By, Sucheta Vijay Limaye. - PowerPoint Presentation

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By,Sucheta Vijay Limaye.M.Sc. Health Science (Dietetics)Consultant Clinical Nutritionist+919922008514 Deenanath Mangeshkar Hospital, Joshi Hospital

O

stomy

Diet and Nutrition

The digestive tract is much more than simply a food processing system. ...

Westernization of our lifestyle has led us to increased incidences of GI disorders

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Nutrients absorbed in our digestive systemSucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

The first few weeks to a month after surgery, you'll likely be advised to eat a diet that is low in roughage. Limiting roughage allows the intestine time to heal and prevents blockage due to swelling.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Short bowel syndrome (S B S)A condition where section of small intestine is removed or by-passed due to disease, surgical complication or injury.The shortened length of intestine can create problems with digestion, absorption and stomy management.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

ESPEN Guidelines for SBS Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.Energy requirement :

30 - 35

Kcal/kg / day.Protein requirement : 1- 1.5 gm /kg / day.Patients with preserved colon should consume diet high in complex

Carbohydrates and low in

fats.

Essential fatty acids and fat soluble vitamins need to be

supplimented

.

DO NOT

restrict milk if intolerance is not documented.

Add soluble fiber.

Use salt liberally.

Limit use of tea, coffee, cola, alcohol, etc.

In

enteral

tube feeds polymeric, isotonic formulas are recommended.

Colostomy or Colectomy Diet After SurgerySucheta Vijay Limaye, Clinical Dietitian. 9922008514.

The amount of food, its form, the frequency of feeding, and the composition of diet each have important effects on GI function and may be used to help ameliorate signs of GI disease. ... The appropriate diet may have a profound effect on 

intestinal

recovery and successful management of chronic or severe GI disease

.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Need for a Special Colostomy or Colectomy Diet After Surgery IV fluids for two to three days, to give the colon time to heal.

Clear liquids

, such as soup broth and juice,followed by easy-to-digest foods, such as rice, toast

and oatmeal. Normal diet

Avoid certain

foods that cause odors or

gas

As these foods can

over-inflate the 

colostomy bag

 and make it more difficult to manage.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Achievement of optimum calorie and protein needsNutritional supplement Complete balanced nutrition

Macro & micronutrient profile

Can be used as supplemental or sole source of nutrition Approx 1 kcal/ml Low residue

Lactose and Gluten free

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Supplements that help Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Low fiber , low residue dietSucheta Vijay Limaye, Clinical Dietitian. 9922008514.First 6-8 weeks of post colonostomy .Easier to digest

Will not over work the bowel during recovery

Need to follow till swelling in bowel is reduced.Add a new food gradually, may be one food at a time.

Foods to Watch With a ColostomyRaw vegetablesSkins and peels of fruit (fruit flesh is OK)

Dairy products

Very high fiber food such as wheat bran cereals and breadBeans, peas, and lentilsCorn and popcornBrown and wild riceNuts and seedsCakes, pies, cookies, and other sweets

High fat and fried food such as fries , fried snacks, fried chicken, sausage, and other fatty meats, etc .

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Foods That Help a ColostomyYogurt (with live and active cultures)Cranberry juiceBananas

Applesauce

Well-cooked, sticky white riceButtermilkTapiocaWhite toast

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Why Chewing Is so Important After Colostomy SurgerySucheta Vijay Limaye, Clinical Dietitian. 9922008514.Thoroughly chew everything you eat.Chewing is an important part of the 

digestive process

 and we all chew our food to some degree. Make a special effort to chew food very well, it helps to manage colostomy more easily.Try to chew everything until it's liquid in your mouth.

Making right food choices is very important Nourishing foods and eat Food that is well tolerated

Consistency of food.

Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Key Tips Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.

For first 1 year of recovery you may need to take multi-vitamin supplement.

Eat variety of foods & try to introduce different foods.Eat at regular intervals & avoid fasting or skipping meals. 6-8 weeks after surgery begin to choose foods with dietary fiber.Lactose intolerance is common.

Include all unsaturated fat & limit saturated fats, consult doctor if fat intolerance is present.Maintain adequate hydration.

Key TipsSucheta Vijay Limaye, Clinical Dietitian. 9922008514.

Eat

regularly – don’t skip meals. Empty bowels produce gas.When adding new foods, try a little bit with other foods.Small frequent

feeds are best – always chew thoroughly.Rice, potatoes /pasta once daily may reduce frequency & irritation.

High

potassium

foods will help offset the effects of diarrhea.

Drink

6-8

glasses of liquid but not with the meal..

Avoid

anal irritants

: 1. Chinese/ oriental veg. 2. Coconut

3. Raw fruits ( orange, apple ) 4. Raw vegetables 5.Dry fruits (raisins, figs ) 6. Spicy foods 7. Foods with seeds & nuts

Sucheta Vijay Limaye. Clinical Dietitian