Maintaining Nutrition and Hydration in the Management of Short Bowel Syndrome

, , ,

Part 1 of a Two-Part Series featuring Emily Rubin MPH, RD, LDN, Thomas Jefferson University Hospital

With over two decades of experience at the Thomas Jefferson University Hospital Division of Gastroenterology and Hepatology in Philadelphia, I am the Director of Clinical Nutrition and Lead Clinical Dietitian for the Division of Gastroenterology and Hepatology. In this role, and over the course of my career, I have provided comprehensive nutrition education and medical management to patients of all ages living with a wide range of gastrointestinal diseases, including short bowel syndrome (SBS).

SBS is a serious and chronic malabsorption disorder that occurs when parts of the intestine are removed surgically or due to injury. The remaining intestine may not be able to absorb enough nutrients from food and drink. When this happens, people with SBS may be at increased risk of malnutrition, dehydration, electrolyte disturbances and/or diarrhea (increased output). I am passionate about educating patients and their family care partners about the roles of nutrition and hydration in the management of gastrointestinal diseases like SBS, and proud to share my clinical experience.

To learn more about SBS, click here. To join the community and talk to others who are living with SBS, check out https://www.facebook.com/TakedaSBS/.

The Nutritionist’s/Dietitian’s Role in Multidisciplinary SBS Care

Managing SBS can be complex, but working with experienced health care providers to establish a set of management goals that are individualized to the distinct needs of the patient can be an important part of self-advocacy. Since nutrition and hydration goals are important parts of an SBS management plan, a nutritionist or dietitian will often be included in an SBS patient’s multidisciplinary health care team.

 

Here at the Thomas Jefferson University Hospital Division of Gastroenterology and Hepatology, we see patients for a variety of reasons. In this two-part series, I am going to share my own clinical experience on two topics that come up frequently with our patients who are living with SBS and ostomies (e.g., ileostomies or jejunostomies). This article will address “Output Consistency” – including thickening or thinning out stools, as well as managing stool acidity. The second article in this series will focus on “Hydration” – including common causes of dehydration in people with SBS, as well as rehydration tips, including Oral Rehydration Solutions (ORS). That article will post in the coming months.

Managing Output Consistency

I see a 35-year-old female patient with a history of Crohn’s disease who underwent her third intestinal resection, resulting in short bowel syndrome (SBS) and an ileostomy. Since the surgery, she has struggled with managing high stoma output and persistent diarrhea and weight loss of 10 pounds over the past four months. She states, “Every time I eat too much fat, it makes my diarrhea worse, but I need to gain weight, so I am not sure what to eat?”

Considerations:

  • Weight Loss: Patient requires a diet that promotes weight gain without increasing stool output.
  • Dietary Concerns: She noticed that consuming high-fat foods exacerbates her diarrhea and stoma output; she needs to gain weight but is uncertain about what foods to eat that won’t worsen her symptoms.
  • Fluid and Electrolyte Management: Maintaining hydration and electrolyte balance is crucial to prevent dehydration due to her high-output stoma.

I stress to my patients that diet therapy is key for getting proper nutrition and for managing symptoms like diarrhea, which is often the biggest challenge for my SBS patients. I typically start with these important diet factors for SBS output consistency: I educate my patients about how to include Fat, Carbohydrates/ Sugar, and Fiber in their diets.

FAT

Did you know that eating too much fat, including fried or creamed based foods, can make diarrhea and output worse and cause nutrient and fluid loss?

Fat provides important calories but is a hard nutrient to digest. Limiting fat intake is most important in my SBS patients who have a remaining colon, severe steatorrhea (poorly digesting and absorbing fats) and/or a history of kidney oxalate stones. In some cases, I advise them to limit their fat to less than 30% of their daily calories and spread fat intake evenly throughout the day to help their bodies digest it better. When it comes to preparing foods such as fried or creamy based foods, I tell them to incorporate small amounts of easily digestible fats such as medium-chain triglycerides (MCTs) found in coconut oil. I have seen that these are better absorbed in my SBS patients.

I also educate my patients about avoiding High Fat Foods, such as fatty meats like beef, lamb, pork, and skin-on chicken and poultry. Dairy foods like whole milk, soft cheese, ice cream, and butter contain lactose. Symptoms of lactose intolerance are often dose-dependent, and some of my SBS patients can tolerate some dairy products, especially if they are spread over the course of the day.

I recommend that my patients incorporate healthier fat choices, such as fatty fish: salmon, tuna, olive oil, avocado and nut butters.

CARBOHYDRATES / SUGAR

Did you know that drinking 100% fruit juice can increase stool output and dehydration?

