Considerations for the First 6 Weeks 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®)