Ileostomy Dietary Advice
For the first six to eight weeks after your Ileostomy surgery you should follow a low fibre/residue diet, aiming to slowly re-introduce foods to achieve a healthy, balanced diet in the longer term. Occasionally, a low fibre diet may be recommended longer term and your dietitian or stoma nurse will advise if this applies to you.
This leaflet gives you some general advice to help you adjust to managing your diet and stoma.
First six to eight weeks post Ileostomy:
Follow a low fibre diet
Low fibre foods contain less than 3g of fibre per 100g. This information can be found on the product’s nutritional label.
| Low fibre foods | High fibre foods to avoid |
| White bread | Brown bread, including 50/50 |
| White rice, pasta | Brown rice, whole wheat pasta |
| Potatoes, no skins | Raw vegetables/salads |
| Well-cooked vegetables | Peas, sweetcorn, baked beans, mushrooms |
| Tinned fruit (not fruit cocktail)/stewed fruit with no pips/skins | Fruit and vegetable skins/seeds/pips pineapple, mango, coconut |
| Cornflakes, Frosted Flakes, Rice Krispies, Coco Pops, Sugar Puffs | Whole wheat/fibre cereals eg Shredded Wheat, All-Bran, Weetabix, Muesli, Porridge. Dried fruit, nuts and seeds |
| Fish, chicken, meat | Fish bones, tough meat, gristle |
| Tofu | Quorn/Soya mince or meat pieces |
| Eggs, cheese | Cheese with added fruit |
| Milk puddings, yoghurts | Yoghurt with pieces of fruit |
| Dairy alternatives | |
| Smooth fruit juices | Fruit juice with bits |
| Seedless jams | Whole fruit jam with seeds |
| Smooth peanut butter | Crunchy peanut butter |
| Crisps (not skin on), ‘melt in the mouth’ snacks ie Skips, Wotsits, Cheese Puffs, Mini Cheddars, Jelly Babies and marshmallows | Twiglets, Popcorn |
| Plain crackers/biscuits/cakes eg Cream Crackers, Rich Tea, sponge cakes | Oat cakes, rye crispbreads |
Meal examples from low fibre choices
Breakfast
Cornflakes/Rice Krispies with full fat milk
Small glass fruit juice
Mid-morning
1-2 slices white toast with butter and scrambled egg/cheese/smooth
peanut butter/jam. Glass of full fat milk
Lunchtime
Fish/chicken/meat in sauce/gravy with white rice/pasta/potatoes (no
skin), yoghurt/milky pudding eg rice pudding
Mid-afternoon
Milky drink eg smooth milkshake/hot chocolate with slice sponge cake/ plain biscuits
Evening meal
Sandwiches eg cheese/tuna/egg, packet puff-style crisps, yoghurt/mousse
Supper
Glass full fat milk/warm milky drink, plain sweet biscuits/crackers with cream cheese
To help healing, it is important to meet your nutritional needs post-surgery
- If you have lost weight, or you have a reduced appetite, try to include high calorie and protein foods, drinks and snacks throughout the day
- Have smaller meals and more frequent snacks
- Fortify your foods with high calorie products such as full fat milk, cream, cheese and butter
- Aim to include sources of protein at every mealtime, as this helps with healing
- Have low fibre fruit (tinned/stewed) and well-cooked vegetables.
Slowly introduce more variety of foods into your diet after 6-8 weeks
- Aim to reintroduce one type of more fibrous food each day
- Chew all foods well and sit upright
- Some foods may disagree with you. A food diary can help identify these foods.
| Foods that may cause wind/colicky symptoms | Foods that can help alleviate wind/colicky symptoms |
| Brassicas eg cauliflower, broccoli, cabbage, sprouts Beans and pulses Onions Eggs Spicy foods Chewing gum Fizzy drinks, fruit juice Beer, lager | Peppermint – try drinking peppermint tea or adding a few drops of peppermint oil to warm water Yoghurt – include as a snack or after a meal |
| Foods that can cause diarrhoea | Foods that can naturally thicken up your stoma output |
| Caffeinated drinks eg coffee, energy drinks Spicy foods, especially ones containing chilli Greasy/fatty foods Fruit/fruit juice Alcohol, especially wine/beer Artificial sweeteners – use polyol sweeteners only, eg Mannitol, Xylitol, Sorbitol, Erythritol, Maltitol | Marshmallows, Jelly Babies, other sweets made with gelatine Under-ripe bananas Stewed apples Smooth peanut butter Pasta, rice, boiled potatoes |
| Foods that may cause blockages It is important to chew all food well to try to avoid this | Foods that can help alleviate constipation |
| Seeds/nuts Peas/sweetcorn/baked beans/mushrooms Dried fruits Popcorn Fruit skins/seeds Coconut | Prune juice Coffee Fruit and fruit juice Increased fluid intake (you should not do this if you have been advised by a health professional to limit your fluid intake) |
Fluids
- An ileostomy puts you at higher risk of dehydration as it causes you to lose more fluid and salt than you would have previously
- Unless you have been advised otherwise, you should aim to drink at least 2 litres of fluid per day
- You should also add extra salt to your food or eat salty snacks.
Get advice from your GP / stoma nurse / dietitian if:
Your stool output is much higher (greater than 1.5 litres) or looser than normal
You are feeling more thirsty than usual/have a dry mouth or are feeling light-headed or dizzy
You have to get up multiple times through the night to empty your bag.
They may advise you to take Oral Rehydration Solution (ORS) or prescribe Loperamide. It is important to take this as directed. ORS should be made daily and kept in the fridge. Discard any remaining solution after 24hrs. Only take if advised to do so. Small amounts of sugar-free squash can be added.
St Mark’s solution is an ORS that you can make up yourself and it can be a cheaper alternative.
St Mark’s Solution recipe
Mix the following into 1 litre of water:
- 20g (6x level 5ml spoons) Glucose powder
- 2.5g (1x heaped 2.5ml spoon) Sodium Bicarbonate
- 3.5g (1x level 5ml spoon) Sodium Chloride (Table salt)
This should be taken throughout the day. If you have been advised to restrict your fluid intake, this solution should be included as 1 litre of your daily allowance.
If you have not had any output from your stoma, and feel it may be blocked, avoid solid foods, drink plenty of fluids and massage the area around the stoma to help relieve symptoms. If this does not help, contact your stoma nurse for advice.
Contact numbers
We hope that you have found this information useful. If you have any questions please see the below contact details:
Stoma nurse specialists: 01305 255 152
Dietetic Department: 01305 254 415
Useful websites
www.nhs.uk/conditions/ileostomy/recovery
www.dansac.co.uk
www.salts.co.uk
About this leaflet
Authors: Persephone Scotcher, Dietetic Assistant and Stephanie Brennan, Dietitian
Written: December 2020
Updated and approved: March 2022
Review date: March 2025
Edition: v2
If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk
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