8 What to eat and drink when you have a High Output Ostomy What to eat and drink when you have a High Output Ostomy © Hamilton Health Sciences, 2009 PD 6629 - 1/2009 dpc/pted/HighOutputOstomyWhatToEat-trh.doc dt/November 4, 2009 ____________________________________________________________________________ 2 7 What to eat and drink when you have a High Output Ostomy What to eat and drink when you have a High Output Ostomy What is an ostomy? An ostomy is a surgically created opening, which connects part of What to try Reason a person’s bowel to the outside of their body. The purpose of this Limit your intake of all other types of Water, tea and coffee may increase opening is to get rid of stool, also called output. There are different fluids each day, including water, tea, your diarrhea. types of ostomies depending on the location in the bowel. coffee and milk to less than 500 ml or 2 cups a day. Choose restricted lactose milk such Milk sugar, called “lactose”, can You have a: as “Lactaid” or “Natrel lactose free” make diarrhea worse in some people. if you find regular milk increases jejunostomy – located in the jejunum your output. ileostomy – located in the ileum Avoid drinks high in sugar such as May worsen diarrhea. colostomy – located in the colon juice, regular pop and fruit drinks. Avoid sweeteners such as sorbitol May worsen diarrhea. and mannitol. They are often found in “diet candies”: sugar free candies, gum and cough drops. What is a high output ostomy? Sip on oral rehydration fluids Helps to prevent you from getting throughout the day. Try to limit fluid dehydrated. A high output ostomy is when you have more than 2 litres (8 cups) of at meals to less than 125 ml (½ cup). fluid from your ostomy in a 24 hour period. The output is usually very Separate fluids and solids. It may be Helps the solid food pass more watery and needs to be emptied 8 to 10 times or more a day. helpful to wait 30 minutes before and slowly through your intestines. The output may also be very difficult to pouch and often leaks. after a meal before drinking fluids. This helps your body to absorb the nutrients. Limit fluids with meals to only sips and have no more than 125 mL (½ cup) in total. __________________________________________________________________________________ ________________________________________________________________________________ 6 3 What to eat and drink when you have a High Output Ostomy What to eat and drink when you have a High Output Ostomy Fluids – things to try … A high output ostomy can increase your risk of dehydration and malnutrition. When you have a high output ostomy, your ability to absorb fluids is reduced. Drinking too much fluid can increase the output from your Signs of malnutrition: ostomy and cause you to become dehydrated. This may be opposite to • sleepiness or tiredness what you might expect. • dizziness To help you absorb fluids: • losing weight without trying to • limit the amount of fluids you drink. • wounds may heal more slowly • you may bruise more easily • change the types of fluids you are used to drinking. There are special drinks available called oral rehydration solutions. Signs of dehydration: • dry, sticky mouth and increased thirst What to try Reason • lightheadedness or fainting Drink ________ cups of an oral rehydration Helps to help keep you solution each day from getting dehydrated • tiredness and decrease diarrhea. • irritability Commercial brands of oral rehydration • headache solutions: • Gastrolyte • flushed skin • Pedialyte • dark, strong smelling urine • Ceralyte • muscle cramps Home made oral rehydration solution recipe: • fast heart rate 1 litre (4 cups) of water 40 ml (8 tsp) sugar 5 ml (1 tsp) salt 250 ml (1 cup) orange juice What does this mean to me? Shake well and dissolve. Making changes to the types of foods you eat and fluids you drink, and when you eat and drink will help control your Other choices: stool output. • Dilute juice (half juice half water) • Gatorade/Powerade Your gastrointestinal tract is too short to absorb enough • V8 juice nutrition` and fluid from the foods you eat and fluids you drink. • Tomato juice You may need additional IV (intravenous) nutrition and fluid, in • Clamato juice addition to making changes to your diet. • Soup __________________________________________________________________________________ ________________________________________________________________________________ 4 5 What to eat and drink when you have a High Output Ostomy What to eat and drink when you have a High Output Ostomy Food – things to try … Foods that may affect your stool output What to try Reason Foods that may decrease the Foods that may increase the number of stools and/or diarrhea number of stools and/or Eat meals regularly. This means • Prevents you from becoming bloated. diarrhea eating small meals every 2 to 3 hours • Helps you to absorb your meals better. Applesauce Alcoholic beverages or 6 to 8 times a day. • Helps you meet your