Eating & Ostomates
An Anthology of Ideas
Articles Included:
§
Foods and Your Ostomy
§
Diet Guidelines for Ostomy Patients
§
Diet Cautions for Ostomates
§
Gas in the Digestive Tract
§
Potassium
§
Abdominal Noises
§
Electrolyte Replenishing Drink
Comparisons
§
Some Food Facts for Ileostomates
§
Toffee Gums Up the Ostomy
§
Quick Food Reference
§
The Affect of Fiber
§
Fat Substitutes
§
Hydrox Fecalis
§
Eat Sensibly with an Ileostomy
Foods and
Your Ostomy
Some Helpful
Hints
By The New
Outlook, Chicago's North Suburban Chapter UOA
There is No
"Ostomy" Diet
There used to be, and to some extent
still are, some outdated theories about what foods ostomates should and should
not eat. Mushrooms, onions and fresh
vegetables were considered troublemakers, along with some meats. Today, we find that the old food taboos don't
necessarily apply. In moderation, most
foods need not be avoided. If you have
any questions about food, and the way your body reacts to it, consult your
doctor or ET nurse. Here are some common
foods, and hints on how to enjoy them without causing excessive gas, irritation
or stoma blockage.
Fibrous vegetables
Vegetables like celery, asparagus and
broccoli have long, fibrous strands running through them. Such strands are hard
to digest and can form a "ball" behind the stoma. When eating:
·
Celery.
Choose the
hearts. These are tender, and the fibers
are not as thick as those in the outside stalks. If you must eat the outer stalks, peel down
and toss out the outside strands.
·
Asparagus. Medium stalks are usually the most
tender. Start at the tip and work
down. As soon as the spear gets tough to
cut, go on to the next one and you should have no blockage problems.
·
Broccoli. The same
principle applies as asparagus. Asparagus
causes odor in the urine, which can be particularly bothersome to a urostomate.
·
Onions can
produce odor in the stool.
·
Broccoli, cauliflower and turnips, among others, are considered gas producers, and
may require an extra trip to the restore to relieve that pressure.
Cheese
Natural
cheese tends to be more binding than processed cheese, so avoid too much
natural cheese at one time. Processed
cheeses, such as american, cream and cottage cheese, are easier to digest.
Fresh Fruit
In moderation,
fruit can and should be included in a well balanced diet. If you have trouble digesting oranges and/or
grapefruit, try squeezing the juice and discarding the skin.
·
Apples, pears and peaches are great without their skins, if you find them
hard to digest.
·
Fruit
naturally produces activity in our elimination systems. Keep this in mind when you're at a picnic or
the beach...or anywhere facilities are not readily available.
Oysters, clams & mussels
Though
delicious treats, mollusks can be more difficult to digest than other types of
seafood, and may cause a minor blockage behind the stoma. Be sure to chew mollusks well. Avoid tough morsels. These are the major offenders giving
ileostomates the most trouble. Seafood of all kinds may cause odor in the
stool. Appliance deodorants are most
helpful in controlling this problem.
Nuts
The
most difficult nuts to digest are the hard ones, such as peanuts, almonds
and hazelnuts. Chew them well, and be
careful not to overindulge--no more than a handful at a sitting. Even non-ostomate nut lovers may experience
discomfort after enjoying more than a reasonable share of nuts.
One
of our members with an ileostomy tells this story. "If I can have one handful of nuts one
night last week, then five handfuls one night this week might be
okay." This error landed our
member in the hospital overnight with a complete blockage. Trying to give birth to a plug of peanut
pieces behind a stoma is definitely not to be put on your wish
list. Moderation is the key.
Also, if he drank water and had other food with the nuts, the blockage
may not have been so bad, or even happened.
Meats
Most
meats and poultry do not present problems for the average ostomate, but those
with fat content or heavy casings can be somewhat more difficult for the bowel
to handle. Some of the bratwurst types
can have very heavy casings that should be removed to reduce the chance of
blockage.
Try
sausage patties instead of links, or try hot dogs with the skin removed. Most sausage casings nowadays are purported
to be very thin plastic, which are not something you would want in large pieces
behind your stoma. When eating fatty
cuts of pork, lamb or beef, cut small pieces, avoid eating gristle, chew well
and limit your intake.
Other
Corn on the cob, popcorn, dried
foods & coconut. Creamed corn seems to be fairly well
tolerated, some people report eating corn on the cob as a sure trip to the
hospital. Coconut seems to be mentioned
very often as something to eat only in small quantities. Some people tolerate popcorn fairly well,
others do not. Try cautiously. When it comes to obstruction
behind the stoma, these are major offenders.
In fact, even people without ostomies can suffer major tummy aches after
indulging.
A
doctor told us of a fellow who would eat huge amounts of popcorn at one
sitting. He was not an ostomate, but
ended up in the hospital three times in one year with gastritis. Chew, chew,
chew... and remember limit your intake.
Never overeat. This warning is
especially true for people with an ileostomy.
Corn and peas are better tolerated when the hard outside husks are
slit. We have ileostomates who will
occasionally eat a small sweet corn.
They slit each line of the cob with a very sharp knife. This breaks the kernel and makes the corn
easier to digest.
