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What to Eat After Bowel Surgery

This information covers the main dietary advice in the first 6 weeks after stoma surgery for jejunostomies, ileostomies, and colostomies. If you have short bowel syndrome, your advice may differ in some places, so please follow your surgical team’s advice.

Why do I need to change my diet after surgery?

After surgery, your body is healing and getting the right nutrition can help you recover. Your body is adjusting to the new way your gut works and gradually working towards normal eating helps the healing process.

There are 4 main stages of eating and drinking after your gut surgery. Each stage includes a range of drinks and foods that the gut manages differently. Seeing how your body reacts to each stage helps your surgical team monitor your recovery and how to best support you.

How will I know when to move from each stage?

This depends on a few factors, such as the type of stoma surgery and how well you are after surgery. Everyone’s recovery is slightly different, and you may move to each stage quicker or slower than we’ve mentioned here.

This information is a guide alongside your surgery team’s specific advice to you.

Usually, a dietitian will work alongside your surgical team and advise you on what to include at each stage to optimise your nutrition for healing.

Your dietitian is also keen to help you move towards normal eating and drinking to get back to enjoying more of what you love.

When to seek extra help/support

If you experience unintentional weight loss or are frequently feeling unwell after leaving the hospital, it’s best to see your G.P. or contact your Stoma Nurse.

What to Eat 0-6 Weeks After Bowel Surgery

Stage 1: Clear fluids – Often within the first few hours after surgery

These are liquids that your gut can manage the easiest after surgery and includes fluids without any fat or fibre.

On your first day, somebody may advise you to have multiple small sips every hour rather than drinking lots at one go.

Your surgical team might give you a slightly lower target than typical advice if you’re prescribed lots of I.V. fluid, e.g., drink 1L rather than 2L a day – everyone is different, so please check with your team.

What counts as ‘clear fluids’?

  • Water (flavoured or plain) – choose tap or still water, not sparkling
  • Tea/coffee (regular or herbal) – without milk and can include sugar
  • Clear fruit juice without ‘bits,’ e.g. apple juice but not orange juice
  • Very weak squash and cordial, e.g. very weak blackcurrant
  • Yeast extract drinks made with water, e.g. Bovril and Marmite
  • Jelly
  • Certain nutritional supplement drinks, e.g. Fortijuce, Ensure Plus Juce etc.

Stage 2: Free fluids – Often within 1-2 days after surgery

These include any fluids and some items you think of like foods. At this stage, your surgical team may advise you to have a 1 cup (~ ½ pint) with each meal or snack to encourage your gut to work normally while not overwhelming it. Unless you’re told otherwise, aim for ~2L (~3.5 pints) of fluid daily.

What counts as ‘free fluids’?

  • ‘Clear fluids’
  • Tea/coffee (regular or herbal) – with or without milk/cream
  • Non-clear fruit juice without ‘bits,’ e.g. orange juice
  • Squash and cordial
  • Milkshakes
  • Milky coffees
  • Hot chocolate
  • Fruit smoothies (no pips, seeds, pulp, or pith)
  • Most nutritional supplement drinks, e.g. Fortisip, Ensure etc.
  • Yogurt
  • Custard
  • Ice cream

Note: Some hospitals advise a short period of ‘soup and sweet’ between the ‘free fluids’ and ‘light diet’ stages. This might happen for 1-2 days after you start ‘free fluids’ and before moving to a ‘light diet’.

In this stage, you may be asked to have something like a yogurt at breakfast, then a soup and a pudding/dessert at lunch and dinner during’ soup and sweet.

Stage 3: Light diet – Often within 3-4 days after surgery

A light diet after bowel surgery includes foods that are quite soft or easy to chew and are very low in fibre. It’s essential to move towards having foods rather than just liquids, as the ‘bulk’ can help everything move through your gut and is part of getting it back to working normally. Beginning to have a little fibre is also helpful for this. During this time, it’s best to minimise spicy foods to give your gut a bit more time to settle.

