Ostomate Eating: Intentional About Food Choices Just Like Everyone Else
Food is often the topic of conversation for ostomates. Being familiar with food do’s and don’ts as well as common sense practices is important both during the holidays and during regular times. I’ve decided it would be helpful to share some thoughts and practices since having my ileostomy surgery and that sitting down with a friend for a Q & A would be the most effective way to do this. Nothing here should be construed as medical advice. Far from it. But as an ostomate, I’m part of a larger community. Since my ostomy, I’ve found being aware of what others are doing and thinking is helpful for calming my fears, addressing my concerns, and in general keeping me on track. So I’d like to reciprocate. Sharing some of my experience may be helpful to you.
Q. Were you finicky about eating when you first had the surgery?
A. Yes, I definitely was. I was actually pretty concerned about a bunch of things, especially because I noticed that foods like beans used to give me a bit of digestive slowing. [Laughing] Actually, at first, because of this, I was like, “Hey, doc, can I eat this or that?”
My doctor said for me, it’s really about the consistency of food more than anything else. Eating a whole lot of whole beans can be bad but eating some beans that have gone through a food processor is fine. That way you can be sure food moves through you as opposed to building up. That’s kind of in line with chewing food well to help digestion which is also important for ostomates and everyone really.
The other thing I did right after I got out of the hospital was meeting with the nutritionist who is affiliated with my doctor. I wanted to get a better understanding of what I should be doing to put weight back on by eating the right foods with the right kind of calories. The nutritionist talked about having good fats like coconut oil which are good for the body. She also mentioned coconut milk, but I found that didn’t always agree with me.
Q. With more time and a few big eating holidays behind you, did you feel differently about food this holiday season than last and will any lessons learned make you better prepared for the new year?
A. Yeah, a little bit actually because I've had a whole year and a couple of months to see where I am food-wise. Last Christmas, it was only just under six months and I sort of had to gingerly figure out how I could or couldn’t eat this or that. I had to wonder, or worry, how I was going to feel. My wife, Michelle, and I were so cautious that we were preparing meals that were honestly very bland.
But around this time last year, we were talking to Michelle's cousin. I said I had become kind of bored with food and that I didn’t know what to eat anymore. I’d described how I like chicken, but we were just cooking chicken, plain, in a pan. He suggested that we ramp up our recipes…you know, why not chicken parmigiana with a little pasta on the side, he asked. It made us think, why not. He recommended punching up simple basic foods to give them more zest. That one conversation helped me/us step a little out of our comfort zone. It worked. I got my enjoyment of food back. I also had to kind of laugh at myself. I had been through the big adjustment with the surgery, but for whatever reason my brain never even thought of reintroducing variations like chicken parm into my daily eating routine to get back to eating more normally.
Q. So, all that said, do you have restrictions now?
A. I am staying away from undercooked vegetables and nuts and foods with a lot of seeds. Everything else is pretty much fair game. Michelle and I have gotten into a comfortable routine with meal planning. In fact, we’re not actually watching as much as we were at first, so meal planning and eating are becoming more natural again.
One thing I did like that I’ve had to modify is broccoli. I can eat the florets but the stems, which I always enjoyed, are hard on the digestion. Chinese vegetables are another culprit because they tend to be lightly cooked. So I avoid them, cut off the tough parts, or in the case of the Chinese vegetables, push them to the side of my plate. Since my stomach problems came from lack of motility, I have to be careful about food that might not easily move through my digestive system. It’s the same with people who pre-surgery suffered from Crohn’s, IBD and colitis. We all have to be mindful of our trigger points.
For me, and I know for many ostomates, gas and bloating are a focus. I even have to be mindful when eating those broccoli florets. They’re gassy. So is cauliflower or something like Brussel sprouts which is not only gassy but also not tender.
The ironic postscript, though, is that I’ve actually been able to eat more fruits since my surgery.
I even eat a little sushi and enjoy spicy tuna rolls or rolls with salmon in them. I sense that one of the things ostomates are concerned about with something like sushi is odor when and after emptying the ostomy bag. Excessive odor is not something I’ve noticed, however, so it has not been a concern for me.
Q. What about coffee and alcohol and hydration?
A. It’s imperative that ostomates keep themselves hydrated. Coffee may keep you from being tired, but it’s a diuretic. So is alcohol. With both, you’re taking in liquid, but they promote the production of urine, so they do nothing to keep you hydrated. In fact, they work against it.
For the past few years, I’ve limited my coffee intake to one cup a day. I drank it in the morning to try and get my intestines moving. (It actually can help with motility.)
As for drinking alcohol, the mantra is the same with an ostomy as it is without one: moderation. With an ostomy, however, it’s important to check with your doctor to make sure you can imbibe in the first place. Beyond moderation and permission from your physician, as we head towards New Year’s we all should have some best practices in place for social drinking. It’s recommended that you drink a glass of water along with your drink. It’s also advisable to eat when enjoying an alcoholic beverage or two, particularly foods that soak up alcohol. For example, starchy foods like bread, pretzels and pasta help slow the absorption of alcohol.
Q. What about nutrition?
A. Ostomates need to be particularly aware of vitamin and nutritional concerns. Alcohol, for example, is one culprit that can result in electrolyte disturbances including low potassium, low magnesium, and low calcium. Electrolytes are minerals in body fluids. They include sodium, potassium, magnesium, and chloride. When you are dehydrated, your body does not have enough fluid and electrolytes. Dehydration can cause an irregular heartbeat, and also kidney damage. Eating a banana which is rich with potassium and magnesium, or a handful of strawberries which is loaded with calcium are not only smart accompaniments to alcoholic beverages but also integrating them into your regular eating regimen also makes for best practice. This is particularly important for ileostomy patients like me because potassium, sodium, and water depletion through the stomach and intestines is common.
Your doctor, like mine, keeps an eye out for your measure of sodium and potassium concentrations and measures these to make sure there’s no lack of these minerals. A combination of fatigue, muscle weakness, shortness of breath, decreased sensation in arms and legs, and/or a gassy bloated feeling may be a red flag signaling a potassium deficiency.
Adequate daily hydration is imperative. It is also an effective antidote to electrolyte imbalanceand is a helpful complement if you’ve had a celebrative drink in the new year or when socializing with family and friends. Nutritional supplements enhance the efficacy of hydration. I like to use my own solution: a mixture of 6 ounces of cran-grape juice, ½ teaspoon of salt and 26 ounces of water .
Q. Did any of your considerations with food motivate you to develop the Ostoh?
A. In a way, yes because I was trying to rid myself of extreme gas problems. You know, really, a lot of our food choices relate to being confident that the choices we make are not going to get us into compromising situations. And for me, Ostoh gives me a higher degree of freedom with food. For example, I don't need to stop myself from eating cheese, so I won’t get gassy. With my Ostoh, I don't have to worry so much.
Life has an unusual way of pushing you to where you need to go. To me, that’s what Ostoh is all about. If you’re interested in learning more about Ostoh and how it can increase your comfort, email us at hello@ostoh.com. Our goal is to make your ostomy life easier and make you feel what it means to be yourself.