Spices & Carbonation
Heavily
spiced foods and sauces can act as agents that speed up our bodily
functions. For some people they may
produce gas. Carbonated beverages are
gas producers, too. One great way to get the bubbles out of carbonated
drinks is with a dash of sugar. It will
cause a frenzy of fizz and leave the beverage safely flat. Don't fill the glass too full first, or the
pop will foam over the top of the glass.
Diet Guidelines for
Ostomy Patients
--Registered
Dietitians Nutrition Services
General Guidelines:
·
You will be able to eat a general diet
eventually, based on your own tolerance, but initially you may be asked to
follow a bland, low residue or soft diet for a month or two.
·
As you advance your diet, add new foods in
small amounts.
·
Eat meals at regular times, three or more
meals daily. Ileostomates especially should
eat many small meals all through the day.
Give up that one big meal once a day.
·
Do not fast for long periods of time because
of the potential to upset your electrolyte balance.
·
Experiment with foods, one at a time to
pinpoint any intolerances. Only use
small quantities. As you get accustom
to the food, you may then try eating more.
·
If a specific food does not agree with you,
and you would like to eat it, you might want to try it again next month in a
very small quantity.
·
Avoid any food which did not agree with you
prior to surgery. This will probably
not change after surgery.
·
Chew foods thoroughly to avoid blockage at
the stoma site. For many foods, the size
of the piece you swallow will be the exact size it will come out. If you chew your food well, all the time, you
will reduce the probability of problems occurring.
·
Drink plenty of fluids - at least 64 ounces
(two liters) per day. This is even more
important for ileostomates and urostomates.
·
Avoid chewing gum. You swallow air with gum chewing which may
create a noisy stoma.
· Avoid gaining excessive weight which may affect stoma function, and make you more susceptible to hernia and other avoidable health issues.
These foods may cause gas:
cabbage,
green beans, radishes, brussel sprouts, onions, beer, peas, melons, carbonated
beverages
These foods may cause odor (of course the pouch is closed
and you may not care about this):
onions,
cabbage, egg yolks, garlic, fish, turnips, cauliflower, alcohol
These foods may help control odor (inside the pouch, if you
are sensitive):
yogurt,
parsley, cranberry juice, buttermilk
These high fiber foods, especially with seeds or kernels,
may cause blockage:
celery
(raw), coleslaw, corn (whole kernels), nuts,
popcorn, coconut, seeds, Chinese
vegetables, olive pits,
tomato skins, orange pulp, apple
skins, shrimp, lobster
Editors
Note: Some people tolerate creamed corn
well. These foods as well as most
others may still be eaten, but should only be eaten sparingly when drinking
plenty of water. In addition, some
foods clump. When eaten alone these may
create a problem but when mixed with other foods are fine. I eat nuts all the time, but chew each one
to a powder. Never swallow large nuts or
seeds whole. You'll need a surgeon to
remove them. Never sit down and eat
three ears of sweet corn. You are
asking for trouble. These items are
mostly concerns for ileostomates.
These foods may cause diarrhea in some people:
fried
foods, highly seasoned foods, beer, raw vegetables, onions, licorice, raw
fruits, baked beans, large meals, milk, chocolate
These foods may help alleviate diarrhea:
banana,
applesauce, boiled rice, cheese
Editors Note: Seems like there are many foods to be concerned about. But not really. There many foods that you can enjoy and most of the offenders in moderation. Most of us eat virtually everything we did before surgery. In fact, many with diseases like Crohn's may actually have a much bigger selection than before. We always chew well, drink plenty of water, never overeat; let me repeat: chew well, drink liquids, never overeat. This keeps us out of serious trouble.
Diet Cautions for Ostomates
By The New Outlook,
If you have just had abdominal
surgery, it will take a little time for your bodily functions to return to
normal, so you should be eating food that is nourishing and easily digested.
Later, the doctor will give you the go-ahead to return to a
normal diet. You may want to add one new
food at a time. But in general, any food
that has agreed with you in the past should continue to do so.
If you are already on a special diet (e.g.., diabetes or
high blood pressure), stay with it to maintain good health, eat a balanced
diet--one that supplies the amounts of carbohydrates, protein, fat, minerals and vitamins your body needs.
Even if you no longer have a colon, the small intestine
will efficiently extract the nutrients you need if you provide it with the
proper food. Chewing your food well,
eating regularly, and drinking plenty of water are a few other common sense
rules to follow. Other than that, eat
what is comfortable for you and what satisfies you.
Editors Note: If you
have had some of your small intestine removed, you may not absorb all of the
vitamins properly. New research
indicates that various sections of the small intestine have specific job
functions to absorb a specific vitamin.
Particularly, the last part of the small intestine is devoted to
absorbing vitamin B12. If you are
checked by your doctor and found to be anemic, you may need injections of B12,
as your body may not be able to absorb enough naturally.
Gas in the Digestive Tract
--National Digestive Diseases Information
Clearinghouse
Everyone has gas and eliminates it by
burping or passing it through the intestines.
However, many people think they have too much has when they really have
normal amounts. Most people produce
about one to three pints a day and pass gas 15 to 30 times a day.
Gas is made primarily of odorless
vapors—carbon dioxide, oxygen, nitrogen, hydrogen and sometimes
methane. The unpleasant odor of
flatulence comes from bacteria in the large intestine that release small amounts
of gases that contain sulfur.
Although having has is common, it can be
uncomfortable and embarrassing.
