Trying new foods

[Cari1975]

Hello all, how is everyone doing? I have a question. I am at week 6 and have begun being brave and trying foods that are off the low fiber diet. YEAH. Been missing lettuce on tacos, lol. So I tried corn the other day by default because the restaurant did not hear me say no corn, hard to eat around. A little personal when I had my jpouch, corn would pretty much come out as whole kernels, so I expected the same. I saw little pieces of kernel but not whole pieces and not enough to make me believe all the corn came out either. I only ate like 15-17 kernels, yes I counted how many I ate. Anyone know if this is normal? Gonna cause a problem but just hasn’t yet?

[oliveoyl]

Hi Cari1975
I hope all goes well with the kernels of corn. Corn is avoided by most ostomates because of those little jackets the kernels are encased in; they just don't digest. If you are craving corn, try creamed corn. It's delicious and sweet and it has never caused any problems for me. Sometimes I will chew a mouthful of something we are supposed to be extra careful of, like corn or pineapple, and after I chew it well and enjoy the taste and suck all the liquid goodness out, then I just take the fibrous part out of my mouth and throw it away. That takes care of the cravings!

[sassie]

I do eat corn but not lots, like you i watch to see if corn comes out and i know that things are moving through ok unless only a small amount comes then i just watch the next time, kinda interesting how this works, at least we got something over the "normal" people, we can see what we eat and what digest best..This is all a learning process for sure.

sassie

[Button]

Hi Cari1975
Sometimes I will chew a mouthful of something we are supposed to be extra careful of, like corn or pineapple, and after I chew it well and enjoy the taste and suck all the liquid goodness out, then I just take the fibrous part out of my mouth and throw it away. That takes care of the cravings!

Olive’s tactic of “ chew and spit” is a a wise and practical approach when craving a food high in soluble fiber.

The “issue” with corn for those with an ileostomy is that corn has a high ratio of insoluble fiber. Insoluble fiber is fiber that does not breakdown well with mechanical chewing nor with digestive enzymes. Think of the digestive end-product of insoluble fiber as remaining stringy, woody, fibrous but that still must exit the body.

Examples of potentially problematic insoluble fiber foods: The outer casing of corn, popcorn kernels, artichoke leaves, celery stalks, dense legumes such as kidney beans, black beans and etamanie, coconut, whole or half nuts such as walnuts and pecans and macadamia nuts, asparagus spears, pineapple.

The diameter of the small intestine and, thus, the diameter of an ileostomy stoma is about an inch or an inch + one quarter. It is the small aperature of an ileostomy that makes foods high in insoluble fiber more concerning for those with an ileostomy as compared to a colostomy. Insoluble fiber can congeal and coagulate as it makes its way through the small intestine, forming a boils or thickened mass that can be difficult to pass through a small aperature ileostomy stoma. In addition, ragged edges of nuts and kernels can be painful to pass (think of passing a kidney stone).

The diameter of the large intestine and diameter of a colostomy is larger and more forgiving to the nature of digestive food material exiting via a stoma.

When eating a food that is higher in insoluble fiber, words to the wise:
A. Consume a small portion. Ex. 1/4 cup of creamed corn or 1/4 cup of air popped pop corn with care to remove unpopped kernels or husks. If you do have fiber forming a bolus in your digestive tract, you do NOT want to have a large accumulation that has to pass out and through the stoma.
B. Drink, drink, drink water or other clear liquid (tea, coffee, fruit juice, flavored water) with the small plate of food. Liberal hydration will help move the digested material along like a running water faucet.
C. Employ Olive’s “chew and spit” strategy. Chew to derive the taste and mouth feel/satisfaction of the food you grave. Do not swallow. Spit the chewed food politely into a napkin. The “chew and spit” strategy is more common then one may think. For someone with a stroke that affects the ability to swallow, for example, a person who is tube fed but who still wants the pleasure of the taste of food will “chew and spit.”

Eating foods with higher insoluble fiber with an ileostomy or a small aperature colostomy or a hostile abdomen with an abundance of adhesions is all about using an awareness of caution. Small/sparing portion size. Liberal consumption of water or other clear liquid to flush food through. Become aware of foods that your body is less agreeing to.

How fibrous foods affect you will be unique to you.

