Brenda Khan
Following an ileostomy reversal, patients should be aware that it will take time for their bowel movements to return to normal. Initially, patients will experience frequent, small bowel movements and gas. To aid the healing process, doctors recommend a bland, low-fibre diet, such as the BRAT diet, to minimise bowel movements. This diet should be maintained for around six weeks, after which new foods can be gradually introduced.
| Characteristics | Values |
|---|---|
| Diet type | Low-fibre, bland |
| Meal size | Small and frequent |
| Foods to eat | Protein-based foods such as meat, fish, eggs, cheese and milk |
| Foods to limit | Fruits, vegetables, wholegrain bread, cereals, coffee, alcohol, carbonated drinks |
| Fluids | Drink plenty of water, at least 6 cups a day |
| Bowel movements | Frequent, often small and may be uncomfortable |
| Therapy | Pelvic floor physical therapy, but only after 6 weeks |
| Recovery time | Up to a year |
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What You'll Learn
- After ileostomy reversal surgery, patients should adopt a low-fibre diet for at least six weeks
- The BRAT diet, a bland, low-fibre diet, can help to minimise bowel movements
- Small meals, snacks and protein-rich foods are recommended to aid healing and weight gain
- Limit caffeine, alcohol and other bowel stimulants to avoid looser bowel movements
- Pelvic floor physical therapy can help patients recover from ileostomy reversal surgery
After ileostomy reversal surgery, patients should adopt a low-fibre diet for at least six weeks
During their hospital stay, patients should expect healthcare staff to monitor their surgical site to ensure it is healing well. The surgical incision itself may take 4–6 weeks to heal completely, and patients will remain in the hospital until their bowel function resumes.
After ileostomy reversal surgery, patients will initially be on a liquid diet, gradually working up to soft, light, low-fibre meals. It is recommended to eat several small meals a day to help minimise bloating and discomfort. Eating regularly without long breaks between meals and chewing food well will help to prevent blockages. It is also important to stay hydrated by drinking plenty of fluids.
There are also some foods that patients should avoid after ileostomy reversal surgery, as they are more likely to cause gas and lead to stomach upset. These include raw vegetables, dried fruit, popcorn, nuts, seeds, and corn kernels. Caffeine and alcohol should also be limited, as they may cause looser bowel movements.
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The BRAT diet, a bland, low-fibre diet, can help to minimise bowel movements
Following an iliostomy reversal, a BRAT diet—consisting of bananas, rice, apples, and toast—can be adopted to help minimise bowel movements. This diet is a type of bland, low-fibre diet, which can help address symptoms like nausea, vomiting, and diarrhoea. It is important to note that the BRAT diet is no longer recommended due to its restrictive nature, but it can still provide a starting point for food options to consider.
The BRAT diet includes soft, easily digestible foods that are gentle on the stomach. Bananas, for example, are a good source of potassium and can help replace electrolytes lost during diarrhoea. Rice, particularly white rice, is a low-fibre starch that can help bind stools and provide carbohydrates for energy. Apples, especially in applesauce form, contain pectin, a soluble fibre that can help solidify loose stools. Toast, preferably made with refined white flour, is another source of starch that is easy to digest.
In addition to the core BRAT foods, there are other bland, low-fibre options that can be included. Soft fruits like avocado, pumpkin, canned fruit (packed in water), and melons are gentle on the stomach and provide essential nutrients. Steamed or boiled vegetables, such as carrots, green beans, potatoes, and squash, are easily digestible and low in residue. Other low-fibre starches like white bread, saltine crackers, cream of wheat, instant oatmeal, and noodles can be included as well.
It is important to introduce these foods gradually, especially if nausea and vomiting are also present. Clear liquids are a good place to start, with options such as water, apple juice, weak tea, broth, or electrolyte beverages. As tolerated, progress to solids with small, frequent meals. It is still important to prioritise healthy foods when transitioning out of the BRAT diet. Lean, tender meats like poultry, whitefish, and shellfish that are steamed, baked, or grilled can be added. Refined, hot cereals like Cream of Wheat (farina cereal) are also suitable.
Remember, it is always best to consult with a healthcare professional or a dietitian/nutritionist to determine the most appropriate diet after an iliostomy reversal. They can provide personalised advice and ensure you are getting adequate nutrition while managing your bowel movements effectively.
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Small meals, snacks and protein-rich foods are recommended to aid healing and weight gain
Following ileostomy reversal surgery, it is recommended to eat small meals frequently throughout the day. This is because eating large meals may cause bloating and discomfort in the first few weeks after the operation. A healthcare professional may recommend the BRAT diet, which is a bland, low-fibre diet that includes bananas, rice, applesauce, and toast. This type of diet can help to minimise bowel movements and reduce discomfort.
Small meals, snacks, and protein-rich foods are recommended to aid healing and weight gain. Eating small meals 4-6 times per day, with snacks in between, is advisable, especially if your appetite is poor. It is important to include protein-based foods such as meat, fish, eggs, cheese, and milk at every meal to promote healing. Starchy foods like potatoes or bread may seem safer, but they should not be the only source of nutrition. Relaxing while eating and chewing food slowly and thoroughly can also aid digestion.