Understanding causes, ways to reduce symptoms and treatment will help
most people find relief.
What Causes Gas?
Gas in the digestive tract; that is, the esophagus,
stomach, small and large intestine, comes from two sources:
·
Swallowed
air
·
Normal
breakdown of certain undigested foods by harmless bacteria naturally present in
the large intestine.
Swallowed
air
Air swallowing—aerophagia—is a
common cause of gas in the stomach.
Everyone swallows small amounts of air when eating and drinking. However, eating or drinking rapidly, chewing
gum, smoking or wearing loose dentures can cause some people to take in more
air.
Burping or belching is the way most swallowed
air—which contains nitrogen, oxygen and carbon dioxide—leaves the
stomach. The remaining gas moves into
the small intestine where it is partially absorbed. A small amount travels into the large
intestine for release through the end.
The stomach also releases carbon dioxide when stomach acid and
bicarbonate mix, but most of this gas is absorbed into the blood stream and
does not enter the large intestine.
Breakdown
of undigested foods
The body does not digest and absorb some
carbohydrates—the sugar starches and fiber found in many foods—in
the small intestine because of a shortage or absence of certain enzymes.
This undigested food then passes from the
small intestine into the large intestine, where harmless and normal bacteria
break down the food producing: hydrogen, carbon dioxide, and in about one-third
of all people, methane. Eventually,
these gases exit through the end of the intestine.
People who make methane do not necessarily
pass more has or have unique symptoms. A
person who produces methane will have stools that consistently float in
water. Research has not shown why some
people produce methane and others do not.
Foods that produce gas in one person may
not cause gas in another. Some common
bacteria in the large intestine can destroy the hydrogen that other bacteria
produce. The balance of the two types of
bacteria may explain why some people have more gas than others.
Which Foods Cause Gas?
Most foods that contain carbohydrates can
cause gas. By contrast, fats and proteins
cause little gas.
Sugars
The sugars that cause gas are: raffinose, lactose, fructose and sorbitol.
Raffinose
Beans contain large amounts of this complex
sugar. Smaller amounts are found in
cabbage, brussel sprouts, broccoli, asparagus, as well as other vegetables and
whole grains.
Lactose
Lactose is the natural sugar in milk. It is also found in products; such as, cheese
and ice cream. It is also found in
processed foods; such as, bread, cereal and salad dressing. Many people—particularly those of
African, Native American or Asian background—have low levels of the
enzyme lactase needed to digest lactose.
Also as people age, their enzyme levels decrease. As a result, over time people may experience
increasing amounts of gas after eating food containing lactose.
Fructose
Fructose is naturally present in onions,
artichokes, pears and wheat. It is also
used as a sweetener in some soft drinks and fruit drinks.
Sorbitol
Sorbitol is a sugar found naturally in
fruits, including apples, pears, peaches and prunes. It is also used as an artificial sweetener in
many dietetic foods and sugar-free candies and gums.
Starches
Most starches, including potatoes, corn
noodles and wheat, produce gas as they are broken down in the large
intestine. Rice is the only starch that
does not cause gas.
Fiber
Many foods contain soluble and insoluble
fiber. Soluble fiber dissolves easily in
water and takes on a soft, gel-like texture in the intestines. Found in oat bran, beans, peas and most
fruits, soluble fiber is not broken down until it reaches the large intestine
where digestion causes gas.
Insoluble fiber, on the other hand, passes
essentially unchanged through the intestines and produces little gas. Wheat bran and some vegetables contain this
kind of fiber.
What Are Some Symptoms and
Problems of Gas?
The most common symptoms of gas are
belching, flatulence, abdominal bloating and abdominal pain. However, not everyone experience these
symptoms. The determining factors probably
are how much has the body produces; how many fatty acids the body absorbs; and
a person's sensitivity to gas in the large intestine. Chronic symptoms caused by too much has or by
a serious disease are rare.
Belching
An occasional belch during or after meals
is normal and releases gas when the stomach is full of food. However, people who belch frequently may by
swallowing too much air and releasing it before the air inters the stomach.
Sometimes a person with chronic belching
may have an upper GI disorder; such as, peptic ulcer disease, gastroesophageal
reflux disease (GERD) or gastritis.
Believing that swallowing air and releasing
it will relieve the discomfort of these disorders, this person may
unintentionally develop a habitual cycle of belching and discomfort. Frequently, the pain continues or worsens,
leading the person to believe he or she has a serious disorder.
Two rare chronic has syndromes are
associated with belching: Meganblase
syndrome and gas-bloat syndrome. The
Meganblase syndrome, which causes chronic belching, is characterized by severe
air swallowing and an enlarges bubble of gas in the stomach following heavy
meals. The resulting fullness and
shortness of breath may mimic a heart attack.
Gas-bloat syndrome may occur after surgery
to correct GERD. The surgery creates a
one-way valve between the esophagus and stomach that allows food and gas to
enter the stomach but often prevents normal belching and the ability to vomit.
Flatulence
Another common complaint is passage of too
much has through the intestine. However,
most people do not realize that passing has 15 to 30 times a day is
normal. Although rare, too much has may
be the result of severe carbohydrate malabsorption or overactive bacteria in
the colon.
Abdominal
bloating
Many people believe that too much has
causes abdominal bloating. However,
people who complain of bloating from gas often have normal amounts and
distribution of gas. They actually may
be unusually aware of gas in the digestive tract.