Bon appetite,
Karen

[Mysticobra]

I'd like to add if I may.
I soon found after the trauma and healing and coming to terms with having a stoma.and a bag. I hate that word. Bag. Let's use appliance.
After I was done with all that I soon realized I could eat and enjoy food again after a couple of decades of trying to be careful of what I ate.
I love food! I didn't realize how much I missed it. Well. The fact now that I could eat anything and have no consequences (burning butt) afterwards. It was and still is wonderful. Ow.
But. Ya. Always a but. Some things I can eat only in moderate amounts.
Cheese and potatoes being two. Slows me down instantly. Which scares me more than a kernal of corn. Corn I have eaten but no matter how much I chew it magically comes out whole. Lol. So just to be careful I eat it in moderation.
I have a very forgiving stoma. It all passes. Even salad. Not much of a benefit to me but I'm sure I get something out of the salad before it passes. I love sweet peppers. Those little ones. Like candy to me.
In the long run trial and error with the foods you like will come. Moderation with some.
And go crazy on others. I love ice cream. Zips right though. I eat so much ice cream it'll give me a heart attack before I can gain a pound from it. I had to stay away from ice cream prior to my pouch removal. Now it's first on my grocery list.
You'll and all of us will be ok. Enjoy food. If you haven't prior like me. It's time to enjoy it.
Food is life!
Richard.

[Cari1975]

Thank you everyone very helpful. So, for anyone that does eat corn, do you always see it come out whole??? I ate it as previously mentioned in my question but still never saw whole kernels. That was on like the 15th and is now the 21st. Everything is still digesting and moving even lettuce. My question is not seeing those whole kernels come out could they still be in the intestine and cause an issue this far past eating them?

[ot dave]

If you are having bowel movements, the corn is likely gone by now. Just like everything else ostomy related, this issue is going to be unique to each person. It's kind of like when a Baptist preacher is asked if Baptist's can dance (Footloose reference), and the answer is, "some can..., some can't..." I have a colostomy, and eat a normal diet. I do however watch how much corn I eat, because in the past, it has occasionally caused me some issues with the irrigation that I perform each day. What works for one, doesn't necessarily work for all, but isn't it great to have all of these suggestions, tips, and information...just one of the many reasons I participate with these discussion boards.

David

[Button]

Thank you everyone very helpful. So, for anyone that does eat corn, do you always see it come out whole??? I ate it as previously mentioned in my question but still never saw whole kernels. That was on like the 15th and is now the 21st. Everything is still digesting and moving even lettuce. My question is not seeing those whole kernels come out could they still be in the intestine and cause an issue this far past eating them?

Cari:
You can rest your concerns about the corn you ate on 15-Jan. Whatever corn you ate has worked its way through and out of your digestive system.

Here are a few informative tid bits on digestive transit:

1. Food in the stomach takes about 3-4 hours to process. The stomach churns and mixes food with digestive enzymes, breaking it down into a liquid “slush” called chum as it passes into the first portion of the small intestine.

2. A study of 650 people showed small intestine transit time, from the beginning of the duodenum to the terminal end of the ileum, varied from 15 minutes to 5 hours. 83% of subjects had a small intestine transit time of less than 2 hours. The average/statistical mean small intestine transit time was 85 minutes.

3. Large intestine transit time varies slightly by gender. Women tend to have a longer large intestine with more redundancy. Large intestine transit time average/statistical mean is 40 hours (inclusive of men and women subjects). For men, large intestine transit time mean is 33 hours and for women is 47 hours.

4. Take away . . . For an intact digestive system without an ostomy . . . From swallowing food to passage of a bowel movement from the anus is about 72 hours, on average. Individual variations, exist of course. Anyone with a slowed intestinal motility will have a protracted transit time.
Karen

[Cari1975]

Thank you Karen.

[Cari1975]

So sorry, I have so many questions that keep coming up along the way. For all out there with a permanent ileo,, how many times a day do you have to empty your bag? It seems like I am emptying like 10+ times in a day. The ostomy nurse acted like that wasn’t abnormal. Also how do all of you sleep? I am a side sleeper and maybe 7 weeks out from surgery it’s just because I am still sore but can’t sleep. I have been sleeping in a chair, and that still isn’t very comfortable. And also sleeping that way keeps the output moving down into bag. Is there something special to do while sleeping whether on back or side to keep output from sitting at the top of the bag? Seems like the output being at the top while sleeping would start breaking the seal down.