When my patients eat concentrated sweets, including candy (e.g., jellybeans or gummy bears), cookies, cakes, and drink sweetened beverages (e.g., soda, juice, lemonade), they draw excess water into the bowel, increasing stool output and exacerbating dehydration. Instead, I tell them to choose complex carbohydrates, like white rice, potatoes, pasta, bread and bananas, to help manage stoma output and improve nutrient absorption. These carbohydrates are easier to digest and absorb compared to simple sugars. I have seen that reducing stool volume and minimizing fluid loss can help my SBS patients maintain better hydration and nutrient balance.

FIBER

Did you know that incorporating soluble fiber like psyllium husk and oatmeal in the diet may improve stool consistency?

Fiber is often a scary word for my SBS patients. Soluble fiber found in oats, barley, citrus fruits, carrots, sweet potatoes, ground flaxseed, and psyllium husk can help to slow gastric emptying, potentially improving diarrhea and stabilizing bowel movements. Fiber dissolves in water, forming a gel-like consistency, which helps slow digestion and manage diarrhea. I tell my patients to focus on soluble fiber to improve stool consistency, especially if a colon segment remains. I encourage a moderate intake of soluble fiber to be spread throughout the day to help my SBS patients manage stool output and enhance fluid retention.

Although insoluble fiber, found in whole wheat, brown rice, bran, cauliflower, broccoli and dark leafy greens, may help thicken stool consistency, it can lead to increased loss of minerals and fluids, exacerbating dehydration. I frequently advise my SBS patients to avoid it.

I often remind my patients that they should not prioritize fiber over meeting their basic nutrient needs, especially for patients with poor appetite or requiring weight gain.

 

Additional nutrition tips I often share with my SBS patients, include:

Small, Frequent Meals: Eating smaller meals throughout the day can help manage symptoms and improve nutrient absorption.

Avoidance of Certain Foods with A Dietitian: Some foods might exacerbate symptoms, so identifying and avoiding these can be beneficial. A dietitian can help identify nutrient dense foods to include in an SBS diet to best manage symptoms based on the length of the patient’s remaining bowel, to help maintain hydration and to create a personalized nutrition plan.

Consistent Communication with Health Care Providers: I can’t stress to my patients often enough that they should always inform their doctor or dietitian about any changes to their diet or hydration plan. The patient’s health care team can adjust the patient’s treatment plan as needed to ensure they’re getting the right balance of nutrients and fluids.

Although there is no “one-size-fits-all” diet for SBS, your own health care team will work with you to develop nutrition and hydration goals that are specific to your needs. Diet therapy focuses on controlled fluid intake, nutrient absorption, and maintaining electrolyte balance to manage high-output stomas effectively. Again, it is important to tell your doctor and dietitian about any significant changes to your diet and output and identify signs of dehydration. A key aspect of nutrition and hydration management in SBS is educating patients on balancing nutrients, fluids and electrolytes.

To learn more about managing your SBS, visit https://shortbowelsyndrome.com/sbs-management.

Watch for Part 2 of this two-part series “Maintaining Nutrition and Hydration in the Management of Short Bowel Syndrome (SBS)” in the coming months!

+++

Emily Rubin MPH, RD, LDN is the Director of Clinical Dietetics, Clinical Dietitian for Division of Gastroenterology and Hepatology at Thomas Jefferson University Hospital in Philadelphia. In addition to her extensive clinical work, her expertise and insights in the areas of diet and nutrition have been featured in numerous online and broadcast media outlets.

This article was created by Takeda.

Editor’s Note: This educational article is from one of our digital sponsors, Takeda. Sponsor support along with donations from our readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

US-NON-11724v2.0 01/25

Christmas with an ostomy, all wrapped up

, , , , , ,

By Convatec

We want to help everyone in our ostomy community have a wonderful holiday.

So, we’ve put together this guide to share our top tips. In our 12 ways of Christmas, you’ll find advice about everything from stocking up on supplies to eating and drinking in moderation. If you have a child with an ostomy, you’ll find tips on how to prepare for Christmas day. You’ll also find our Accessories Wish List, featuring our most popular accessories.

12 Ways of Christmas

The countdown to the big day has begun. To help you prepare, we’ve put together our 12 ways of Christmas. Share your tips on our social media channels using the hashtag #OstomyHoliday

1. Stocking up

Now’s the time to order more ostomy products if you haven’t already done so.

2. Get wrapping and packing

If you plan to travel, make a checklist of everything you need to pack or better still, pack an overnight bag now.

3. Eat, drink and be moderate

Avoid the risk of bloating or even a blockage by enjoying your favorite foods in moderation.

4. It’s all about the bubbles

Remember champagne, sodas and other carbonated beverages can cause ballooning and indigestion.

