Frequently Asked Questions

Food & Nutrition II

Margaret Allan is a qualified Nutritionist with a history of Crohn’s Disease. She had ileostomy surgery over twenty years ago, and combines her personal experience and professional knowledge in clinical practice to advise both ostomates and the general public on diet and health-related matters.

Here she provides suggestions to help ostomates gain maximum benefit from food intake.

It is important for everyone to eat well for good health, but this is even more critical for ostomates. The gastrointestinal tract is the main portal of entry for nutrients into the body, and any disease or dysfunction affecting the digestive system has the potential to affect the breakdown and absorption of nutrients, leading to possible nutritional imbalances and deficiencies.

Due to the smaller surface area of the intestinal tract after stomal surgery, an ostomate’s digestive system needs additional support to promote maximum function. This includes choosing good food that is healthy and nutritious, and combining and preparing it in a manner that promotes vitality.

There are many commercially prepared foods available today that contain substances the body can’t recognize or digest, and this can place an unnecessary burden on the body that contributes to a poor state of health. And eating a complex combination of foods at one time can throw the intestinal tract into chaos and place stress on an already fragile system.

Choosing simple, straightforward foods can help to assist the body by presenting nutrients to the intestinal tract in a recognizable and digestible format. For example, fresh skinless chicken, fish and vegetables are easily digested foods that the intestinal tract can break down with a minimum of fuss.

However, if sauces, coatings, marinades, spicy flavourings, additives and preservatives are added to a meal via bottled and packaged ingredients, it can be harder for the digestive system to break down all the different components of the meal. Commercially-prepared foods may also contain ingredients that affect stomal output. For example, both powdered and tinned soup are foods that I have found to significantly increase stomal ouput, whereas home-made soup made from simple ingredients is much less likely to do so.

Preparing simple meals without a lot of fuss or garnish can help a compromised digestive system to perform better. Using lemon juice, fresh herbs and tamari (wheat free soy sauce) as flavour enhancers can add zest to a meal if it needs embellishment.

Snacking on simple foods is also effective, such as a piece of fresh fruit or a tub of yoghurt. Many snack foods have complicated ingredients and additives, and these increase the overall load on the digestive system. Choosing food that is fresh, seasonal and wholesome increases the overall potential for good nutrition and effective digestion.

Eating foods in simple combinations can also assist digestion and maximise the absorption of nutrients. The three major macronutrients (fat, carbohydrate and protein) are broken down via separate processes in the intestinal tract, but they all compete for absorption across the bowel wall once in the small intestine.

Therefore, eating just one or two macronutrients at a time can simplify the digestive process and ease the burden on the intestinal tract. For example, eating a protein food with carbohydrates, such as skinless chicken with vegetables, is easier to digest than a meal containing fat as well, such as chicken with the skin left on.

Omitting starchy carbohydrates such as rice, pasta and potato from meals containing protein also simplifies a meal and increases the potential for effective digestion, for example making a stir-fry with just lean meat and vegetables without rice or noodles as accompaniment. However, if rice or noodles are preferred with a stir-fry, make it a vegetarian meal so the load is lighter on the digestive system.

Eating until satisfied but not overly full also helps to maintain effective digestion, as the body has a smaller quantity of food to deal with at one time. It takes a lot of energy to digest food, and a heavy, weighed-down feeling after a meal can be an indication that the digestive system is under strain. Light yet satisfying meals and snacks of fresh, simple foods can be more effective in supporting good health and vitality. For example, finishing a meal with a simple piece of fresh fruit rather than a complex combination of dessert ingredients is gentler on the digestive tract and frees up energy for other activities.

Food preparation also plays a major role in the digestive potential of a meal, and while many of our more recent food preparation practices are quick and easy, I feel there is still merit and possible health promoting properties in many of the more traditional methods of preparing and cooking food.

For example, poaching, grilling, stir-frying and steaming are all beneficial cooking methods, whereas deep frying may cause diarrhoea for ostomates and consequently deplete valuable nutrients from the body. Microwaving food under plastic wrap also has the potential to introduce foreign chemicals into food from the plastic wrap, which the human body doesn’t recognize or process easily. Using paper towel as a cover for food in the microwave is a safer option.

Due to our hectic schedules these days, it is not always possible to eat good quality, simple, home-cooked food, but incorporating it into our lifestyle as much as possible can tip the scales in favour of good health and vitality for ostomates. A few simple changes can make all the difference

Wishing you good health and happy days, - Margaret.

Margaret is based in Melbourne and is available for clinical consultations in Northcote or phone consultations for those outside Melbourne. She can be contacted here.

Reprinted from the "Ostomy Australia" (Volume 18 No. 1 - April 2009)

Click here for Food & Nutrition I (on the compromised digestive function of ostomates and strategies to help maximise the absorption of nutrients from food).