Doctors believe that bloating is usually
the result of an intestinal motility disorder; such as, irritable bowel
syndrome (IBS). Motility disorders are
characterized by abnormal movements and contractions of intestinal muscles. These disorders may give a false sensation of
bloating because of increased sensitivity to gas.
Splenic-flexure syndrome is a chronic
disorder that seems to be caused by trapped gas at
bends—flexures—in the colon.
Symptoms include bloating, muscle spasms and upper abdominal discomfort. Splenic-flexure syndrome often accompanies
IBS.
Any disease that causes intestinal
obstruction; such as, Crohn's disease or colon cancer, may also cause abdominal
bloating. In addition, people who have
had many operations, adhesions—scar tissue—or internal hernias may
experience bloating or pain. Finally,
eating a lot of fatty food can delay stomach emptying and cause bloating and
discomfort, but not necessarily too much gas.
Abdominal pain and discomfort
Some people have pain when has is present
in the intestine. When gas collects on
the left side of the colon, the pain can be confused with heart disease. When it collects on the right side of the
colon, the pain may feel like the pain associated with gallstones or
appendicitis.
What Diagnostic Tests Are
Used?
Because gas symptoms may be caused by a
serious disorder, those causes should be ruled out. The doctor usually begins with a review of
dietary habits and symptoms. The doctor
may ask the patient to keep a diary of foods and beverages consumed for a specific
time period.
If lactase deficiency is the suspected
cause of gas, the doctor may suggest avoiding milk products for a period of
time. A blood or breath test may be used
to diagnose lactose intolerance.
In addition, to determine if someone
produces too much gas in the colon or is unusually sensitive to the passage of
normal gas volumes, the doctor may ask patients to count the number to times
they pass gas during the day and include this information in a diary.
Careful review of diet and the amount of
gas passed any help relate specific foods to symptoms and determine the
severity of the problem.
If a patient complains of bloating, the
doctor may examine the abdomen for the sound of fluid movement to rule out
ascities—build up of fluid in the abdomen—and for signs of
inflammation to rule out diseases of the colon.
The possibility of colon cancer is usually
considered in people 50 years of age and older, and in those with a family
history of colorectal cancer, particularly if they have never had a colon
examination—sigmoidoscopy or colonoscopy.
These tests may also be appropriate for someone with unexplained weight
loss, diarrhea or blood not visible in the stool.
For those with chronic belching, the doctor
will look for signs or causes of excessive air swallowing. If needed, an upper GI series—x-ray to
view the esophagus, stomach and upper small intestine—may be performed to
rule out disease.
How is Gas Treated?
The most common ways to reduce the
discomfort of has are changing diet, taking medicines and reducing the amount
of air swallowed.
Diet
Doctors may tell people to eat fewer foods
that cause gas. However, for some people
this may mean cutting out healthy foods; such as, fruits and vegetables, whole
grains and milk products.
Doctors may also suggest limiting high-fat
foods to reduce bloating and discomfort.
This helps the stomach empty faster, allowing gases to move into the
small intestine.
Unfortunately, the amount of gas caused by
certain foods varies from person to person.
Effective dietary changes depend on learning through trial and error how
much of the offending foods one can handle.
Nonprescription medicines
Many nonprescription, over-the-counter
medicines are available to help reduce symptoms, including antacids with simethicone
and activated charcoal. Digestive
enzymes; such as, lactase supplements, actually help digest carbohydrates and
may allow people to eat foods that normally cause gas.
Antacids; such as Mylanta II, Maalox II and
Di-Gel, contain simethicone, a foaming agent that joins gas bubbles in the
stomach so that gas is more easily belched away. However, these medicines have no effect on
intestinal has. The recommended dose is two
to four tablespoons of the simethicone preparation taken one-half to two hours
after meals.
Activated charcoal tablets may provide
relief from has in the colon. Studies
have shown that when taken before and after a meal, intestinal gas is greatly
reduced. The usual dose is two to four
tablets taken just before eating and one hour after meals.
The enzyme lactase, which aids with lactose
digestion, is available in liquid and tablet form without a
prescription—Lactaid, Lactrase and Dairy Ease. Adding a few drops of liquid lactase to milk
before drinking it or chewing lactase tablets just before eating helps digest
foods that contain lactose. Also,
lactose-reduced milk and other products are available at many grocery stores.
Beano, a newer over-the counter digestive
aid, contains the sugar-digesting enzyme that the body lacks to digest the
sugar in beans and many vegetables. The
enzyme comes in liquid form. Three to 10
drops are added per serving just before eating to break down the gas-producing
sugars. Beano has no effect on gas
caused by lactose or fiber.
Prescription medicines
Doctors may prescribe medicines to help
reduce symptoms, especially for people with a motility disorder; such as,
IBS. Promotility or prokinetic drugs;
such as, metocopramide (Reglain) and cisapride (Propulsid), may move gas
through the digestive tract quickly.
Reducing swallowed air
For those who have chronic belching,
doctors may suggest ways to reduce the amount of air swallowed. Recommendations are to avoid chewing gum and
to avoid eating hard candy. Eating at a
slow pace and checking with a dentist to make sure dentures fit properly should
also help.
Conclusion
Although has may be uncomfortable and
embarrassing, it is not life-threatening.