Check out our top ostomy nutrition tips here

5. Add Accessories to your wish list

The holiday break is a great time to give ostomy accessories a try. If you’ve got an ileostomy, give Diamonds™ Gelling Sachets a try – just pop one in your pouch to thicken your output and reduce gas.

6. Beware of what’s hidden in the dessert

If you’re one of the few who enjoy fruitcake, be aware of the ingredients and which might cause irritation.

7. Marshmallows aren’t just for S’mores

Many people with an ileostomy find that marshmallows are a great way to quickly thicken output.

8. Enjoy it

Sometimes the holidays can be stressful, even without an ostomy! Being knowledgeable and prepared can ensure you have a great time.

9. Dreaming of holiday food?

From a vegetable overload to rich, spicy foods, the holiday menu is packed full of potentially gas-inducing foods. Many people find they can enjoy these foods in moderation. And remember, if you’re at someone else’s house, it’s not rude to refuse.

10. Don’t expect the Santa Express…

If you’re traveling by land, air or sea, there’s likely to be a limited service. So, it’s a good idea to keep a supply of pouches and supplies within easy reach, just in case.

Check out our top travel tips for ostomates here

11. Stay hydrated

It’s tempting to hope that all that soda and eggnog is keeping you hydrated, but in reality, the opposite is more likely to be true. Alcohol is a diuretic, so if you decide to indulge a little, make sure to also drink plenty of water.

12. Take it easy the day after

Whatever day you celebrate on, it can be hugely fun, but also tiring. So be sure to plan to rest the day after.

Let’s make it all about stockings, not pouches: holiday tips for children with an ostomy

We all want our kids to wake up on Christmas morning (not too early!) thinking about their stockings, not their ostomy pouches. Best of all, there are things we can do as parents to help.

Plan ahead

You’ve already got so many things to think about, so it’s a good idea to make a checklist. Have you got enough supplies? If you’re going away, have you packed a bag?

Eat ahead

It can be a good idea to give your child bland food a day or so before a big holiday feast, to compensate for any overload the day of.

Sleep easy on Christmas Eve

You’re likely to already have an established bedtime routine. If so, try making it a bit earlier so you and your child are not rushed. Remember, to minimize the risk of leakages, avoid eating too close to bedtime and make sure the pouch is completely empty.

Wrap the mattress in a plastic sheet

If you’re not already doing so, get wrapping! A plastic sheet is easy to clean, avoiding any unnecessary upset.

Editor’s note: This blog is from one of our digital sponsors, Convatec. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

How to Stay Hydrated from a Marathoner with an Ostomy

, , , , ,

Ileostomate and athlete Collin Jarvis shares his recommendations for staying hydrated when you’re physically active. 

My name is Collin and I had ileostomy surgery in 2014 when I was on the Cross Country and Track & Field teams at the University of California – Berkeley. Staying hydrated was always an important aspect of my athletic performance, but after I had surgery, it became even more critical for me to drink enough fluids. Why? Because having an ileostomy can meaningfully reduce the body’s ability to get hydrated.1,2

Over the last decade I have continued to compete as an endurance athlete. Below are my top three tips for new ostomates looking to stay on top of their hydration:

Tip #1 – Make sure you are getting enough hydrating fluid throughout the day 

It can be challenging to keep up with fluid intake, especially when living with an ileostomy.3 I know this from personal experience!

Start by talking to your clinician about how much fluid you need on a daily basis. They will be able to point you to the best resources for your specific needs. General guidance is available online, but every body is unique. Keep in mind that the resources you come across online are going to be calculating fluid needs for a person who has all of their internal organs. So once you identify that baseline, ask your doctor if you need to increase your fluid intake above that level. In my case (i.e., as someone who is extremely active and has had their entire large intestine removed), I take in about 20% more fluids than what the average online calculator recommends.

Tip #2 – Be aware of when and how you are taking in your fluids 

Make sure to spread out the volume of liquid that you’re drinking as evenly as possible. In other words, take small and frequent sips throughout the entire day. This is important because our bodies are not perfectly efficient at absorbing the fluids that we put into them.

For example, you may have determined that you need around 100 ounces of liquids each day to meet your hydration needs. However, if you were to wake up in the morning and drink all 100 ounces right away, you would end up urinating most of that water out. In addition, drinking too much water at one time can dilute your body of the electrolytes it needs to properly absorb water which can exacerbate dehydration. Spreading out your fluid consumption evenly throughout the day is going to allow your body to work most effectively.

Keep reading on Hollister.com.

Hollister Incorporated is a proud sponsor of United Ostomy Associations of America and dedicated to delivering the highest standard of quality in ostomy care products. To learn more, visit www.hollister.com/ostomycare or call 1.888.808.7456.

