Post Surgical Diet

Food, water and ?
As an ileostomate, I'll tell you that the absolute most important thing
is to stay hydrated.

You shouldn't drink "more", you should drink more often The rate
of about 4oz per hour, every hour, can suffice. Drinking too
much all at once, will go straight through.

When they give you an ileostomy, they remove the ileocecal valve
along with the colon, since it's part of that colon. The valve serves
two purposes:
1. It keeps the bacteria in the colon from backing up into the
ileum (small intestines), and
2. It allows the brain/body to control the flow from the ileum into
the colon.

Without the colon, the digested food is going out the stoma and
into the appliance (pouch) for disposal. The colon isn't there to
take out the balance of liquid and recycle it, keeping you hydrated.
(Likewise, nourishment is going to be lost as well)

The processing of food from your mouth to the top of your large
intestines (colon) usually takes about four hours. Without that
valve, it can take as little as fifteen minutes. We can go about four
hours also, but there is no way to control it, to keep it predictable.

As far as a diet? You should be able to eat anything you want to,
just as before, but you will want to chew everything thoroughly.

The intestine is the same size, and the same food particles will
pass through as well. But..... and this is important.... You will
experience some problems with adhesions. An adhesion is when
the intestine sticks to another organ and gets kinked or twisted.

It happens from the invasiveness of surgery, and there's not
much that can be done to avoid that.

Also.... where the stoma is formed, is where it takes an unusual
turn out through your body, and it's at that location that a chunk
of un-chewed food (like broccoli) can get jammed..

All that aside......

I hope you have taken great time consulting with the surgeon
about exactly where the stoma will be?

You should have an experienced colorectal surgeon. If you do not,
please take some time to do some research.

The stoma should be placed so that you have at least 3/4" to 1"
protruding from your body.

The location is generally a 4x4 rule. It should sit off to the side
of your middle (belly button) by about 4", and below your normal
waistline by about 4".

Those dimensions can vary, but you want it placed where you can
wear fairly normal clothes, without obstructing the outflow.

You also want it placed where there is no fold of the skin.

A good surgeon will have you marked for it's position, and let you
wear an appliance (bag) filled with applesauce (or whatever)
and have it stuck to where he is going to place your stoma.

That will give you the best experience prior to the surgery, to
know if it will be the best place for it.

Doing that well ahead of surgery will take a million tons of
grief and headaches out of having an ostomy.

If I can help further, just ask. But do tell your surgeon not to
operate until this is done your way.

Good Health!

John

Ostomy
I had a colostomy and there was talk for awhile of a total colectomy. I found the most help at the ostomy assc website: uoaa.org Click on 'disscussion' for the forums. You will find answers and can ask questions. HTH

Outwit. Outplay. Outlast.

Kimby

gitelfagel said:

diet
Thanks John for your very valuable advice.

I have already worn the bag for awhile. I just needed some advice on food to have in the house for when I get home. I am already prepared for the hydration as well. I am a good hydrator since I have kidney issues, but the timing advice is something else of which I wasn't aware.

However, I didn't know about the protrusion length of the stoma. I will definitely be covering that with my doc beforehand. What do I do about the adhesions? That is not something the doc has covered either. Hopefully he will as part of my followup.

More stuff
The protrusion of the stoma of 3/4" to 1" should be mandatory!
It's that "spout" that allows your stoma to expel the digested
food directly into the pouch. If it's too short, or an "innie" (sitting
below the skin), it will be difficult to keep a good seal, since the
waste will work itself under the wafer and destroy your skin.

I didn't have the options, since I had absolutely no idea they were
going to give me one. (My first operation took 4' of colon, but
left me connected. They goofed up and had to re-open me a week
later, doing the same operation and leaving me with an ileostomy)
I lucked out, since they were "experienced" colorectal surgeons,
(albeit clumsy), and I ended up with what I can live with. And although
it's "temporary", it would require the same intensive operation
as the 1st and 2nd.....

Anyway...... You have time to demand it to be the way it
will work best for you. Placement and that "spout" is most
important.

Adhesions...... are nothing that can be avoided, and there's not
much you can do when you get 'em. Any operation to clear
an adhesion will produce more adhesions. The only time an
operation is required (or even suggested), is if the organ is being
twisted to the point of strangulation, causing an obstruction or
worse, cutting off blood supply to the organ. It's rare, but it happens.

Hernias are also fairly common. The intestines will be pushing
against much thinner areas, and against muscles. Where they yank
that part of intestine through to give you that delightful stoma,
is where it's easiest to get a hernia. And again, repairing
a hernia causes more problems.

After surgery, there are weight limitations that will stay in effect
for months or longer. Since they take "stuff" out, leaving more room,
your intestines and organs have room to drift about, and settle,
and adhere, and herniate , oh my.

So using abdominal muscles, can push inwards as well as outwards,
and force things into areas they shouldn't be.

It's all part of abdominal surgery.

Isn't it just grand? Gotta' love it.

After you finally get through all this, all the people that have never, ever
complimented you regarding looks, will tell you how good you look.

That's probably the only up-side, ehh?

Stay well, and see you here when you get out of surgery.

John