Understanding causes, ways to reduce symptoms and treatment will help
most people find some relief.
Points to remember
·
Everyone
has gas in the digestive tract.
·
People
often believe normal passage of gas to be excessive.
·
Gas comes
from two main sources: swallowed air and
normal breakdown of certain foods by harmless bacteria naturally present in the
large intestine.
·
Many
foods with carbohydrates can cause. gas.
Fats and proteins cause little gas.
·
The most
common symptoms of gas are belching, flatulence, bloating and abdominal
pain. However, some of these symptoms are
often caused by an intestinal motility disorder; such as, IBS, rather than too
much has.
·
The most
common ways to reduce the discomfort of gas are changing diet, taking
non-prescription or prescription medicines and reducing the amount of air
swallowed.
·
Digestive
enzymes; such as, lactase supplements, actually help digest carbohydrates and
may allow people to eat foods that normally cause gas.
Foods that may cause gas include:
·
Beans
·
Vegetables;
such as, broccoli, cabbage, brussel sprouts, onions, artichokes and asparagus
·
Fruits;
such as, pears, apples and peaches
·
Whole
grains; such as, whole wheat and bran
·
Soft
drinks and fruits drinks
·
Milk and milk products; such as, cheese
and ice cream, and packaged foods prepared with lactose; such as, bread, cereal
and salad dressing
·
Foods
containing sorbitol; such as, dietetic foods and sugar-free candies and gums.
Potassium, sodium, and chloride are intricately related
electrolytes—mineral salts that conduct electricity when dissolved in
water. Electrolytes are always found in pairs. A positively charged molecule
like potassium or sodium is always accompanied by a negatively charged molecule
like chloride.
This is why they are intricately related. Every cell has a
sodium-potassium pump which actually pumps sodium out and potassium into the
cell. If sodium is not pumped out, water accumulates in the cell and causes it
to burst. The pump also helps maintain the electrical charge within the cell.
This is very important to muscle and nerve cells, and explains why a potassium
deficiency affects muscles and nerves first.
Potassium is the most important of the three because it is also
essential for converting blood sugar into glycogen, the storage form of blood
sugar in the muscles and liver. A shortage of potassium results in lower levels
of stored glycogen, which can hinder exercise due to the rapid depletion of
energy. A potassium deficiency produces great fatigue and muscle weakness, the
first signs of potassium deficiency.
Excessive fluid loss through sweating, diarrhea or urination is a
common cause of potassium deficiency. Athletes, people who regularly exercise,
or those working in warm environments can lose up to three grams of potassium a
day through perspiration. Diuretic medicines, which are designed to rid the
kidneys of excess fluid and help sodium, can also cause potassium deficiencies.
Where sodium goes, potassium does too, and so potassium needs to be
replenished.
The proper potassium and sodium balance in food is important, as is the
proper balance of potassium and sodium consumption. One of the most common
problems is too much sodium in the diet, thus disrupting the balance. A
great many studies demonstrate that a low-potassium, high-sodium diet plays a
major role in the development of cancer and cardiovascular disease. A diet low
in sodium and high in potassium, not surprisingly, protects against these
diseases.
Though low potassium levels are associated with
high blood pressure, it is not clear if higher potassium levels regulate
it. Sodium restriction alone will not
improve blood pressure control in most people. It should be accompanied by a
high potassium intake. Most Americans ingest twice as much sodium as potassium
mostly through prepared foods. Researchers recommend a dietary
potassium-to-sodium intake of greater than 5 to 1 to maintain health, a level
that is ten times higher than the average intake.
To insure that enough potassium is being
received, a natural diet rich in fruits and vegetables high in potassium is
strongly recommended including:
avocados; bananas; chard; citrus fruits and juices; lentils; milk;
almonds, brazil, cashews, peanuts, pecans and walnuts; potatoes; raisins;
sardines; spinach; whole-grain cereals.
Some of the proven benefits:
·
Promotes
regular heartbeat.
·
Promotes
normal muscle contraction.
·
Regulates
transfer of nutrients to cells.
·
Maintains
water balance in body tissues.
·
Preserves
or restores normal function of nerve cells, heart cells, skeletal-muscle cells,
kidneys, stomach juice secretion.
·
Treats
potassium deficiency from illness or taking diuretics (water pills), cortisone
drugs or digitalis preparations.
Some unproved speculated
benefits:
·
Cures
alcoholism.
·
Cures
acne.
·
Cures
allergies.
·
Cures
heart disease.
·
Helps
heal burns.
·
Prevents
high blood pressure.
Special benefits are given
to:
·
People
who take diuretics, cortisone drugs or digitalis preparations.
·
Anyone
with inadequate caloric or nutritional dietary intake or increased nutritional
requirements.
·
Older
people (over 55 years).
·
Pregnant
or breast-feeding women.
·
Women
taking oral contraceptives.
·
People
who abuse alcohol or other drugs.
·
Tobacco
smokers.
·
People with
a chronic wasting illness, excess stress for long periods or who have recently
undergone surgery.
·
Athletes
and workers who participate in vigorous physical activities, especially when
endurance is an important aspect of the activity.
·
Those with part of the gastrointestinal tract
surgically removed.
·
People
with malabsorption illnesses .
·
Those
with recent severe burns or injuries.
·
Vegetarians.