 

References:
1. Justiniano, Carla F et al. “Readmissions With Dehydration After Ileostomy Creation: Rethinking Risk Factors.” Diseases of the colon and rectum vol. 61,11 (2018): 1297-1305.
2. Chen, Sophia Y et al. “Predicting the Risk of Readmission From Dehydration After Ileostomy Formation: The Dehydration Readmission After Ileostomy Prediction Score.” Diseases of the colon and rectum vol. 61,12 (2018): 1410-1417.
3. Absorption of Water and Electrolytes (colostate.edu) – http://www.vivo.colostate.edu/hbooks/pathphys/digestion/smallgut/absorb_water.html

 

Collin received compensation from Hollister Incorporated for his contribution to this article. The testimonials, statements, and opinions presented are applicable to the people depicted. These testimonials are representative of their experience, but the exact results and experience will be unique and individual to each person. Please make sure to consult with your healthcare professional for further guidance and instruction. The information provided herein is not medical advice and is not intended to substitute for the advice of your personal physician or other healthcare provider. 

Diet and Digestion with an Ostomy

, , , , ,

Twelve years ago, Sarah had ileostomy surgery after living for years with ulcerative colitis. Ostomy surgery has allowed Sarah to get back to eating foods she loves, and she says “it has been the best thing for me.”

Sarah now eats many of the same things she did before her ileostomy and enjoys them more than ever. Here are some tips that Sarah has learned over the years for eating, digestion and activity.

  1. Drink up. Hydration will always be an issue, so drink lots of water. I like to toss in a slice of lemon for a little extra flavor.
  2. And chew some more. If it looks the same coming out as it did going in, you need to chew those foods better.
  3. Start slow and build up. If you’re right out of surgery, you might be more sensitive to foods than you will be six months down the road. Use trial and error to see how foods work for you and be sure to track the results. If you’ve had ileostomy surgery, add high-fiber foods back into your diet gradually to make sure you can digest them well. These include raw fruits and veggies (especially with skins), nuts, seeds and popcorn.
  4. Input always makes output. With an ileostomy, your stoma is going pretty much all the time, so it’s important to track and manage your input and output. For example, if I was going on a job interview, I would not eat a big meal right before, because my stoma may create output and my pouch would fill up – and you don’t want that during an interview!
  5. Do what you love! I go on bike rides, I go boogie boarding. It may take a little time and tracking to know what works best for your body, but you can do all those things and keep your stoma safe.

Sarah, with the help of the My Ostomy Journey App, now has the ability to track everything digitally. She can also use the app to contact someone for additional support, or if she has any questions.

Sarah says, “The My Ostomy Journey app makes it easy for us to keep track of whether we’ve had enough water or what foods we eat. I wish I’d had this resource right after surgery, especially when I was first figuring out what does and doesn’t work for my body!”

 

Editor’s note: This blog is from one of our digital sponsors, Convatec. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Bethany’s Story: An Architect Learns to Engineer Life with Short Bowel Syndrome

, , , , , ,

My journey to a Short Bowel Syndrome (SBS) diagnosis followed years of motility issues, intestinal complications and numerous surgeries, including a jejunostomy, which is an ostomy that creates an opening in the part of the small intestine called the jejunum. As a trained architect, I believe there’s no problem too big to solve, and applying that mindset has helped me to navigate the challenges of SBS and life with an ostomy. This is my story.

When I was diagnosed with a motility disorder at the age of 15, I never thought that it would have such an effect in my life. I was able to function with physical activity and limited diet until I had my colon removed in 2015 due to colonic volvulus. In my case, this meant that my colon twisted around itself, causing tissue death from lack of blood flow. The procedure worsened my underlying motility disorder of the small intestine. As a result of my underlying condition of chronic intestinal pseudo obstruction (CIPO), my intestines wouldn’t function. I lost the ability to absorb nutrients through my small intestine. I was in desperate need of answers.

Ultimately, I was evaluated for an intestinal transplant. At the time, my small intestine was severely compromised due to small intestinal bacterial overgrowth. In order to improve my odds of surviving the transplant, I underwent surgery to remove the majority of my small intestine in 2018, leaving me with only four inches of small intestine that didn’t function properly. The surgery, and the resulting serious and chronic malabsorption disorder that accompanied it, resulted in my diagnosis of short bowel syndrome, SBS.

To learn more about SBS, visit https://sbs-whattoknow.com/. To join the community and talk with others who are living with SBS, check out https://www.facebook.com/TakedaSBS/.

