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With a new ileostomy, it is normal to have high ostomy output as your body adjusts to a shorter bowel. This handout explains what you need to know about diet when you have an ostomy.

How do you know if you are having high ostomy output?

Check your ostomy output by measuring the fluids you empty from it.

Before you go home, we will give you a graduated cylinder to measure your ostomy. Write down your ostomy output on the form at the end of this handout.

Normal ileostomy output after the first week is 600 ml per day. Output more than 1200 ml can mean poor absorption and lead to dehydration. If you have output of more than 1200 ml a day for 2 days call your doctor.

Weigh yourself daily at the same time.

Write down your weight on the attached form. If you lose more than 2.2 pounds (lbs.) in 1 week call your doctor.

If you stop urinating or if you do not urinate often.

Before you go home, we will give you a urinal or a urine hat to measure your urine. Write down your urine amount on the form at the end of this handout.

You should be urinating every 3-4 hours and it should be pale yellow to clear. If you are not urinating normally or if you have less than 700 ml of urine a day for 2 days call your doctor.

How can you slow down your ostomy output?

 

Diet Changes

  • Chew food well.

  • Eat low sugar foods and drinks.

  • Eat salty foods and add salt to meals and snacks.

  • Eat smaller more frequent meals and snacks.

  • Drink fluids ½ hour before or after meals, not with food.

  • Avoid alcohol and caffeine.

  • Eat more soluble fiber which forms a gel when mixed with water and slows movement.

    • Good sources of soluble fiber include

      • peeled sweet potatoes

      • applesauce

      • refried beans

      • wheat and oat bran.

      • You may also try adding fiber like Benefiber®, Metamucil®, Nutrisource, or guar gum

  • Try adding these foods that naturally thicken stool to your meals:

  • Applesauce

  • Cream of rice

  • Peanut butter (creamy)

  • Bananas

  • Marshmallows

  • Rice

  • Cheese

  • Mashed potatoes

  • Soda crackers

  • Tapioca

Medicines

For high ostomy output, your doctor may have you take medicine to help slow down output. If you are having high ostomy output, talk to your doctor about increasing or adding medicine to help.

  • Antidiarrheals (take 30 minutes before you eat).

    • Imodium®(loperamide)

    • Lomotil (diphenoxylate)

    • Tincture of Opium

  • Proton Pump Inhibitors (PPI)

    • Nexium®(esomeprazole)

    • Protonix® (pantoprazole)

    • Prilosec® (omeprazole)

    • Prevacid® (lansoprazole)

  • Histamine2-Receptor Antagonists (H2 blockers)

    • Cimetidine (Tagamet®)

    • Famotidine (Pepcid®)

    • Ranitidine (Zantac)® 

Fluids and Electrolytes

You lose sodium, potassium, and water in ostomy fluid, so it is important to stay hydrated. It is common for someone with an ostomy to feel thirsty. But, drinking large amounts of water can make dehydration worse. Nutritional supplements, such as Ensure®, have too much sugar and are not recommended if you have high ostomy output. Drinks like juice and Gatorade® can be too sugary alone.

Ready to Drink Liquids

  • Parent’s Choice Pediatric Electrolyte available at Walmart

  • Pedialyte* available at most retailers

  • Drip Drop* available at Walgreens

 *available in hospital


Recipes

Gatorade G2® Improved

  • 4 cups (32-ounce bottle) Gatorade G2®

  • ¾ tsp salt

 

All Sports® Base Improved

  • 1 ½ cups of All Sport®

  • 3 cups water

  • ½ tsp salt

 

Apple Juice Improved

  • 1 cup apple juice

  • 3 cups water

  • ½ tsp salt

 

Grape or Cranberry Juice Improved

  • ½ cup of juice

  • 3½ cups water

  • ½ tsp salt

 

Ensure® Plus Improved

  • 1 ounce Ensure® Plus

  • 8 ounces 2% milk

 

Chicken Broth Improved

  • 2 cups liquid broth

  • 2 cups water

  • 2 tablespoons sugar

 

Tomato Juice Improved

  • 2½ cups tomato juice

  • 1½ cups water

 

Sugar and Salt Water

  • 1-quart water

  • ¾ teaspoon salt

  • 6 teaspoons of sugar

  • Optional-Crystal Light to taste


Teach Back

  • What is the most important thing you learned from this handout? 

  • What changes will you make in your diet/lifestyle, based on what you learned today?

 

Questions

If you are a UW Health patient and have more questions, please contact UW Health at one of the phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.