Complications
include:
·
Hypokalemia—abnormally
small amounts of potassium ions causing weakness or paralysis due to loss from
gastrointestinal tract or kidneys.
·
Low blood
pressure
·
Life-threatening,
irregular or rapid heartbeat that can lead to cardiac arrest and death
Note well: It is virtually impossible to develop a potassium deficiency with a balanced diet. People with diabetes, ulcerative colitis, Crohn’s or kidney disease are an exception. Potassium supplements should only be taken under your doctor's supervision.
Abdominal Noises
--Internet Sources
Everyone seems
to receive those certain messages from inside our tummy at some time or
another. Rumbles, grumbles, growls and
howls…these noises come from the abdomen and are sometimes noticed by
anyone within hearing distance.
Since this
happens to everyone, you would think that we could just laugh them off or
ignore them. Instead, we are
embarrassed. As ostomates, we wonder if
something is wrong since it seems to happen more often with us. Or, at least we seem to be more sensitive to
it than we were before we had surgery.
These
abdominal noises are formally named barborygmi (bore-bore-rig-my). If pain accompanies these noises, it could be
a sign of an obstruction, an ulcer or a gall bladder problem. It is necessary to see a doctor if these
conditions persist. However, it is usual
that all these sounds with all there fury really signify nothing
important. The cause may be any of the
following:
·
You are hungry. Peristalsis goes on whether there's anything
to move or not.
·
You are nervous. Peristalsis increases with stress.
·
You have been drinking coffee, tea, cola or
beer. These also stimulate
peristalsis. Since these are often drank
on an empty stomach, they produce gurgles as peristalsis redoubles its
movement.
There is
literature about lowering ones cholesterol by eating a high fiber diet. You may have taken this advise and adder
these high fiber foods to your diet.
Digesting fiber produces gas therefore, abdominal noises will
increase. If you wear an appliance, you
will notice that it quickly fills with gas, and you are wearing a balloon.
Eating too
many carbohydrates will also increase gas.
Our digestive systems do not digest starches and sugars as easily as
protein and fats. The concerns are often
lactose, a sugar found in milk and mild products, sorbitol, a sugar free
sweetener, and raffinose and stachyose, sugar in dried beans. The result is more gas gurgling.
You may be
eating too fast, have your mouth open when eating or talking while eating. Your mother always told you it was impolite,
but she didn't mention that you would swallow air. Air which makes grumbly noises as it is moved
along the digestive tract.
To prevent
gas eat a snack of healthy fruit or vegetables between meals if your are
hungry. You may also eat smaller more
frequent meals. And finally, eat slowly,
chew your food well and don’t gulp.
Electrolyte Replenishing Drink
Comparisons
By http://ourworld.compuserve.com/homepage/branded/gatorade.
Sports Drinks
The problem with some sports drinks is that they have too much carbohydrate(CHO) and that can slow down gastric emptying (and cause you stomach distress). The recommendation has been to keep to drinks that are 8% or less CHO load (or dilute down to that point) to avoid this problem. You can also make your own, as most of these drinks provide fructose and sucrose along with sodium to help you maintain electrolyte balance. For instance, Gatorade provides 14g of CHO per 8 oz serving, half of what you'd get from the same amount of apple juice. A diluted mix (1:2 or 1:4 of fruit juice with water) with a few tablespoons of table sugar and a pinch of salt would do it. I have used a mix of 50% apple juice, 50% water, and a squeeze of lime to improve the taste, to limit things to mostly fructose. I tend to mix Gatorade 50/50 with water, or carry one bottle of each. The key is that you want to like the taste of whatever you're drinking to be sure that you keep drinking - and stay hydrated! Here are some typical products I have found some data on (some specialize in adding potassium, calcium, chloride, magnesium, or vitamins):
Values for 8 oz serving (~225
ml)
Drink
%CHO sodium
mg potassium mg
Quickick 5 115 25
Gatorade 6 110 25
Gatorlode 20 low n/a
10-k 6 55 25
Endura 6 90 180
ThirstAde 6 110 25
Everlast 6 100 20
Hydra Fuel 7 25 50
Exceed 7.5 50 45
Exceed Hi Carb 26 115 n/a
PowerAde 8 70 30
Pro Motion 8 8 100
Allsport 9 55 55
Cytomax 11 100 200 Gookinaid 12 70 70
The higher percentage products are often intended for after exercise recovery of your lost glycogen stores (studies have shown that glycogen levels in the muscles reach normal quicker if you do carbo loading after a workout).
Editors note: The home-made drink does not appear to have much potassium, an important thing for ostomates. The 6% to 8% CHO (carbohydrates) has been proven by studies to be the most effective in getting rapidly from your bloodstream, across the capillary walls, to the muscles, etc. Up around 12% CHO, it actually impedes rapid crossing from the bloodstream into your body and happens at a much slower rate with less efficiency.
Some Food Facts for Ileostomates
By Dr. Phillip Kramer
For
ileostomates, it's important to know the effects of various foods on ileal
output.
Dr. Phillip Kramer of
Boston University's School of Medicine has conducted 224 studies of
ileostomates, exploring exactly that. Here's a summary of what
he found:
·
The average output per day from
an ileostomy is about a pint, comprised 90% of water and IO% of solids. Normal fecal matter is 70% water and 30%
solids. Fat and nitrogen content of
ileal discharge is normal, indicating food absorption in an ileostomate is
normal. Salt output is very high, around
one tsp. per day, versus almost none in the feces of a person with an intact
colon. Proper intake of salt by an
ileostomate is therefore very important.