Learn More

 

While not everyone will experience an SBS diagnosis the same way, for me, the removal of my colon and most of my small intestine eliminated the ongoing pain and discomfort I experienced when I was living with a motility disorder and chronic intestinal pseudo-obstruction syndrome. Just prior to the surgery to remove my small intestine, I weighed 87 pounds and couldn’t walk half a mile without becoming exhausted. I now weigh 122 pounds and was able to walk nine miles the other day. Keep in mind that this is just my experience and everyone’s journey will be different. In consultation with my medical team, I have decided to put my intestinal transplant on hold.

In my case, living with SBS also means that if I don’t eat the right things, it can affect my electrolytes and fluid balance. Without my colon, I don’t absorb fluids. So, I have found that if I drink water, I can actually lose fluids. A key part of managing my condition has been learning to listen to my own body and trying to understand what’s happening inside. For example, I have learned to recognize the signs of dehydration and have made it a priority to understand my lab values. As I have gained a better understanding of my condition, I also think it’s been important for me to find the right providers for what I’m going through at each stage of the process.

 

Navigating how to live with a jejunostomy was a challenging aspect in my SBS management, especially when I experienced leaking. I remember once going to a rare bookstore and my ostomy bag opened. In those moments, with liquid pouring down my legs, I had never felt more embarrassed. However, my grandma taught me that you have a choice in uncomfortable situations – you can either cry or laugh. I try to choose the latter. Not everyone will experience leaks with an ostomy, but if it happens to you, I’d encourage you to give yourself grace. Adapting to life with an ostomy can be a gradual process. For example, when I first had my jejunostomy, it took me an hour to change my bag and now it only takes me 15 minutes.

Despite the challenges, I never gave up on looking for answers and solutions. My training as an architect has led me to believe there is nothing that can’t be solved. After consulting with multiple ostomy teams and connecting with people who share similar experiences, I started to embrace the changes that came with my SBS diagnosis and jejunostomy.

I have been lucky enough to receive tremendous support throughout my SBS journey. My family is my biggest source of support. My husband has been there for me despite knowing about my chronic condition. My dad is the one who figured out how to empty the additional drainage bag overnight by flipping it upside down. My mother and grandma have created customized recipes to help with my oral food intake. But, for me, it’s been a continual process to educate the people around me about my condition. I have learned to be patient and vocal about my specific needs.

For anyone living with a rare and chronic illness, I encourage you to reach out and seek community support. A few members of the SBS community have inspired me and helped me to better understand my condition and encouraged me to break down barriers in my own SBS journey by sharing their own experiences. I’m grateful for the opportunity to connect with others going through similar experiences.

When I was first diagnosed with SBS, I did not think it would be possible to continue doing the things I love. Along the way, the architect in me has looked for opportunities to “design my future” with SBS by embracing challenges, educating myself and the people around me, and connecting with others in the community. I am proud of the progress I’ve made – I have a job that I love and I live in a city that I love. SBS is only a small piece of who I am, and it does not define who I am. I hope you can embrace YOUR journey with SBS, too.

This article was created by Takeda.

 

Editor’s Note: This educational article is from one of our digital sponsors, Takeda. Sponsor support along with donations from our readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

LeeAnne’s Healthy Eating and Fitness Tips for People With Ostomies

, , , , , , ,

Actress, model, businesswoman, and cancer survivor LeeAnne Hayden shares diet and fitness tips that can help you live your best life with an ostomy.

Learn simple lifestyle changes you can make to improve your health and wellness.

Living a healthy lifestyle. We all know we should be doing it, but sometimes it’s not so easy – especially after having ostomy surgery. When it comes to eating and exercise, we’re worried about the possibility of blockages and hernias. I get a lot of questions about those issues.

I have had my colostomy for over six years now, and after doing a lot of testing of what my body can and can’t tolerate, I feel great. Regardless of any concerns you may be experiencing, it is so important to live a healthy lifestyle. When we feed our bodies the right foods and move our bodies with exercise, over time we will see, and more importantly FEEL, the positive results.

6 Tips for Healthy Eating With an Ostomy

So, what do we do? Our Moms always said, “Eat those vegetables and have an apple!” However, most of us must watch our fruit and vegetable intake so that we avoid intestinal blockages. Here are six tips that can help you eat well and safely:

  1. Cook your fruits and vegetables. When foods are cooked, they are easier for the body to break down. Try sautéing, baking, or even air frying your favorite fruits and vegetables. I am constantly sautéing spinach, red peppers, onions, and mushrooms, and then tossing in some lean protein and jasmine rice or sweet potatoes to complete the meal.
  2. Blend your fruits and vegetables. After every workout I have a protein smoothie. I combine one cup of unsweetened almond milk with one scoop of vanilla whey protein, a handful of spinach, a half of a banana, and one tablespoon of peanut butter.
  3. Chop your salads. The smaller the pieces, the easier they are to digest. I’ve been loving the bags of pre-chopped salad that are in grocery stores now.
  4. Take a digestive enzyme after a meal. These supplements can help your system break down vegetables and fruits even more.
  5. Chew slowly. Our lives are so busy that when we sit down to eat, we often don’t take our time. Slow down at the table and chew your food more. This will help you digest it better.
  6. Keep a food log. Writing down what you ate and how it made you feel will help you make better choices.

