Slow output/new foods ... advice?

OK, so it's been more than three weeks since I had a total colectomy and ileostomy (temporary). It took me a while, but I'm starting to get comfortable eating solid foods. However, it takes about nine to 10 hours for anything to pass. Does anyone else have to wait that long?

Also, I'm wondering about trying new foods, as I have only had eggs, cheese, mashed potatoes and egg noodles. Does anyone have an opinion of/experience with meatloaf? What about ice cream? I'd like to try that but don't know what kind would be best.

And, I really would like to have something hot and caffeinated. I was a coffee addict prior to surgery, though I'm wondering if maybe I should try tea instead (I have some green tea). If anyone could chime in on this, it'd be much appreciated.

I'm currently on TPN, so I'm getting most of my nutrients from that, as well as Ensure Clear and Ensure Plus. But I really want to be able to eat like a normal person -- or, at least, a normal ostomate.

I have been given the impression that as long as you are not having blockages, slow transit isn't necessarily a bad thing. The longer the food takes to get through your intestine, the more nutrients your body absorbs....if it moves through too quickly, you don't get as much nutritional value from the things you eat.

That said, a lot of the things you say you are eating are known to cause slow or thick output. Maybe you should try adding foods that might thin it out some....sugary things, more liquids, fruit juice, coconut water. Some others here might have more suggestions. I am a little over 4 months out from surgery and am now eating almost anything with no problem. I have had meatloaf...no issues at all....I eat ice cream almost every day (yikes!) and no problem there either. I also drink lots of coffee....something I am SO happy to be able to do again. Just be careful with caffeine because it can be dehydrating....I always drink extra water if I have a lot of coffee.

Just try things a little bit at a time to see how it goes. Let us know if you have any more questions.

Like uc what said, the potatoes and pastas are thickening foods and will move more slowly. Also applesauces, bananas, and rice move slowly through my system.

If I feel uncomfortable and am experiencing cramping, I will drink 100% welch's grape juice or pickle juice and these will usually get things moving. I have a parastomal hernia and it will sometimes get hard and painful. I wonder if this is a partial blockage??? I don't want another surgery though anytime soon. Ugh.

Why do you have a stoma?

Billy, I had that too. Lots of gas and just a bit of kidney bean shaped output. Sure wasn't equal to the amount of food I was eating! Try prune juice to get things moving again, even a 1/2 cup worked for me. You may want to increase the amount of liquids/water you're drinking throughout the day, too.

If you start feeling a lot of pain, call your doctor's office. You don't want to develop a blockage. I was checked for one, didn't have it....but boy, my intestines hurt when they were full! Also, check booklets you've received on caring for your stoma. Hopefully they will have a list of foods that will thin your output/stool (and a list of foods to thicken your stool).

Someone recommended I take chewable gas tablets before every meal. Great advice, I have a lot less gas now! Good luck, hope you get the issue sorted out soon. :)

Billyostomy said...
OK, so it's been more than three weeks since I had a total colectomy and ileostomy (temporary). It took me a while, but I'm starting to get comfortable eating solid foods. However, it takes about nine to 10 hours for anything to pass. Does anyone else have to wait that long?

Also, I'm wondering about trying new foods, as I have only had eggs, cheese, mashed potatoes and egg noodles. Does anyone have an opinion of/experience with meatloaf? What about ice cream? I'd like to try that but don't know what kind would be best.

And, I really would like to have something hot and caffeinated. I was a coffee addict prior to surgery, though I'm wondering if maybe I should try tea instead (I have some green tea). If anyone could chime in on this, it'd be much appreciated.

9-10 hours was totally normal for me when I had an end ileostomy (which I assume is what you have too?). It didn't really make me uncomfortable unless I ate a BIG meal, but giant meals don't make ANYONE comfortable, colon or no.

If you're not happy with your transit time or the consistency of your output, you could try diversifying your diet. All of the foods that you're eating right now are the ones that are suggested to help firm up output and slow down transit time, so it's not surprising that yours is on the slower side. Ice cream would speed things up, but it can also cause gas if you're lactose intolerant at all so careful on that front.

One of the most benign ways to speed up transit is a hot beverage. Caffeine works too. Tea or coffee will definitely speed things up/thin your output. I drink tons and tons of tea (mostly iced, it's incredibly hot here) with my ostomy, and usually a cup of coffee each day.

I understand all of the food fear -- I was on a severely limited diet of only about five different foods for several months before surgery, and I was really scared of adding new things to my diet after I got my ostomy. I know it's not very deep, but one of the residents in the hospital said to me when I was advancing my diet for the first time: "We don't want you to be afraid of food." Simple but it really stuck with me! I was TERRIFIED of eating and absolutely neurotic about watching my output, checking for GI distress, etc. I know no one can tell you "don't worry" and instantly cure your worrying, but... don't worry. Let yourself try a new thing everyday, in a small amount. Let those things be the things you LIKE that you really miss!

Has your transit time sped up since you added coffee and more foods? My guess is that fiber was constipating in the colon, not the small intestine, but either way you're going to have to attack it like anything else and just try very small amounts to start and ramp up. Seems like you're about 5 or 6 weeks post-op now, so it wouldn't be crazy to start adding small amounts of fiber. Cantaloupe and honeydew melon are good starter fruit because they don't have a lot of insoluble fiber, stringy pieces, seeds, etc. I would continue to steer clear of whole grains, nuts, and seeds for a while.

Chew everything well, have a small quantity, obviously no peels etc. Another good tip is to eat it with something that passes well like a piece of bread.

If you haven't had ANY output for the past six hours, you might be having a blockage. Don't take in any solids until you see output. Drink hot liquids, walk, drink juice, try lying in different positions (e.g. on your side), take a hot shower, gently massage your abdomen... no solids until you see output in your bag. With an ileostomy there are 'quiet times' with relatively less output but you should never go very long with absolutely nothing coming out.

I had the same exact thing before my stoma. Consuming fiber was counter productive and caused a worse constipation and a severe bloat. Even the fiber in a cup of Cheerios caused my stomach to swell up.

Now I can have some fiber, but not much. I can eat more food at a time, but I still get full quicker than most. I did gain weight though with this end ileostomy and had to cut back on calories, something I never had to do before. But you have the liver sickness, so I'm not sure about you.