MSc 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 ID: 911316
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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
Slide2The 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.
Slide3Nutrients absorbed in our digestive systemSucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide4Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide5The 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.
Slide6Short 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.
Slide7Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide8ESPEN 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.
Slide9Colostomy or Colectomy Diet After SurgerySucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide10The 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.
Slide11Need 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.
Slide12Achievement 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.
Slide13Supplements that help Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide14Low 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.
Slide15Foods 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.
Slide16Foods That Help a ColostomyYogurt (with live and active cultures)Cranberry juiceBananas
Applesauce
Well-cooked, sticky white riceButtermilkTapiocaWhite toast
Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide17Why 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.
Slide18Making right food choices is very important Nourishing foods and eat Food that is well tolerated
Consistency of food.
Sucheta Vijay Limaye, Clinical Dietitian. 9922008514.
Slide19Key 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.
Slide20Key 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
Slide21Sucheta Vijay Limaye. Clinical Dietitian