Ileostomy vs Colostomy: Diet, Hydration and Daily Care

Ostomy surgery changes a person’s lifestyle completely, as it feels like living in a new body. What to eat? How can I look like others (normal) again? Is this ache a sign of something serious? These fears can hit a person with an ostomy, or their family members. In the UK and in other countries, thousands of people are living with an ileostomy or colostomy. With the right guidance, a person can return to their daily life.

This article covers the actual difference between ileostomy and colostomy, suggests a proper diet plan or food habits, and explains how to spot signs such as dehydration or blockage. 

Ileostomy vs Colostomy: What Is the Difference?

Ileostomy and colostomy are both types of ostomy surgery due to bowel dysfunction. The surgery creates an opening (a stoma) on the abdominal wall to remove stool (waste) from the body. The key difference is which intestine the procedure is performed on. These surgeries can be temporary or permanent depending on the condition a person may have.

Key Differences	ILEOSTOMY	COLOSTOMY
Part of Body used	Small Intestine	Large Intestine
Common reason for surgery	Crohn’s, Ulcerative colitis, FAP, intestinal infection	Colorectal cancer, Severe abdominal trauma, Volvulus
Stool	Liquid	Semi-formed
Output	Frequent	Less frequent
Skin irritation	Higher	Lower
Bag emptying	5-8 times a week	1-3 times a week

Around 200,000 people in the UK are living with a stoma, including people with ileostomies and colostomies. Approximately 21,000 new stoma operations are performed each year in the UK.

Diet After an Ileostomy or Colostomy

After ostomy surgery, the first few weeks are crucial. The patient’s body is healing and recovering from the procedure. Follow this guide to keep yourself comfortable:

• More frequent meals in small portions
• Avoid eating too much in the evening
• Drink more water (more than 2 litres)
• Consume low-fibre foods
• Add new food one at a time in your diet

A clinical dietitian will guide you before you get discharged. After discharge, your GP and outpatient dietitian will help you get back to your usual diet. 

Bland and low-fibre foods are easy to digest and aren’t heavy or spicy. This can help avoid diarrhoea, bloating, gas and swelling at your ileostomy site. People with a colostomy have more flexibility in diet. Avoid spicy and wind-producing foods, as it creates discomfort.

Managing Loose Output, Wind and Blockage Risks

Living well with a stoma comes with many variables: the food or drink you consume, managing loose output, wind, and blockage risks. Loose output is common with an ileostomy as it has not passed through the colon. The output can become watery due to high-sugar foods, alcohol, or greasy meals. Medication changes, food poisoning, or anxiety and stress can speed up digestion and loosen the output.

Beans, onions, and fizzy drinks can cause wind or excess gas problems, while a more serious risk is a food blockage. Poorly chewed or hard-to-digest foods get stuck at the stoma and create a blockage. To manage these problems, follow the guide below:

1. Loose Output: The ostomy nurse suggests binding or starchy foods to thicken the output and electrolyte intake for rehydration.
   
2. Wind (Excess Gas): Eat slowly, skip carbonated drinks, use filtered ostomy pouches.
3. Blockage: Switch to warm fluids, gentle abdominal massages, avoid eating large amounts at once.

Hydration and Signs of Dehydration

If a stoma exceeds 1 litre of output within 24 hours, it is considered a high output. In an ileostomy, stool bypasses the colon, which absorbs the liquids and salt for the body from the stool. Therefore in case of high stool output from the stoma results in dehydration. 

An overview of Oxford Academic BJS on stoma management suggests that a high-output stoma producing more than 1500 ml can cause serious kidney injuries. A carer or the person themselves must be aware of signs of dehydration listed below:

1. Dizziness or weakness
2. Dry lips
3. If you notice any changes in urine, usually dark urine
4. Muscle cramps, headaches
5. Sudden increase in stool output

In such cases, contact their GP or stoma nurse to get a better read on the condition. 

Daily Stoma Care at Home

Day-to-day stoma care becomes overwhelming in the early days. Getting used to various changes that come with it can be challenging. At Secure Healthcare Solutions, we have well-trained and experienced stoma nurses. They will help you prepare a good routine to prevent small mistakes or things that affect daily activities from becoming uncomfortable habits.

Follow these things to complete your daily stoma routines:

• Check your stoma daily for swelling and irritation
• Stoma bag changes
• Keep all necessary medication or supplies handy
• Have an emergency kit ready at all times

With the help of your nurse or GP, a stoma care routine can become a person’s second nature. Adjusting to a new routine can take up to 6 months to a year.

Emptying and Changing Your Stoma Bag

Emptying a stoma bag and how often one should change it for an ostomate (a person with stoma surgery) depends on the type of ostomy. Ileostomy patients need to change bags 5-8 times a day, mostly right after the surgery. A colostomy has firmer and less frequent output (2 times a day) than an ileostomy. 

A stoma bag should be changed when the bag is filled three-quarters full due to risks of leakage and damaging the adhesive seal. The baseplate of the stoma needs to be replaced every 3 days, in morning times preferably. A stoma should be cleaned with warm water and completely dried afterwards to place a new baseplate, which prevents soreness and leaks.

Looking After the Skin Around Your Stoma

In the UK, a cross-sectional study of 114 people who had an ostomy found that 85% had skin complications ranging from mild to severe complications linked to poorer mental well-being. 

A stoma commonly creates the most discomfort in the skin surrounding the stoma (peristomal skin), and it is still poorly addressed. Several factors contribute to skin damage or irritation, which are listed below:

• Direct contact between skin and stool
• Leakage due to appliance application faults
• Trauma from appliance removal
• Allergic or irritant reactions

To prevent any damage to peristomal skin, change the stoma bag before it is full, clean the skin gently and thoroughly, avoid adhesive or harsh soap that can create irritation, and dry the skin thoroughly.

How Secure Healthcare Solutions Can Support Stoma Care

Having an ileostomy or colostomy redefines a person’s life and habits. From managing the new adjustment of managing the stoma to regaining social standing and confidence back. At Secure Healthcare Solutions, we aim to help people return to a lifestyle that feels comfortable and familiar, with personalised stoma care at home tailored to their individual needs.

Our staff is well-versed and trained to help make day-to-day life and tasks more comfortable. We have stoma nurses and dietitians who can make a specialised plan with home care support. Secure Healthcare Solutions is here to help you manage it safely, comfortably, and with dignity, every single day.