Nutrition tips for ileostomy recovery?

I am about 5 weeks post-surgery for permanent ileostomy, and I have completely lost my appetite. What are the best things to add to my diet that will give me enough nutrition? Any protein drinks that actually taste good? Vitamins? This is all new to me, and I was pretty malnourished from being sick for so long prior to surgery. I have heard some take liquid vitamins. If you have had good results with something, please let me in on tips and brands.
Thank you!

Good evening, Feb 9 - and welcome! :)

I am an ileostomate of 3 1/2 years and have been a member of MeetAnOstomate.org (MAO) since last September.

You may find - as I did - very caring individuals with a great deal of experience and tips to share on this site and, perhaps, you will be in a position to help someone else in need down the road.

I was also very malnourished months before my proctocolectomy with end ileostomy, and my surgeon gave me some tips to help raise my blood protein levels, which needed to be done so I would have a better chance at surviving the surgeries.

The first thing he suggested was Ensure nutrition shakes. Knowing my physical state, I chose the Ensure PLUS Dark Chocolate option: 13 grams protein, 350 calories, 26 vitamins & minerals. Then, as now with my ileostomy, sipping any liquid or liquidy foodstuffs is better than gulping. Gulping liquids with an ileostomy will put the majority of the liquid right through your GI tract and into your bag/appliance, a counterproductive waste.

I was/am a dairy fan, so yogurt, milk, cottage cheese, cheddar cheese...all of these high-protein items were options prior to surgery. I would caution that with eating hard or sticky cheeses, to eat something high-fiber (whole grain crackers?) with it, and drink liquid between bites to keep the sticky cheese from lumping together in your GI tract and creating a blockage. Painful, stressful, worrying, and (worst-case scenario) potentially deadly. Avoid blockages at all costs!

Speaking of "sticky"...refined carbohydrates (low-fiber breads, cakes, cookies, etc.) and nut butters (and Nutella!) should also be consumed with more fiber and plenty of fluids to prevent blockages. (I have found that eating peanut butter directly from a spoon or in a sandwich to be a gooey no-no for me.)

Back to what is great to eat, in my opinion... I prefer whole foods to supplements: fruit & yogurt smoothies, cooked eggs in most any form, super-healthy hummus & crunchy pita chips, tuna or chicken salad on whole grain bread with your favorite condiments and veggies (or just on whole grain crackers), V8 Juice (regular, not the low-sodium, unless you have health issues involving sodium intake!), tortilla chips with salsa or pico de gallo and/or guacamole, cooked pasta with a flavorful tomato-based sauce and a sprinkling of Parmesan cheese, stir-fried rice with vegetables... Almost anything.

A few notes of caution:

Stay hydrated by sip-sip-sipping water throughout the day. My surgeon blatantly told me post-surgeries that the reason most ileostomates are rehospitalized is due to dehydration, kidney failure. Staying hydrated is harder for those of us without a colon, but it is doable: eat foods with a high-water content, i.e., watermelon is wonderful, as are strawberries, citrus fruits, bell peppers, cucumber, tomato!

Eating saltier foods is recommended for ileostomates, as it increases our thirst and helps our body retain the fluids it needs to function and to flush toxins. My own tip: I drink about 20 oz. of water immediately before getting into bed at night. Lying down, the water doesn't go directly into my pouch, as gravity is less of an issue than when I'm upright, so my stomach and small intestine have a longer period of time to absorb the water while I sleep. Another note: If you have any issues with increased sodium in your diet, consult your physician first!

When eating, chew-chew-chew every mouthful until it is almost to a pastelike consistency before swallowing because - blockages! Some ileostomates have trouble eating leafy greens, cabbage, and fruits and vegetables with the peel still on it: apples, grapes, tomato, English cucumber, eggplant...and dried fruit can be another sticky challenge for the GI tract to process easily.

A lot of these food options you may be uncomfortable trying so early in your recovery, so when you do decide to incorporate them - or something that sounds even better to you :) - introduce them slowly and in small amounts to your body. Then, pay attention to how your body (read: GI tract) responds to these reintroduced foods.

You may find it best to begin with something like the Ensure supplemental drink (chilled Dark Chocolate is wonderful), V8 Juice, smoothies, puddings, Jell-o, warmed bone broth or other broths*, creamed soups, yogurt, kefir drink, etc., then start to add a little more protein (eggs, cheese, poultry, seafood, beef, pork) with grains (rice, barley, legumes) and some soft-cooked (poached or roasted) vegetables.

Again, take it slowly when introducing a new food to your diet. Stay hydrated and get sufficient rest with some low to moderate activity to help rebuild your muscles, strength, and stamina. It will happen, and your perseverance and guidance from other wonderful, caring souls on this site and your medical teams are essential, as none of us can make this journey alone. Nor should we.

Be well, and feel better, Feb! And drop us a response and/or other inquiries whenever you like, or even if you just want to chat. We're here! :)

Lily17

*Bone broths are a wonderful tip from member Ritz, so credit for this one goes to her! :)

I'm 5 weeks post-surgery, too. I don't know if it's different but my surgery was colon removal from diverticulitis. My appetite has returned and I am eating fairly normally. I found that milk chocolate Ensure High Protein tastes okay and is good when I don't feel like eating.

Hi Feb9, I've had an ileostomy for about 35 years due to UC and was really run down from it. I craved pasta after my surgery but couldn't eat much. However, I would heat up a small bowl of it several times a day. I also snacked on those peanut butter crackers and yogurts. I also started walking twice a day when I was able, not a lot but short distances, which helped get my appetite back.

Just lost a lengthy note.
So now I must keep this short.
Try TANGY TANGERINE 2.0. It's a powerful organic multi-vitamin and mineral complex. You add this powder to water and drink it. It's the best! Also, be sure you're hydrated. Drink something like Pedialyte. It has the electrolytes you need. Ostomates lose most of their water through feces.

This is VERY IMPORTANT.
You can get TANGY TANGERINE AND PEDIALYTE through Amazon. Pedialyte can also be found in the Babies Aisle at any chain of pharmacies. I like the red and grape flavors the best. Gatorade has electrolytes too, but it has a lot of sugar but less expensive than Pedialyte.
For a pick me up, try beet juice powder mixed with water. It comes in a few flavors.
Stay away from cooked mushrooms. They don't break down.
When I had your type of ileostomy, I could eat anything. I've read on this site that ostomates have problems with clogging.
Read, then read more about what ostomates reveal on this site. Keep asking questions.
Hope I helped. Take care.
Sharon

Words of Encouragement from Ostomy Advocates I Hollister

I've written two other letters to you, and lost them both. So writing this short one.
Yes. Take liquid vitamins and minerals.
Tangy Tangerine is a great way to get what your body needs.
You can get it on Amazon. It's excellent for ostomates.
Also, make sure you're not losing water through your excrement. Pedialyte is a great source.
Hope this helps.
Sharon