Be sure to check with a dietitian about what foods you can safely eat. For example, mushrooms can cause intestinal blockages for some people living with an ileostomy.

3 Tips for Exercising Your Core After Ostomy Surgery

When you have an ostomy, working on your core is important. It can be scary prospect, however, since the fear of getting a hernia is a real thing. So, always check with your doctor before starting any fitness program.

Core exercise is great for improving pelvic floor strength, posture, and balance. It also can help prevent ostomy bag leaks because the flange will fit better on your peristomal skin.

Here are three gentle core movements that you can do to help strengthen your core:

  1.  Standing single knee lift. Stand with your feet hips-length apart, and your hands on your waist or down by your side. Tense your abdominal muscles and lift one knee. Do as many as you can or three sets of 10 to 20 on one side before moving to the other side.
  2.  Holding a plank position. Planks put less strain on your spine and hip flexors than abdominal crunches or sit-ups. A beginner version can be done against a piece of furniture (e.g., a chair or a low table). Place your forearms on the furniture, keep your back flat, don’t sag into your forearms, keep your core tight, and hold that position for 15 to 30 seconds. The further away your legs are from the furniture the more activated the core will become. Advanced options are done on the floor. Put your hands directly under your shoulders, grind your toes into the floor, and tighten your gluteal and core muscles. Neutralize your neck and spine by looking at a place on the floor about a foot beyond your hands. Hold this position from 20 seconds to two minutes.
  3.  Stomach crunches. Lie on your back with your knees bent to a 90-degree angle and your feet on the floor. Make sure your back is flat. Squeeze in your abdominal muscles and bring your head to your knees. Your glutes will try to play too, but don’t let them. Focus solely on your abs, hold for three to five seconds, and then release. Do three sets of 10 to 20.

I hope these wellness tips have been helpful to you! Share with us on social media your favorite fruit and vegetable recipes, and what you think of these moves!

To learn more about LeeAnne Hayden, listen to The Beautiful Bag podcast, visit leeannhayden.com, or follow @leeannehayden on Instagram, Facebook, and YouTube.

People who provided testimonials received compensation from Hollister Incorporated. The testimonials, statements, and opinions presented are applicable to the people depicted. These testimonials are representative of their experience, but the exact results and experience will be unique and individual to each person.

 

Editor’s note: This article is from Hollister Incorporated, a digital sponsor in support of the free online resources of ostomy.org and UOAA, a 501(c)(3) nonprofit organization.

Holiday Eating with an Ostomy

, , , ,

By Robin Glover

Oh, the holidays! When cookies, cakes, and delicious pies suddenly appear everywhere, beckoning you to indulge in their sugary goodness. Don’t forget about those casseroles and their incredible aromas billowing from underneath a melted cheese topping. And those nuts — salty little kernels of flavor often found hiding among the decadently seasoned pretzels and cereal in everyone’s favorite snack mix.

The holidays are delicious, and food and drink are some of the many traditions friends and families have shared for generations. But, for people with an ostomy, eating and drinking around the holidays isn’t just a matter of likes and dislikes. Depending on the individual, certain things should be avoided while others can be enjoyed with no issues. The following is a guide to holiday eating (and drinking) with an ostomy.

It’s important to remember that these are general guidelines. Everyone is different, and each person experiences food differently. Consult with your physician or a registered dietician to know what’s best for you.

That being said, there’s no reason your ostomy, whether a colostomy, ileostomy, or urostomy, should hold you back from enjoying many, if not most, of your favorite holiday treats.

Maintain a Balanced Diet

Even during the holidays, maintaining a balanced diet is vital. No matter how good those sweets look, keep in mind that excess sugar and high-fat content can cause diarrhea, leading to the malabsorption of nutrients, leaving you feeling tired, irritable, and not in the holiday spirit. That doesn’t mean you need to deprive yourself, though. Just choose wisely.

For those with a urostomy, choosing non-citrus foods high in Vitamin C can lower the risk of infections. Examples of these include cranberries, broccoli, potatoes, strawberries, and leafy vegetables.

Chew Your Food Thoroughly

And while you’re at it, chews wisely too. For those with an ileostomy or short bowel, this is especially important. Both of these reduce the time your body has to digest the food you eat. Chewing your food a little extra can go a long way in helping your body get the nutrients it needs.

