Download High output stoma dietary information

Patient Information
High output stoma
dietary information
The information contained within this diet sheet is intended to
be used alongside the tailored dietary advice provided by your
dietitian
Author: Dietetics and Nutrition
Produced and designed by the Communications Team
Issue date Jan 2016 - Review date Jan 2019 - Expiry date Jan 2020
Version 2
Ref no. PILCOM1737
Having a high output stoma can mean that nutrients and fluids pass
rapidly through your bowel, which can lead to poor absorption of nutrients,
fluid and salts. Over time, your bowel may begin to absorb nutrients more
efficiently and your output may begin to thicken.
A high output stoma can lead to severe dehydration and weight loss.
Learning about the types of food and fluid you should take and in what
quantities can help successfully manage your stoma output.
2
Food
Fibre
Foods that are high in fibre are often difficult to digest and can increase
your output, lower fibre foods are therefore recommended. Below is a
table showing the type of foods to have and those to be avoided.
Low fibre foods
Foods to avoid
z White varieties of rice, pasta and z Brown/whole varieties of rice,
bread
pasta and bread
z Tinned fruit
z Hard fruits, e.g. pineapple
z Ripe fresh fruit without skin, pith, z Unpeeled fruit, pips, stalks,
pips or seeds
seeds and pith
z Peeled well cooked or pureed
z Vegetable skins, pips, stalks,
vegetables including passata
seeds and pith
z Peas, pulses (e.g. lentils, dahl);
beans (e.g.kidney beans, mung,
chickpeas)
z Flours made from pulses (e.g.
gram flour)
z Raw vegetables and windproducing vegetables (e.g.
Brussel sprouts, cabbage,
onions)
z Sweetcorn, celery, coconut,
mushrooms, tomatoes
z Fruit juices with no pulp z Dried fruit and nuts
in moderation
z Dairy foods - plain cheese,
z Cheese and yoghurts with added
fruit and/or vegetables
yogurts, milk (including yoghurt
with fruit puree)
z Lean meat, fish and eggs
z Well-cooked meat (e.g. pulled
pork, meat in casseroles)
z Highly spiced meats
When your stoma has settled after surgery you may want to re-introduce
fibre but always in small quantities, ensuring that the foods are well
cooked and chewed.
3
Salt
Salt is lost through a high output stoma, which we can replace in the food
we eat.
z Sprinkle a little salt on your meals – ½-1 teaspoon every day
z Try cooking your meals with salt
z Eat salty foods such as cheese, bacon, ham, sausages, smoked fish
(kippers), shellfish, canned fish in brine or sauce (tuna, sardines,
salmon), meat paste, fish paste, tinned foods such as spaghetti and
ravioli, meat extracts, yeast extracts, salted crisps, savoury or salty
biscuits
Meal Pattern
z Try to develop a regular eating pattern
z Smaller but more frequent meals may be better
z Take your time over your meals and chew foods well
z Avoid heavy meals or snacks before bedtime
z Avoid alcohol and caffeinated drinks before bedtime e.g. coffee, tea,
cola
z Opt for decaffeinated drinks where possible
z Try not to eat and drink at the same time
4
Fluids
A large amount of fluid lost through the stoma can lead to dehydration.
Fluids may need to be replaced intravenously (fluid straight into the blood)
whilst you are in hospital.
The following will help prevent dehydration:
z Restrict the amount you drink, as drinking a high amount of normal
fluid can make your output higher, the amount you should drink will be
advised by a doctor
z Start to take your oral rehydration solution as directed by your doctor,
dietitian or nutrition nurse (see below)
z If you are feeling thirsty having a small volume of water with a salty
snack may help
z Avoid drinking around mealtimes
z If applicable take your anti-diarrhoeal medication 30 minutes before
your meals and at night as prescribed
Oral Rehydration Solution (ORS)
In some cases the dietitian, doctor or the nutrition team may advise you
to take a special drink called an oral rehydration solution or St Mark’s
solution. This is a salty sugary drink, which helps your bowel absorb water
and salts from the food and fluid you consume. This drink will help to
reduce your stoma output and keep you hydrated.
It is best if you chill the drink. Do not add ice cubes to it, as it will dilute the
drink. The drink can be flavoured with a small amount of squash or cordial.
Some people prefer the drink when taken through a straw.
5
Recipe for St Mark’s Solution:
z 6 heaped 5ml teaspoons of glucose
z 1 level 5ml teaspoon of salt
z Half a heaped 5ml teaspoon of sodium bicarbonate
z Stir all ingredients into 1 litre of water and chill
6
Key points
z Avoid fibre-containing foods, seeds, pips and skins
z Add salt to foods and have salty foods when you are drinking fluid
z Avoid drinking large amounts of plain water, squash, tea or coffee
7
Not to be photocopied
Basildon University Hospital
Nethermayne
Basildon
Essex SS16 5NL
01268 524900
Minicom
01268 593190
Patient Advice and
Liaison Service (PALS)
01268 394440
E [email protected]
W www.basildonandthurrock.nhs.uk
The Trust will not tolerate
aggression, intimidation or
violence directed towards its staff.
This is a smokefree Trust.
Smoking is not allowed in any of our
hospital buildings or grounds.
This information can be provided in a
different language or format (for
example, large print or audio
version) on request.