·
Intake of too much salt is to
be avoided because it increases ileal output.
The body itself seems to compensate for salt and water loss by discharging
less salt and water than normal through urination and perspiration.
·
Above-normal water intake is
needed to minimize potential for kidney stone development, because urine output
is usually subnormal in an ileostomate.
·
One of Dr. Kramer's studies involved
high intake of water, up to 3.5 quarts per day.
At this high level, ileal output was unchanged, but urine output
increased.
·
Some foods tested in Dr.
Kramer's studies produced no increase in ileal output. They are:
dark rye bread, milk, cottage cheese, pork, apple juice, grape juice,
watermelons and cantaloupe. Some
foods which increased output were: prunes, raw figs, dates, stewed apricots,
strawberries, grapes, bananas, beans and cabbage.
Toffee Gums Up
the Ostomy
By The New Outlook,
I wanted a sugar fix and went out and bought
lots and lots of nice soft toffees.
Alas, after
having to change my flange 5 times in 48 hours, I realized the toffees had
gummed up the works. That is to be taken
literally and figuratively.
Yes, my
system was stressed. The stoma was
stretched and bleeding. It also
exhausted me, and I spent most of the of that day lying down. I
hope this warning prevents some of you ostomates from going through the pain
and frustration that I went through before I clued into the fact that the
problem was the toffee.
Oh well, I
did enjoy them but never again.
Editors
note: Many of us continue to eat
toffee. The problem comes in when you
eat too much for your system to handle.
Also, you should always drink water whenever you eat anything. This is more true for ileostomates than
colostomates or urostomates. In our new
life we must never overeat. Some test
this and get away with overeating because the foods they eat are safe for their
system and pass right through.
Eventually, they will overeat something like toffee. That is when they have problems. They blame the food and not their own
eating habits. I don't mean to be
insensitive. I do want you to live a
full live without any pain or problems with your ostomy. Maybe if I make a warning stern enough, it
will save just one person from this.
Quick Food Reference
By Jason Dale, United Kingdom
After you have had a stoma operation you may find certain foods affect you in ways they didn't before. This can be embarrassing at times and it helps if you know which food can do what to your system. This table is designed to help you find problems foods, and either avoid them or moderate your intake.
Remember that we are all different though, if it affects me for example, it may not affect you. Don't be afraid to try new foods, we are all different. Read the key so that you can see how foods affect you. This table is designed for colostomy, ileostomy and urostomy patients.
F = May cause flatus
O = May cause odor
L = May cause loose stool
C = Requires chewing well
D = May discolor urine
Col = Colostomy patients
Ileo = Ileostomy patients
Uro = Urostomy patients
Food &
Drink
Col
Ileo
Ur
------------------------------------------------------------------------------
Apples
L
Apricots
L
Artichokes
F
Asparagus
F
O
Bananas
F
F
Beans (all
types)
FLO FLO
Beef
C
Beer
F
F
Beetroot
D
Broccoli
O
FO
Brussel
Sprouts
F
Bean
Sprouts
L
Bamboo
Shoots
L
Food &
Drink
Col
Ileo
Ur
------------------------------------------------------------------------------
Cabbage
F
LF
Cauliflower
FO
FO
Cereals
L
Cheese
O
Celery
L
Chocolate
L
L
Coconut
CL
Coleslaw
C
Cucumber
F
OF
Curry
LF
LF
Eggs
OF
Figs
L
L
Fish
O
O
Fizzy
drinks
F
F
Gooseberries
L
Food &
Drink
Col
Ileo
Ur
------------------------------------------------------------------------------
Grapes
LC
Kiwi
Fruit
L
Lamb
C
Lettuce
L
Mango
L
Mushrooms
F
F
Nuts (all
types)
C
C
Oil based salad dressing
L
L
Oranges
L
Onions
OF
OLF
Parsnips
O
O
Peas
L
Pears
L
L
Pineapple
LC
Plums
L
Food &
Drink
Col
Ileo
Ur
------------------------------------------------------------------------------
Popcorn
L
Porridge
L
Potatoes
C
Prunes
L
L
Radishes
F
F
Raspberries
LC
Rhubarb
L
L
Seafood
O
O
Spinach
LF
L
Spring
Greens
O
Strawberries
L
Sweet
corn
L
LF
Tomatoes
L
Turnip
O
O
The Affect of Fiber
By Kay L. Peck, MPH
Whether or
not to include fiber and to what extent should be based on the ostomates
tolerance of foods. The intestine has a
remarkable capacity to adapt. Digested
food in the small intestine is quite watery.
After it moves into the large intestine, a good portion of the water is
re-absorbed into the body.
Most fiber is
indigestible material from plants that acts like a sponge, soaking up water and
increasing the bulk of the intestinal contents.
This makes matter move through the system more quickly.
In a person
with a colon, fiber is essential to preventing constipation and keeping a
person regular. This is the main
function of fiber. Another theory about
fiber is that it promotes mucosa growth thus keeping the intestines healthier
and promoting gut function.