[Diane C]

Hi Cari1975,

I'm a rather new ileostomate -- since November -- although I had a colostomy since 2002 so others can help you much more. But I do sympathize with the frequent emptying of the pouch.

I used to irrigate as a colostomate and to do so, one wears a long irrigation sleeve with much room inside but no filter (which I'm finding pretty useless anyway as an ileostomate). I'm still sleeping with that irrigation sleeve because if I don't, the likelihood that the pouch will puff up with air and leak is still pretty high. In a recent order, I asked for a box of 5 irrigation sleeves and, to my surprise, it was approved even though ileostomates can't irrigate. I'm trying to figure this out but don't do well when sleep-deprived. I also prop myself up with a LOT of pillows and can sleep that way. However, in my sleep, I must move to my favorite position on my left side. Karen also gave us much info about those beds that rise up -- and that's under consideration although I'm not too crazy about the cost but we'll see. I also sleep with puppy pads or other coverings on the bed and under my sheet is a quiet, plastic liner.

Use of liquid Immodium lately has helped me quite a bit. I probably take too little because I feared constipation or a blockage. I am going to increase the dose. Everyone is different but you might try some of that if your doctor gives you the green light. Many people in my non-virtual support group use it daily -- morning and night. It's easy to titrate and experiment with if you get the liquid.

Karen/Button provided many suggestions so you might do a search for them. Supposedly some foods slow output but frankly, I don't think they do for me. Applesauce and bananas (even unripe ones) go right through me. Oatmeal seems to thicken up the output. I think it's Convatec that has a product I like called Diamonds that will thicken the output in your pouch but I don't think insurance or Medicare covers it.

I still haven't had raw foods except nuts, I think, or salads (unless it was in error at a restaurant) and I'm holding on that until I'm more used to the ileostomy. I have eaten some sliced almonds as I must increase my protein. Had no problem with them and am sure that if I chew, chew, chew, I can consume whole ones.

An old-timer with an ileo in my support group loves corn. When she eats corn on the cob, she takes a knife and runs it down the cob to split each kernel and has never has a problem. More digestible that way. (I realize you weren't eating that kind of corn but I sure hope spring/summer will return.)

It's good to have the info that Karen/Button posted about transit and digestion times. Agree -- don't be concerned any longer. Our bodies surprise us (usually for the better) and can deal with many things.

Oh -- Convatec and other manufacturers (unsure which) have "high output" pouches that are larger than normal. You might try one of those. Convatec sent me a sample but it's far too large. Must call them.

I am also a MAJOR fan of Cymed MicroSkin's products. The material is unlike any other. I went online and asked for samples and was warned it'd take a while -- and that was 2 wks ago. This company is small and the products more costly. I hope they arrive soon. You may want to experiment with them by asking for samples, too.

GOOD LUCK!

Diane C

[Diane C]

Cari1975,

PS. Just saw that we have a thread here about high output pouches so you may want to check that out. I'm quoting from it: "Coloplast, convatec and hollister all make high output pouches. Some with clips some with drain ports and some with velcro. I’d you call all three, you can talk to an advisor to help get you samples that will work for you."

I was pleasantly surprised by the size of Convatec's so am calling right now to get a sample that's the correct size.

Diane C

[agichk]

Thank you guys for the posts as I am having questions about foods I can eat now that I am 11 weeks today post ileostomy.

I am finding part of my issue with accepting the situation is all the foods that I was told not to eat: no nuts, raisins, romaine lettuce (i don't eat any other since colectomy 2010), pistacios, trail mix, popcorn, corn, no potato skins etc.

I was told cream corn is ok by the GI but canned green giant was recommended. I love Rudy's in Leon Springs TX. that is real cream corn but it more like real corn off the cob, which is coming into season and another one of my summer favorites.

I am going to try strawberries if chopped to pulp almost per GI though i used to eat a pound a day from breakfast thru my 10 hour work days. I haven't had the courage to waste the money on a pound in store until the local farms have pick your own when ripe.

Where do you guys get the info on resuming regular eating with ilesotomy though only try 1 new thing per 3 to 4 days?

I am going back to work after almost 6 months out and really having hard time finding snacks to replace the trail mix and popcorn that is not just straight carbs, which I love but need to get as much protein as can to help with wound healing.

any websites or ideas are welcome. email me if easier.

Kathleen