Eat Small Meals

Don’t forget to take breaks throughout the day to have a small meal or nutritious snack, even while you’re busy wrapping presents, decorating, and socializing. Eating several small meals is more beneficial than waiting to eat one large meal at the end of the day. An empty stomach can also be a source of gas.

Focus On Hydration

With all the hustle and bustle of the holidays, it’s easy to forget about the need to stay hydrated. That’s why it’s even more important to focus on good hydration during the holiday season. This includes drinking plenty of water while trying to limit drinks with added sugars, artificial colors or sweeteners, caffeine, or alcohol. Aim for 8-10 glasses of water a day.

Water alone won’t do it, though. Your body needs electrolytes, too. Sports drinks are a good source for this. However, you should dilute them with water to lower the sugar concentration. Electrolyte drops are also a good solution.

Low electrolyte levels can lead to many undesirable effects, including fatigue, irritability, and nausea. These symptoms only get worse the more dehydrated you get. So drink up!

If you have a urostomy, it’s crucial to drink plenty of water to avoid possible urinary tract infections (UTIs). And, since it’s recommended to consume plenty of Vitamin C, enjoy some holiday apple cider too!

Depending on the individual, certain things should be avoided while others can be enjoyed with no issues.

Ask About Ingredients

Things like casseroles, dips, cultural specialties, and cakes can often include ingredients you might not notice right away. During the holiday season, nuts can often be the biggest culprits and can cause discomfort or even a dangerous blockage for those with an ileostomy and to a lesser extend a colostomy. Other foods to be careful of are corn, if not fully ground in dishes like tamales, and dried fruits. Skip over foods, as tempting as they may be, that may include any of your trigger foods. Don’t worry; it’s ok to ask. Many people avoid certain foods for all kinds of reasons.

Know Your Safe Foods

 If you want to play it safe this holiday season, then stick to foods you know your body handles well. Consider keeping a food journal to help you keep track for next year. If you’ve recently had surgery for a colostomy or ileostomy, keep in mind these foods to avoid, but know that through trial and error you should soon feel more confident you’ll be able to enjoy most all of your holiday favorites.

 

Please read UOAA’s Eating With An Ostomy guide for more comprehensive information.

 

Robin Glover is a writer based in the Houston area. He has a permanent ostomy after being diagnosed with Crohn’s Disease in 2017.

Ostomy Output Challenges

, , , ,

Ostomy Nurse Anita joins host Elaine O’Rourke (an ostomate and IBD patient) to discuss the different challenges that ostomates (ileostomy, colostomy) face with output. Learn what you can do about pancaking, high output, different consistencies, bag ballooning up, ostomy pouch options, filters or no filters, open and closed-end pouches and much more.

A good dose of humor is included! Nurse Anita, RN CWOCN offers private consultation: www.anitanurse.com.

 

 

Elaine works directly with people with Ostomies, Crohn’s Disease, Ulcerative Colitis. If you are struggling please reach out to her. Grab the free guide via www.ElaineOrourke.com (under IBD or Ostomy programs) “3 simple ways to eliminate fears about your ostomy” or “Hidden Causes: 5 mistakes even well informed people with IBD make”

Holidays with an Ostomy

, , , , , ,

By Molly Atwater

Ah, November… the leaves are changing colors and falling from the trees, the jack-o-lanterns have been put away and exchanged for candy canes, and the Black Friday sales emails have started trickling into our inboxes. That can only mean one thing: the holiday season is upon us! It’s safe to say that our celebrations in 2020 will be a little different than what we’re used to. A non-traditional Thanksgiving or holiday gathering can be hard on all of us now that the CDC is suggesting limiting gatherings to just those in your household. (They’ve got some suggestions on safer alternatives to consider here.) Regardless of how we’ll celebrate, there are still lots of cookies to bake, memories to make, and laughs to share. But what does that mean for those of us with ostomies? The holiday season is inherently stressful, but adding medical issues on top can feel overwhelming. But fear not – with a little extra planning and mindfulness, you can handle the next few weeks like a pro. Here are a few tips and tricks to make sure you have a HAPPY holiday!

Travel Prepared

If you must travel during this time, make sure you pack more than enough supplies. Odds are you won’t need all of them, but it’s always better to be safe than sorry. My rule is to figure out how many bag changes I expect to perform while I am away, and then pack double that amount of supplies.  That way, even if I have to do extra bag changes, I never have to worry about running out of my necessities. I also pack in-bag odor reducers and a small bathroom aerosol spray so I don’t have to feel self-conscious about any expected or unexpected ostomy smells.