For the first two to three weeks after surgery, it is recommended to limit fibre intake and introduce high-fibre foods such as fruits, vegetables, and some cereals gradually. If these foods cause abdominal discomfort, stop consuming them for a few days and then slowly reintroduce them into the diet. It is also important to stay hydrated by drinking plenty of fluids, aiming for at least 6 cups of water per day, or 8-10 cups if you have an ileostomy.
In addition to small meals and snacks, pelvic floor physical therapy may be recommended to aid healing and bowel control. However, it is important to wait at least 6 weeks after surgery before starting this type of therapy. During recovery, it is also recommended to take short walks daily to regain energy and promote healing at the surgery site.
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Limit caffeine, alcohol and other bowel stimulants to avoid looser bowel movements
After ileostomy reversal surgery, it is normal to experience changes in bowel movements, including frequent, small bowel movements and gas. To manage these symptoms, it is recommended to limit caffeine, alcohol, and other bowel stimulants.
Caffeine is known to stimulate the bowels and can make bowel movements looser. Therefore, it is advisable to limit or reduce caffeine intake after ileostomy reversal surgery. This includes coffee and tea, which are commonly consumed caffeine-containing beverages.
Alcohol can also act as a bowel stimulant and contribute to looser bowel movements. It is recommended to limit or avoid alcohol consumption during the recovery period after ileostomy reversal surgery. This will help to manage bowel function and reduce any discomfort associated with loose stools.
In addition to caffeine and alcohol, there are other bowel stimulants that may need to be limited or avoided. These can include certain foods and beverages that are known to stimulate bowel activity. For example, carbonated or fizzy drinks may cause discomfort and should be approached with caution. It is also important to note that high-fibre foods, such as fruits, vegetables, and some cereals, can be difficult to digest and may cause abdominal discomfort or bloating. While fibre is essential for a healthy diet, it may be beneficial to introduce high-fibre foods gradually and in small amounts during the recovery period.
Overall, limiting caffeine, alcohol, and other bowel stimulants can help manage bowel function and reduce the likelihood of looser bowel movements after ileostomy reversal surgery. It is important to note that everyone's experience may vary, and it is always advisable to consult with a healthcare professional for personalised guidance.
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Pelvic floor physical therapy can help patients recover from ileostomy reversal surgery
Following ileostomy reversal surgery, patients will need to adjust to a new routine of bowel movements, as stool will once again pass through the rectum. This adjustment period can be challenging, and pelvic floor physical therapy can play a crucial role in helping patients regain control and confidence in their bodily functions.
Pelvic floor physical therapy can help retrain the pelvic floor muscles, improving their strength, coordination, and motor control. This therapy can be particularly beneficial in reducing discomfort during bowel movements, as it can enhance rectal sensitivity and reduce urgency. For example, rectal balloon training can increase a patient's ability to perceive rectal distension, counteracting the recto-anal inhibitory reflex. Additionally, biofeedback training can provide valuable insights into the performance of the pelvic floor, enabling targeted improvements.
Following ileostomy reversal surgery, patients may experience discomfort due to the rectum stretching to accommodate stool. Pelvic floor physical therapy can help alleviate this discomfort by improving muscle control and reducing the likelihood of accidental stool leakage (incontinence). Patients can also perform Kegel exercises to strengthen their pelvic floor muscles, aiding in bowel control.
In addition to physical therapy, dietary changes are crucial after ileostomy reversal surgery. Patients should initially follow a low-fibre diet and gradually introduce new foods to identify any problem areas. Some foods, such as raw fruits and vegetables, beans, cabbage, and carbonated drinks, may cause gas and stomach upset. A clinical dietitian or nutritionist can provide guidance on dietary choices and help patients adjust to their new nutritional needs.
The recovery process after ileostomy reversal surgery typically takes several weeks, during which patients should avoid driving and strenuous activities. Pelvic floor physical therapy, in conjunction with dietary adjustments and other medical advice, can help patients effectively manage their symptoms and regain control over their bowel functions, enabling them to resume their usual daily activities with confidence.
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Frequently asked questions
Right after surgery, you will be on a liquid diet and then gradually work up to soft meals. You should eat 5-6 smaller meals per day. It is recommended that you eat a low-fibre diet for about 2-3 weeks after the operation while your bowel heals. You can then gradually introduce new foods to your diet to check if they cause any problems.
You should limit foods that irritate your digestive system or cause gas. These include wholegrain bread, cereals, coffee, and other bowel stimulants such as alcohol.
You can reduce the discomfort of bowel movements by soaking in warm water, applying a skin protectant to the area around the anus, using moistened, flushable wipes, and taking medications to soften the stool if prescribed by a doctor.
It will take time for your usual bowel movements to return. At first, you will have frequent, small bowel movements and pass gas. Your bowel control may be irregular for a few months after surgery, but these symptoms should improve over the first year.
It is important to drink plenty of fluids and take short walks daily to help your surgery site heal. You should also avoid lifting anything heavy for 6 to 8 weeks and consult a doctor, dietitian, and pelvic floor physical therapist for further guidance on recovery.
