After your stoma surgery you may discover that your appetite has reduced, but it is important to eat little and often, to help your recovery after your surgery.

If you have recently had surgery and an ileostomy formed, particular foods will alter the consistency of your stool output, therefore what you eat plays an important part in controlling the output. After you’ve had stoma surgery, you should aim for a porridge-like stool consistency, which can be easier to manage, reducing leaks from occurring and avoiding dehydration. 

Adjusting to eating with a stoma can feel daunting at first, but most people find that, with a little time and the right guidance, they can return to enjoying a varied and nutritious diet. The advice below is designed to support you at each stage of your recovery - from the early days after surgery through to long-term everyday eating.

Early day diet tips

After your stoma surgery, you are likely to have lost weight. With this in mind, it is important to have a well-balanced diet and maintain a healthy calorie intake, as this will aid the healing process. In addition to your normal daily diet, there are some foods which we highly-recommend should be included, to help with the ongoing recovery of your recent surgery:

• Full fat cheese & milk
• Foods which are high protein (e.g Tender Meat, Eggs & Fish)
• Double cream - To add; Puddings, mashed potato & soup
• Snacking Biscuits & cakes
• Drink fluids regularly to avoid dehydration (avoiding plain water, try adding cordial or isotonic drinks)

It’s normal for your appetite to fluctuate in the weeks following surgery. Try not to force large meals - smaller, more frequent eating throughout the day is often better tolerated and helps your body absorb the nutrients it needs to heal.

What can I eat if I have a stoma?

In general, people who are living with a stoma can eat and drink what they want, unless the surgeon, Stoma Care Nurse or GP has indicated that a particular diet plan must be in place. Some foods prior to surgery will have been digested easier than after your surgery. With this in mind it may be very helpful to pay extra attention right after your surgery, so be aware of any digestive issues you are experiencing such as changes to your output, bloating and abdominal cramps. 

Foods that may affect your stoma output

While most people with a stoma can enjoy a wide range of foods, some are known to have a noticeable effect on output, wind, or odour. Everyone’s digestive system is different, so these won’t affect everyone in the same way - but it’s worth being aware of them, especially in the early stages after surgery.

Foods that may loosen output: Spicy food, fried food, and high-sugar drinks can cause looser output.

Raw fruit and vegetables, particularly with skins on: These are a common cause of blockages, especially with an ileostomy, as the skin and fibre are harder to digest. They can also make ileostomy output looser and faster. We'd recommend peeling and cooking fruit and vegetables thoroughly, especially in the early weeks — see [ileostomy diet link] for more guidance.

Foods that may thicken output (ileostomy): Bananas, white rice, white bread, plain pasta, marshmallows, and peanut butter.

If you find a particular food consistently causes problems, simply reduce or avoid it for a while and try reintroducing it in smaller amounts later on. Your Stoma Care Nurse can offer personalised guidance if you’re finding certain foods difficult to manage.

What can’t I eat if I have stoma?

After your surgery, you should be able to eat normal foods and revert back to the food which you enjoyed before your stoma surgery. You may discover that some foods can change the way your stoma works, such as making the output much thicker or even much looser. We would advise to start with softer, thoroughly cooked foods and gradually transition to firmer, less cooked options as you feel confident. Generally this is after 6-8 weeks once the swelling in your bowel reduces. Then you should be able to eat anything you like and we can guide you on how to do this. 

What are the best fruit & vegetables to eat?

You'll still need to get your five-a-day. If you have a colostomy, you can generally eat fruit and vegetables as you did before surgery, including skins, unless you notice they cause you problems.

If you have an ileostomy, it's worth preparing fruit and vegetables more carefully. Tough skins can be hard to digest and may increase the risk of a blockage, so it's best to peel fruit and vegetables such as potatoes and apples. You may also find it easier to prepare them in different ways, for example:

• Make soups
• Blend fruit into a smoothie
• Sweat vegetables (cook quickly to soften them)
• Mash root vegetables

Well-cooked or blended vegetables are a great way to keep a varied, nutritious diet while managing your output. As your confidence grows and your bowel recovers, you'll likely find you can gradually reintroduce more textures over time.

Ongoing Dietary Advice

• Eat food and drink fluids regularly
• Include fruit & vegetables in your daily stoma diet
• Include foods which are high in protein, in everyday meals, including; Fish, meat, eggs, milk, cheese or yoghurt
• Include carbohydrates within each meal of the day such as; Pasta, bread, rice, potatoes and breakfast cereals.
• Include dairy products, including milk products in meals two to three times per day, as dairy products are rich in calcium. Alternatively, you choose a lower-fat variety if you are looking for a healthier diet. 

Please note: People with either colostomy or an ileostomy will usually experience the same common digestive issues, which they may have had prior to their stoma surgery.

Common digestive issues:

• Wind
• Odour
• Constipation
• Diarrhoea
• Loose output (ileostomists only).

Managing common digestive issues with a stoma

People with either a colostomy or an ileostomy may experience some of the same digestive issues they had prior to surgery, as well as some new ones. These are generally very manageable with the right dietary adjustments and, if necessary, advice from your Stoma Care Nurse.

When to seek support

Eating well after stoma surgery is something most people adjust to over time, but there are occasions when changes to your diet or output may indicate something that needs professional attention. You should contact your GP, Stoma Care Nurse, or call NHS 111 if you experience any of the following — whichever you can reach quickest

• A sudden or significant change in your stoma output that doesn't improve within 24–48 hours
• Signs of dehydration that don't resolve with increased fluid and salt intake
• Persistent bloating, abdominal cramping, or swelling that doesn't settle
• A complete or near-complete stop in output, which may indicate a blockage
• Unexplained weight loss or a significant reduction in appetite over several weeks
• Nausea or vomiting alongside changes to your stoma output

If you're not sure whether what you're experiencing is normal, it's always better to seek advice sooner rather than later. Your Stoma Care Nurse is a specialist resource and is there to support you - not just in the early days after surgery, but at every stage of life with a stoma.

For further help and guidance, you can also explore the stoma support groups and networks available to you, or contact the Medilink team directly.