Usually a
person without a colon doesn't have a problem with constipation and may have
mostly watery stools. Over time a person
may adapt, especially if the last section of the small bowel, the ileum, is
still intact.
Consuming too
much fiber, that is insoluble fiber, may aggravate a person's watery
stool. If this is the case, limiting insoluble
fiber such as bran, popcorn hulls, seeds, nuts, skins and stringy parts of
fruits and vegetables may be helpful.
However,
another type of fiber, that is soluble, may be beneficial. The function of soluble fiber is to make
intestinal contents thicker. This can
actually prevent diarrhea.
This fiber is
found in oatmeal, barley, certain beans, apple sauce, and the pulp of certain
fruits and vegetables. Most foods have a
combination of both types of fiber.
Editor's note: Ileostomates and some colostomates must be
careful not to over eat certain types of fiber.
These will cause a blockage at the stoma. Always moderate your eating, and drink plenty
of liquids to keeps these foods soft while being digested. This article is suppose to encourage
ostomates to eat fruits and vegetables.
Fat Substitutes
Contributed by Jane Michnik
Individuals using products with fat substitutes rarely lose
weight, researchers say. Their report in Circulation: Journal of the
American Heart Association notes than more than 90 percent of U.S. adults
report eating low or reduced-fat foods and drinks, many of them made with fat
substitutes.
“Yet the number of overweight individuals continues
to increase," said Judith Wylie-Rosett, a member of AHA’s Nutrition
Committee. Fat substitutes are compounds
used in place of fat to provide food with the moisture retention and texture
that usually come from fat. "The
bottom line is that foods made with fat substitutes, used in moderation, may
provide some flexibility in food selection, but are not an effective strategy
on their own for weight control.
Often, reduced-fat versions of products have the same or
even more calories than their full-fat versions," said Wylie-Rosett, a
professor of epidemiology and social medicine at the Albert Einstein College of
Medicine in New York. Fat substitutes
have contributed to the overall trend of less fat in the U.S. diet, she
notes. Americans have nearly met the
government's population-wide goal of reducing fat consumption to no more than
30 percent of total calories.
A 1988-1991 government survey showed that Americans
consumed about 34 percent of total calories from fat, compared to 40 to 42
percent of total calories in the 1950s. "We've done well in getting out
the message about reducing fat intake," Wylie-Rosett said. "Now we
must put the emphasis on obesity, which has doubled in the last 20
years.”
Hydrox Fecalis
--Tufts University, Diet
and Nutrition Letter
Dark
Bowel movements are met with alarm by physicians and patients alike,
particularly when they coincide with stomach aches. The blackish color can be a sign of serious
illness.
The
greatest concern is that it is a sign of blood loss from some internal organ. But, an editorial report in the New England
Journal of Medicine suggests that black stool may simply be the result of
overindulgence in Hydrox-type cookies.
Stephen
Sulkes, MD of Monroe Developmental Disabilities Service Office in Rochester,
NY, reports on a presence of black stool movements and abdominal pain be
questioned about their dietary habits.
Dr.
Sulkes states that tests with other cookies, including oatmeal, peanut butter
and chocolate chip, have not caused bowel color change, "although abdominal
pain or nausea or both appear to be equally frequent associations" and
suggests that people complaining of dark stool movements and abdominal pain be
questioned about their dietary habits.
So,
if you go on a binge of eating chocolate sandwich cookies or other dietary
components, including licorice, certain fruits, and iron supplements. (these
can also give you black stools) be prepared.
Eat Sensibly with an Ileostomy
--The Good News, Macomb County Michigan
Say it has been several months since you had your ileostomy surgery, and
now you are beginning to adapt to your new plumbing. You have a beautiful stoma, and changing your
ostomy system is almost routine. Your
skin has now become accustom to the skin barrier, and you wear you appliance
about five days before changing it.
Boy, this is living! No more
pain, and you can go out without worrying about finding the location of every
toilet. You accept an invitation to a
party for the first time in two years and really enjoy being out with you
friends again.
You drink with freedom and down handfuls of peanuts. You wander to the table set with raw
vegetables and dip and join in. The
dinner is delicious, including the corn.
This has been a truly good night—just like old times.
Now,
it’s two o’clock in the morning and you haven’t been able to
sleep. There has been a persistent pain
around your stoma that won’t let you sleep. And now it is increasing.
You recall that you have not had much effluent in your pouch and what
you did have looked like dirty water. By
three o’clock, it is much worse and be four o’clock you are
considering calling your doctor. But,
you decide to wait just a little longer.
You remember remedies that were mentioned at a Chapter meeting. You drink some hot tea; pull your knees to
your chest and rock back and forth. You
drink some more and get on your hands and knees and rock. You eat some crackers, drink more tea and
knead your stomach.
You drink some more hot tea while getting into the shower to let the
warm water roll down your back. You’re
about to remove your barrier to let your stoma expand when things seem to ease
up a bit, and then you notice that your pouch is not longer empty.
When you finally empty your pouch, it’s like pouring a bag mixed
with peanuts, vegetables and corn into the toilet. You have learned a valuable lesson. You may be able to eat nuts, popcorn, raw
vegetables, or even corn-on-the-cob, but common sense will tell you that in the
future not to eat large quantities of them all at the same time. The moral of this story is:
·
Never
overeat
·
Eat high
fiber foods only in moderation
·
Chew...chew...chew!