It can be helpful to have smaller meals and 2-3 snacks compared to 3 usual-sized meals a day if you have a small appetite. We’ve created a lower fibre and low-irritant foods and drinks table in our Ostomate’s Kitchen Nutritional Guide. This guidance and our chef-created recipes are available in our Ostomates Kitchen guide.

Some ‘light diet’ examples:

Breakfast

  • Flaked or puffed rice cereal with milk
  • White toast with butter/margarine and smooth jam, honey, or yeast extract
  • Plain or fruit flavoured yogurt (without ‘chunks’)
  • A glass of milk or a smooth fruit juice

Lunches and Dinners

  • Cottage pie or similar
  • Jacket potato (no skin) and filling like tuna mayo
  • Macaroni cheese
  • Meat or fish in breadcrumbs with chips and
  • Omelettes (plain or cheese, without vegetables)
  • Roast meat, roast potatoes, and soft carrots/swede/parsnips or similar
  • Sandwich with white bread, e.g. cheese and ham, egg mayo
  • Smooth soups or those with small chunks of soft vegetables like carrots

Snacks or Desserts

  • Cake or pies (without nuts or fruit ‘chunks’)
  • Cheese and biscuits/crackers
  • Custard or similar
  • Ice cream
  • Jelly
  • Rice pudding
  • Soft and/or tinned fruits like bananas, peeled apples or pears, tinned peaches
  • Sweets (boiled or jelly types)
  • Yogurt (plain or fruit flavoured without ‘bits’ or chunks)

An example meal plan for a ‘light diet’ when at home

Time of dayPlan 1Plan 2 (vegan)
BreakfastA cheese omelette + A fruit flavoured yogurt without ‘chunks’ + A mug of decaf tea Our green smoothie (made with vegan yogurt and maple syrup)
Mid-morning snack (if you’re trying to re-gain weight) 2-3 crackers and a few cheese slices + A glass of water 2-3 crackers and 1-2 tablespoons of smooth nut butter + A glass of water
LunchChicken and peeled cucumber sandwich on white bread, with butter or margarine and mayonnaise + 1 peeled pear + A glass of water Grilled tofu and peeled cucumber sandwich on white bread, with plant-based spread + 1 peeled pear + A glass of water
Mid-afternoon snack (if you’re trying to re-gain weight) A pot of custard + A glass of water A pot of a soya dessert + A glass of water
DinnerOur chicken curry recipe + A glass of water Our chicken curry recipe (made with seitan chunks) + A glass of water
Pudding/Dessert of Later Evening snack (if you’re trying to re-gain weight) A pot of rice pudding + A glass of water A mug of decaf coffee made with lots of plant-based milk

Stage 4: Usual diet

  • Possibly within 3-4 weeks of colostomy surgery
  • Possibly within 6-8 weeks of ileostomy surgery

Some ways to tell you’re ready to move to this stage are that your appetite may have increased, and you’ve noticed your gut doesn’t feel as sore and bloated. You’ll usually be passing slightly less watery stools. For extra guidance about what bowel movements are ‘normal’ after stoma surgery, take a look at our Ostomates Kitchen Nutritional Guide:

Although there is no set way to reintroduce your usual foods, we’ve given you some tips on adding them in a structured way to boost your confidence.

For extra support, you could use our stoma symptom and food diary for ostomates to help you monitor how your gut manages your usual foods and drinks after your surgery.

Please remember that your stools will remain fairly loose if you have an ileostomy.

