Considerations for the First 6 Weeks for Ostomates Following Bowel Surgery:
- Diameter of intestine is narrowed due to swelling post-surgery.
- Until swelling reduces, fibrous foods may have difficulty passing through the narrowed diameter, risking blockage.
- Eat small frequent meals especially if you have a limited appetite.
- Eat a well-balanced diet.
- Eat slowly, and chew food well.
- Drink 8 glasses of fluid/day (total of 2 litres).
What Causes Constipation?
- Low fibre or fluid intake; inactivity; some medications.
What Causes Diarrhea?
- Gastrointestinal viruses, certain medications, or certain foods may contribute to loose stool, with or without a colostomy.
Long-Term Diet Considerations for Colostomates
- Certain foods impact your bowels in terms of consistency, frequency, odour, and gas production. It may be helpful to keep a simple diary. The following lists are general principles, and do not necessarily affect every individual in the same way.
- Do not adjust medications without discussing with your physician.
CONSTIPATION FOR COLOSTOMATES: ACTION POINTS
Making simple lifestyle changes is the first step to preventing and addressing mild constipation. Monitor fluid & fibre intake. 20-40g of dietary fibre (eg. bran cereal, prunes and apricots) is recommended daily to address/prevent constipation. Increase your activity levels, as tolerated.
STEP 1: Bulk Forming Agents
- Bulkier stool stimulates move-ment through the bowel tract
- Should produce results within 12-72 hours
- Requires adequate fluid intake to be effective (1.0-1.5 L a day)
- Examples: Metamucil®, Bran (eg, cereal, wheat bran), Citrucel® (follow instructions on label)
STEP 2: Ostomotic Laxatives
- Use if Step 1 has been unsuccessful after using daily for 3-4 days
- Retains water in the stool, promoting movement through the bowel tract
- Should produce results within 30 min-3 hours
- Examples: PEGLAX, Restorlax®, Milk of Magnesia, magnesium citrate
OTHER MEDICATIONS:
Stimulant Laxatives
- Not recommended for individuals with colostomies.
- Examples: Cascara, Sennoside, ex-lax®, Dulcolax®, Bisacodyl
Stool Softeners
- No guideline available for individuals with colostomies.
- Should produce results within 1-3 days
- Promotes water retention in stool – increases stool moisture
- Example: Docusate sodium (Colace®)