nutritional needs and Bananas Beverages that have caffeine such eat enough calories. Bread – white as coffee, tea and cola Chew your food very well. • Helps you to digest or breakdown Cheese Chocolate your food. Oat bran Dried fruit and pineapple Include foods in your diet that may • These foods pass through your intestine Honey help thicken your stools. See the list of more slowly or form a gel-like substance. Oatmeal foods in the chart on page 5 that may Helps to thicken stool or decrease output. Pasta – white Jams and Jellies decrease the number of stools. See list on page 5. Peanut butter – smooth Juice especially apple, grape At each meal and snack try to eat a • These foods slow the movement of food Potatoes and prune starchy food and protein food. through your intestines giving your body Pretzels Licorice more time to digest them. Rice pudding Nuts Starchy foods include bread, cereal, Olives rice, pasta and potatoes. Rice – white Peas, beans and legumes Tapioca Pickles Protein foods include meat, fish, Popcorn cheese, peanut butter and eggs. Skins and seeds of fruits and Add extra salt to your meals or include • Helps you to absorb fluids better. salty snacks such as crackers, chips vegetables or cheezies. Spicy foods/sauces You may benefit from reducing the • Helps to decrease bloating and diarrhea. Vegetables: broccoli, cauliflower lactose in your diet. and onions Whole grains Foods with lactose include milk and ice cream. Avoid high fibre foods (such as whole • Helps to reduce stress on your bowel and grains), stringy foods and foods with symptoms of cramping and bloating. Helps skins and membranes and other foods to decrease output. See list on page 5. that may increase output. Avoid foods high in sugar such as • May worsen diarrhea. white or brown sugar, jam, honey, hard candy, molasses, juice and regular pop. __________________________________________________________________________________ ________________________________________________________________________________ 4 5 What to eat and drink when you have a High Output Ostomy What to eat and drink when you have a High Output Ostomy Food – things to try … Foods that may affect your stool output What to try Reason Foods that may decrease the Foods that may increase the number of stools and/or diarrhea number of stools and/or Eat meals regularly. This means • Prevents you from becoming bloated. diarrhea eating small meals every 2 to 3 hours • Helps you to absorb your meals better. Applesauce Alcoholic beverages or 6 to 8 times a day. • Helps you meet your nutritional needs and Bananas Beverages that have caffeine such eat enough calories. Bread – white as coffee, tea and cola Chew your food very well. • Helps you to digest or breakdown Cheese Chocolate your food. Oat bran Dried fruit and pineapple Include foods in your diet that may • These foods pass through your intestine Honey help thicken your stools. See the list of more slowly or form a gel-like substance. Oatmeal foods in the chart on page 5 that may Helps to thicken stool or decrease output. Pasta – white Jams and Jellies decrease the number of stools. See list on page 5. Peanut butter – smooth Juice especially apple, grape At each meal and snack try to eat a • These foods slow the movement of food Potatoes and prune starchy food and protein food. through your intestines giving your body Pretzels Licorice more time to digest them. Rice pudding Nuts Starchy foods include bread, cereal, Olives rice, pasta and potatoes. Rice – white Peas, beans and legumes Tapioca Pickles Protein foods include meat, fish, Popcorn cheese, peanut butter and eggs. Skins and seeds of fruits and Add extra salt to your meals or include • Helps you to absorb fluids better. salty snacks such as crackers, chips vegetables or cheezies. Spicy foods/sauces You may benefit from reducing the • Helps to decrease bloating and diarrhea. Vegetables: broccoli, cauliflower lactose in your diet. and onions Whole grains Foods with lactose include milk and ice cream. Avoid high fibre foods (such as whole • Helps to reduce stress on your bowel and grains), stringy foods and foods with symptoms of cramping and bloating. Helps skins and membranes and other foods to decrease output. See list on page 5. that may increase output. Avoid foods high in sugar such as • May worsen diarrhea. white or brown sugar, jam, honey, hard candy, molasses, juice and regular pop. __________________________________________________________________________________ ________________________________________________________________________________ 6 3 What to eat and drink when you have a High Output Ostomy What to eat and drink when you have a High Output Ostomy Fluids – things to try … A high output ostomy can increase your risk of dehydration and malnutrition. When you have a high output ostomy, your ability to absorb fluids is reduced. Drinking too much fluid can increase the output from your Signs of malnutrition: ostomy and cause you to become dehydrated.