Tips for reintroducing foods

  • You might like to introduce only 1 new food and drink a day to see the effect it makes
  • Try a half portion on the first day and see how you feel over the next 24 hours
  • After this time, you can try a normal portion
  • If you feel well afterwards, you can try these steps with a new food
  • Introduce a new food at least every 2-3 days if your gut can manage it

Types of foods to experiment with:

  • Wholemeal bread and brown rice
  • Fruits and vegetables (well-cooked at first)
  • Beans, lentils, chickpeas etc
  • Whole nuts and seeds
  • Tougher cuts of meat (if you’d like to)
  • Spicy foods (if you like and miss these)

What to Eat After Bowel Surgery Meal Plans

These non-vegan and vegan plans show you how you can begin to introduce new foods and textures gradually over a few days. You may like to go quicker than this if you feel able.

Key

  1. This style denotes the starting amount and texture
  2. This style denotes the amount and texture to progress to
  3. Having snacks is helpful for those who can only eat small portions at meals and/or are trying to gain weight
  4. These are only example meal plans; please include the foods and drinks you’d like to

Day 1 Meal Plan

Plan 1
Time of day Plan 1 Vegan plan
Breakfast Half a portion of thin porridge made with milk + A fruit flavoured yogurt without ‘chunks’ + A mug of decaf tea Half a portion of thin porridge made with plant-based milk + A full portion of a fruit flavoured plant-based yogurt without ‘chunks’ + A mug of decaf tea
Mid-morning snack
(if you’re trying to re-gain weight)
2-3 crackers and a few cheese slices + A glass of water 2-3 crackers and 1-2 tablespoons of smooth nut butter + A glass of water
Lunch Chicken and peeled cucumber sandwich on white bread, with butter or margarine and mayonnaise + 1 peeled pear + A glass of water Grilled tofu and peeled cucumber sandwich on white bread, with plant-based spread + 1 peeled pear + A glass of water
Mid-afternoon snack
(if you’re trying to re-gain weight)
A pot of custard + A glass of water A pot of a soya dessert + A glass of water
Dinner Our chicken curry recipe + A glass of water Our chicken curry recipe (made with seitan chunks) + A glass of water
After-dinner snack
(if you’re trying to re-gain weight)
A pot of rice pudding + A glass of water A mug of decaf coffee (made with lots of plant-based milk)

Day 2 Meal Plan

Plan 2
Time of day Plan 1 Vegan plan
Breakfast A full portion of thin porridge + A fruit flavoured yogurt without ‘chunks’ + A mug of decaf tea A full portion of thin porridge + A full portion of plant-based yogurt without ‘chunks’ + A mug of decaf tea
Mid-morning snack
(if you’re trying to re-gain weight)
A banana + A glass of water A banana + A glass of water
Lunch A large jacket potato + egg mayo + some peeled carrot sticks + A glass of water A large jacket potato + A very mild chilli con Carne made with soya mince + A glass of water
Mid-afternoon snack
(if you’re trying to re-gain weight)
Our green smoothie Our green smoothie (made with vegan yogurt and maple syrup)
Dinner Our turkey burger recipe + A glass of water Our turkey burger recipe (made with a meatless burger) + A glass of water
After-dinner snack
(if you’re trying to re-gain weight)
1 of our panna cotta pots + A glass of water Some slices of melon + A glass of water

Day 3 Meal Plan

Plan 3
Time of day Plan 1 Vegan plan
Breakfast A full portion of porridge, the texture of your choice + Half a portion of yogurt with fruit ‘chunks’ + A mug of decaf tea A full portion of porridge, the texture of your choice + Half a portion of plant-based yogurt with fruit ‘chunks’ + A mug of decaf tea
Mid-morning snack
(if you’re trying to re-gain weight)
2-3 plain biscuits + A glass of water 2-3 plain vegan biscuits + A glass of water
Lunch A cheese and onion omelette + 1 peeled apple + A glass of water A hummus and falafel wrap + A glass of water
Mid-afternoon snack
(if you’re trying to re-gain weight)
Half a tin of peaches with a dash of cream + A glass of water Half a tin of peaches with a dash of vegan cream + A glass of water
Dinner Our quiche Lorraine recipe + A glass of water A casserole made with vegan sausages + A glass of water
After-dinner snack
(if you’re trying to re-gain weight)
1 of our wholemeal muffins + A glass of water A vegan flapjack + A glass of water

