Your large intestine is one of the most important parts of your body that focuses on nutrient absorption. It works to take in all the vitamins and minerals that the previous parts of your digestive system have broken down and produced. It also draws in excess water to help hydrate your cells. However, if you’ve undergone an ostomy surgery, your large intestine may not have as many opportunities to absorb some key nutrients. Therefore, many ostomates, especially those who have undergone an ileostomy, are more prone to nutritional deficiencies. To help make sure that you stay healthy and fuel your body with the minerals it needs, we’ll go over everything you need to know about optimizing your nutrient intake with an ostomy.
What is an Ostomy?
An ostomy is a surgical procedure that’s performed when a person's normal bowel or urinary function is disrupted or impaired due to illness, injury, or surgery. During an ostomy surgery, a part of the intestine or urinary tract is brought to the surface of the abdomen, creating a stoma. A pouch or bag is then attached to the stoma to collect the waste, which is then disposed of.
Ostomies can be temporary or permanent, and they’re commonly performed to treat conditions such as inflammatory bowel disease, colorectal cancer, bladder cancer, and birth defects. People with ostomies may need to make lifestyle adjustments and receive specialized care, but with proper management, they can lead full and active lives. Although it can be a scary transition, ostomies are lifesaving procedures that shouldn’t disrupt your ability to do the things you love.
How Will an Ostomy Impact Your Eating Habits?
An ostomy won’t result in limitations to most foods or beverages, but it may require some adjustment until your body gets used to the changes. This is especially true during the recovery period, as you want to make sure your digestive system isn’t overloaded too quickly. However, with the proper guidance and some time, you’ll be able to continue enjoying all the foods you love.
In the immediate post-operative period, your doctor may recommend that you follow a low-fiber diet. This reduces the amount of stress that’s put on your digestive system, thus facilitating the healing process. Gradually, as healing progresses, you’ll be able to start reintroducing more fiber and other foods into your diet. However, always talk to your doctor to determine what types of foods you can have and how much you should eat based on your individual needs and the type of ostomy you have.
Everyone is different, but some foods may cause more gas or odor than others. During the recovery period, try to pay extra attention to your body and how it responds to different foods, and to make adjustments as needed. A good way to help with this process is to keep a food diary. It may also be helpful to eat smaller, more frequent meals throughout the day, chew food thoroughly, and drink plenty of water to help keep the digestive system moving smoothly. If you have any questions regarding your eating habits post-surgery, don’t hesitate to talk to your doctor or ostomy nurse.
Common Nutritional Deficiencies in Ostomates
Due to the changes in the digestive system and how it absorbs nutrients, people with ostomies may be at risk for certain vitamin and mineral deficiencies. Although everyone is different and nutrient absorption will vary based on the type of ostomy, some common deficiencies that may occur include:
Vitamin B12
Vitamin B12 is primarily absorbed in the small intestine. Therefore, if you’ve undergone an ostomy that required the removal of a portion of the small intestine, it can lead to a deficiency. Even many people without ostomies have B12 efficiencies, so it’s common regardless of your situation. Symptoms of a deficiency may include weakness, fatigue, and tingling in the hands and feet. If low B12 levels continue for too long, they can result in anemia, which may lead to nerve and/or brain damage.
Folic Acid
Some ostomates may need to take a medication called Sulfasalazine to help with inflammation, but this can also impair your body’s natural ability to absorb folic acid. A deficiency here can result in issues with the intestinal lining, which isn’t ideal if you already have an ostomy. Unfortunately, folic acid can be difficult to monitor and may be mistaken for a B12 deficiency. Seeing your doctor regularly can help ensure you’re getting enough of this key nutrient.
Potassium
Potassium deficiencies are also common in some ostomates, especially those who have undergone an ileostomy. This is due to the salt: potassium ratio that maintains balance in your intestines. However, an ileostomy can lead to sodium and water depletion, which then makes the entire ratio decrease, thus causing a potassium deficiency. Signs of this may include muscle weakness, a shortness of breath, general feelings of fatigue, gassy or bloated feelings, and a decreased sensation in your arms or legs. It’s important to see your doctor as soon as possible, as a potassium deficiency can be dangerous and lead to other complications.
You may also suffer from iron deficiencies or decreased absorption of calcium, vitamin B1, vitamin B9, magnesium, zinc, vitamin D, and vitamin K. Ostomies can also increase the risk of dehydration, which can lead to electrolyte imbalances and other complications. Therefore, it’s important to stay hydrated throughout the day. If you’re not sure how much water to drink, talk to your doctor or ostomy nurse and make sure you can recognize the signs of dehydration.
Your doctor may also recommend undergoing regular blood tests to check vitamin and nutrient levels, as well as adjustments to the diet or supplementation as needed. A registered dietitian can also provide personalized guidance on nutrition and help identify foods that are high in the nutrients needed to support optimal health.
How to Prioritize Nutrition with an Ostomy
There are a few things you can do to prioritize your nutrition as an ostomate. Some of these include:
Consider Working with a Registered Dietician
A registered dietitian can help ostomates learn the best foods for their situation and how to optimize their nutrition. They can also address specific concerns, such as maintaining healthy weight, preventing dehydration, and managing digestive symptoms. Your dietitian can also work with your doctor to create a personalized meal plan that meets your specific dietary needs and preferences.
Eat Balanced Macronutrients
Your diet should include all macronutrients, which are carbohydrates, proteins, and fats. Each macronutrient plays a key role in your overall health. Carbohydrates provide energy, proteins build and repair tissue, and fats help absorb essential vitamins and minerals. Eating a balanced diet that includes all three macronutrients can help promote optimal digestive functioning and maximize nutrient absorption.
Focus on Foods with Essential Micronutrients
Micronutrients are essential vitamins and minerals that fuel the body. Try to avoid processed foods and instead focus on foods that are rich in essential micronutrients, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.
Consume Microbiome Friendly Foods
The microbiome is made up of microorganisms that live in the digestive tract and play a crucial role in overall health. Consuming foods that promote a healthy microbiome can help improve digestion, boost the immune system, and promote overall health as an ostomate. Examples of microbiome-friendly foods include fermented foods, such as yogurt, kefir, kimchi, and sauerkraut. Your doctor may also recommend taking either a prebiotic, a probiotic, or a combination of both.
Chew Your Food Thoroughly
Finally, chewing food thoroughly can help prevent digestive symptoms and discomfort, such as bloating and gas. When an individual with an ostomy eats, the food bypasses a portion of the digestive tract and enters the colon more quickly. Chewing food thoroughly can help break food into smaller particles, making it easier to digest, improving nutrient absorption, and reducing the risk of digestive symptoms.
Living with an ostomy doesn’t mean you can’t live a long, happy, and fulfilling life. However, dealing with the changes can be overwhelming and a bit isolating. To help, consider joining an ostomy support group. Just search the list of support groups affiliated with The United Ostomy Associations of America (UOAA) to find something near you. UOAA is a national, 501(c)(3) nonprofit organization that supports, empowers, and advocates for people who have had or will have ostomy or continent diversion surgery.
Byram Healthcare also aims to be a helpful resource for ostomates. We provide ostomy education and support, and ostomy products that can be discreetly delivered to your door.
