or on a long-term basis.

If you are trying new foods, it is advised to try them slowly and one at a time. This will help you to have a better understanding of how your body works with the new foods and if any will cause excess gas, constipation, strange odors, or diarrhea. Slowly incorporate them into your diet and make note of how your body responds to them. Remember that every body is different and what affects someone else may not affect you in the same way. This is why it can be helpful to keep a journal or diary of how your body responds to different foods.

Drink Lots of Liquids

It is important to drink lots of liquids with an ostomy. If you have an ileostomy, more specific ileostomy dietary guidelines will be helpful. Dehydration can happen as you lose more fluids daily after an ileostomy, due to the fluid not being reabsorbed into the large intestine. Make sure to hydrate even more on hot and humid days or if you are participating in active sports. (Sports drinks and other high electrolyte drinks can help with this.)
Coffee and tea are fine to drink, but water and juices are still better sources of liquid, so be careful not to use coffee or tea as a substitute for water.

Can I Drink Alcohol With my Ostomy?

Alcohol is fine in moderation, you may want to try one drink (or even a half) and wait and see how it affects your body. Like other carbonated beverages, beer may cause extra gas and uncomfortable bloating but every body is different and what affects one person may not affect you in the same way.

Ostomy Problem Foods

Even though you can still enjoy most of the foods you loved before surgery, there are some foods to be aware of after your ostomy, specifically foods that are hard on digestion and can cause blockages. The following is a list of common foods that can cause problems, as they don’t break down easily:

  • Nuts
  • Seeds
  • Popcorn
  • Dried fruit
  • Mushrooms
  • Raw-crunchy vegetables

Eat these foods in small quantities and be sure to chew them well. If you think you have a food blockage, you should call your doctor or ostomy nurse. Having an ostomy certainly doesn’t mean you have to completely change your diet. By steering clear of a short list of problem foods and making sure to stay hydrated, you can get back to enjoying the foods you love.

To learn more about proper nutrition with an ostomy, visit Coloplast Care online.

Follow the advice of your surgeon, dietitian, and/or ostomy nurse regarding any dietary restrictions right after surgery or on a long-term basis.

Editor’s note: This educational article is from one of our digital sponsors, Coloplast. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.