Day 4 Meal Plan

Plan 4
Time of day Plan 1 Vegan plan
Breakfast A full portion of porridge, the texture of your choice + A full portion of yogurt with fruit ‘chunks’ + A mug of decaf tea A full portion of porridge, the texture of your choice + A full portion of plant-based yogurt with fruit ‘chunks’ + A mug of decaf tea
Mid-morning snack
(if you’re trying to re-gain weight)
A mug of milky decaf coffee A mug of decaf coffee made with lots of plant-based milk
Lunch Our butternut squash soup recipe + A glass of water Our butternut squash soup recipe (made with vegan spread and cream) + A glass of water
Mid-afternoon snack
(if you’re trying to re-gain weight)
1 of our almond and apple scones + A glass of water A vegan cereal bar + A glass of water
Dinner Our salmon goujons recipe + A glass of water Our salmon goujons recipe (made with extra firm tofu) + A glass of water
After-dinner snack
(if you’re trying to re-gain weight)
1 of our blondies + A glass of water 2-3 scoops of vegan ice cream + A glass of water

What to Eat 6-12+ Weeks After Bowel Surgery

The stages of diet after surgery:

  • Clear fluids
  • the first few hours after surgery
  • these don’t contain any fat or fibre, e.g. water or very weak squash
  • Free fluids
  • 1-2 days after surgery
  • these are any fluids, e.g. milk and soups without chunks
  • Light diet / Low residue diet
  • 3-4 days after surgery
  • An easy to digest diet that’s low in fibre
  • Usual diet
  • 3-4 weeks of colostomy surgery
  • 6-8 weeks of ileostomy surgery
  • aiming for a balanced diet without restriction where possible

From 0-6 weeks after colon surgery, you’re building up from fluids to at least a light diet. You may have smaller amounts more often than you previously would have to overcome reduced appetite or hunger.

From 6-12 weeks, you’ll be consistently reintroducing foods from your usual diet and possibly increasing the amount you’re eating to fuel your body to be more active. You’ll be aiming to reach a balanced diet.

What is a balanced diet?

A balanced diet includes a variety of foods in the amounts needed by your body. The NHS’s ‘Eatwell Guide’ is a handy diagram of balanced eating for most people.

For most people, a balanced diet is having:

  • 3 meals a day
  • a third of your meal is made up of each of these groups: a high-protein food, a starchy carbohydrate, vegetables
  • 5 portions of fruits and vegetables a day
  • higher fibre carbohydrates, e.g. oats, brown rice
  • 3-4 portions of dairy foods or its alternatives, e.g. fortified soya
  • 6-8 glasses or ~2L of drinks a day (unless your Doctor has advised otherwise)

Our Ostomates Kitchen nutritional guide looks at the different food groups in a balanced diet.

At first, you may find it tricky to manage 5 portions of fruits and vegetables or higher fibre carbohydrates. Gradually reintroducing them will help you get there.

Reintroducing foods

What order shall I reintroduce foods in after my colon operation?

In part 1, we advised how to tell you’re ready to experiment with more foods and introducing them in a structured way.The order you reintroduce foods is entirely up to you as there’s no set recommendation. The example order here is based on nutrition priorities and the textures you’ll likely manage first.

Using this reintroduction order could help you feel more confident:

  • Wholemeal bread and brown rice
  • Fruits and vegetables (well-cooked at first)
  • Beans, lentils, chickpeas etc
  • Whole nuts and seeds
  • Tougher meat (if you’d like to)
  • Spicy foods (if you miss these)

Top tip: Trying these foods when you’re going to be at home rather than out could help you feel reassured.

How will my body react to reintroducing foods?

You may feel a little bloating when eating a new food you’ve not had for some time. If you feel very uncomfortable or there are drastic changes in your stools, then these are signs your body cannot manage this food just yet.

Are there any foods and drinks I shouldn’t reintroduce yet?

Generally, it’s ok to experiment however you’d like. Some foods and drinks are linked to specific stoma symptoms or events, and you may prefer to leave these until closer to 12 weeks after your colon surgery.

Problem Triggers
Pouch-inflating and bloating Broccoli, cauliflower, Brussel sprouts, cabbage, beans, lentils, fizzy drinks (including beer).
Undigested food and blockages Popcorn, bean sprouts, sweetcorn, cooked mushrooms, fruit or vegetable skins, e.g. from tomatoes, whole nuts and seeds.
Increased stool frequency and watery stools Lettuce, rhubarb, spicy food, lots of alcohol or caffeinated drinks like coffee.

A thorough table looking at fibre and bowel irritants is available in our Ostomates Kitchen Nutritional guide.

How much should I eat after bowel surgery?

Although your body may not use as much nutrition to heal, you could be using more energy by being active and getting back into your daily routine. While recovering, your surgical team might have told you to eat little and often, maybe having snacks on top of meals.

Your portion sizes may have been smaller, or you tried to increase them.

Some people can find they gain unwanted fat in the first 6-12 weeks after colon surgery, although this can then reduce once they’re more active.

If you feel you’ve been overeating, it’s important to not reduce your eating too much during this time. Your body is still healing, and if you become more active, the extra weight may drop.

Possbile signs to increase your eating Possbile signs to decrease your eating
Higher appetite and hunger levels Unwanted fat gain (e.g. clothes getting tighter around your stomach)
Unwanted weight loss/looser clothes
Your energy levels aren’t high enough to do all the activities you’d like

How to increase my nutrition

  • Review your portion sizes and perhaps increase them
  • Add extras to your meals, e.g. a drizzle of olive oil over vegetables
  • Choose higher calorie options, e.g. regular yogurt rather than low fat
  • Add an extra snack to your day, e.g. a few oatcakes, a banana, or one of our delicious muffin recipes from our Ostomates Kitchen guide.

How to reduce my eating (only from 10-12 weeks onwards)

  • Review your portion sizes, decrease them to our recommendations where you can
  • Use less oil or fat when making a meal
  • Try to not snack
  • Choose lower-calorie options, e.g. lean meat and removing visible fat
  • Swap high energy drinks like fizzy drinks and milkshakes for choices such as water (you can flavour it with fresh fruit slices or squash)

For more advice about portion sizes and to see our tasty recipes, head over to our Ostomates Kitchen resources.

Top tip: Please don’t weigh yourself more than once a week and ideally not for the first 6-8 weeks after bowel surgery. Weight is just a number on the scale and is affected by how much fluid is in your bladder and gut and how much muscle you have. Focusing too much on weight may not be helpful to your recovery.

I think I’m eating enough but still feel hungry. What can I do?

People can find that they feel hungrier since changing their way of eating but that they’re gaining unwanted weight.

  • Check if you’re following our balanced diet advice
  • Check you’re spacing out your meals and drinks across the day
  • Try taking longer to eat to give your body time to recognise the nutrition
  • Reflect if it’s ‘true hunger’ rather than craving a food/drink or boredom eating

Who wrote this information?

This information was created by Laura Coster, a Registered Dietitian who has experience at multiple NHS hospitals working with patients who have undergone stoma-formation surgery. The information provided is intended as guidance alongside any professional medical advice from your healthcare team and isn’t a substitute for any tailored advice you are given.

Useful Resources

Sources of Support

The Fittleworth Stoma Nursing Team:

UK

Scotland

Colostomy U.K

The Ileostomy and Internal Pouch Association

  • Website: http://iasupport.org/
  • Address: I.A. National Office, Danehurt Court, 35 – 37 West Street, Rochford, Essex, SS4 1BE.
  • Company number: 10375943
  • Tel: 0800 018 4724