If your holiday plans include traveling by airplane, pack your supplies in your carry-on. Airlines are notorious for misplacing luggage, so keeping your supplies with you at all times can save you a lot of worrying. Also, go ahead and download one of the UOAA TSA advocacy cards to make your security checkpoint experience easier. For even more peace of mind contact TSA Cares 72 hours before your flight for additional assitence. Don’t forget to throw an empty water bottle in your carry-on to fill up once you’re at your gate to prevent dehydration. 

Enjoy Meals with Peace of Mind

When it comes to eating, everyone’s post-ostomy diets are different. For some, ostomy surgery can open up foods that were previously off-limits, while for others, options might be more limited. Regardless of your digestive system’s abilities, take the opportunity to make your meals a little more festive! If you can eat things you’ve missed for a while, go for it! But if you’re dealing with more restrictions, all is not lost. Maybe you could make macaroni and cheese with turkey-shaped pasta or try your hand at some homemade applesauce.

Chew, chew, chew! A lot of the foods we eat over the holidays are out of our normal diet, so give your body some help with digesting. It’s not a ton of fun to step away from the festivities to deal with a blockage! If at all possible, it’s also helpful to stay on your normal eating schedule. With all of the uncertainties that come with the holidays, having one steady touchstone can really help.

Alcohol is a staple for some families’ celebrations, but it can be very dehydrating. That’s an issue for everyone, but it’s crucial for those of us with ostomies. Try to alternate your cocktails with a glass of water or your electrolyte beverage of choice. Don’t forget that with the weather cooling down, warm drinks like tea also count as hydration!

Trust Your Emotions

The holidays can be emotionally challenging for everyone, but for those dealing with chronic conditions, things may feel a little tougher.  If you are feeling blue, that is ok! All emotions are valid, so give yourself the time and space to feel sad or angry and to grieve what was.  But it’s also a great time of year to reflect on the things that you are grateful for, whether that’s your support system, your health, or even just for making it through this crazy year.

Some people don’t mind talking about their medical conditions, but if you’d rather not focus on your ostomy this holiday season, think of some ways to steer the conversation in a different direction. The questions people ask typically come from a good place, but you are fully entitled to a few hours without thinking about your health.  Brainstorming quick responses or coming up with other topics to bring up instead can help you feel more prepared if you do find yourself in a situation where you want a quick “out.”

Listen to Your Body

Dealing with chronic health conditions is exhausting, and putting on a smile when you aren’t feeling great makes it that much harder. Finding others who can accept and acknowledge that things are hard instead of offering common and well-meaning phrases like “it will get better” and “stay strong” can be extremely helpful and validating. Nobody wants to be a Scrooge during this time of year, but having a safe space where you can feel seen and heard can bring you back into the celebration faster than wallowing alone.

Find an outfit that makes you feel AMAZING with your ostomy! Since a lot of us have spent more time in sweatpants than ever before thanks to quarantine, take the opportunity to wear something that makes you feel confident. It doesn’t have to be fancy – maybe just your favorite pair of pajamas or an extra-festive mask!

Get Creative

If you can’t participate in some of your favorite holiday traditions, now is the time to get creative! There might be ways to augment some existing traditions, like making different cookies without hard-to-digest ingredients, or you can create brand-new ones.  Maybe it’s time to introduce a holiday movie marathon or invite your friends to join you on a wintery walk through the woods! Whatever you choose to do, I encourage you to find an activity that brings you joy.

The holidays might feel tricky to navigate, but with a little extra preparation, you can remove ostomy stress from your list of worries.  Whether you’re a new ostomate or a seasoned pro, I encourage you to find your own tricks for making this time of year as merry as possible. From all of us here at UOAA, we wish you a happy and healthy holiday season!

 

Molly Atwater is UOAA’s Director of Young Adult Outreach. After struggling with chronic constipation for decades caused by a collagen deficiency disorder, she underwent ileostomy surgery in June 2016. In addition to serving with the UOAA, Molly runs a social media account (“MollyOllyOstomy”) that aims to teach her more than 20,000 followers about life with an ostomy and other chronic illnesses. She lives in Northern Virginia with her fiancé, Thomas.

Date Night with an Ostomy

, , , , , ,

Are you feeling nervous at the thought of date night after ostomy surgery? You’re not alone. With a little planning ahead, you can be sure to have a great night out.

My first question would be, what are your plans for the evening? Plans might be different for a first date versus dining with a long-term partner or spouse. You might be considering an outdoor outing following dinner, such as a walk. Or you may need to keep in mind if there is a potential for intimacy at the end of the night.

Keep in mind where you will be throughout the evening. Will you be in a place where you won’t have access to a bathroom, or do have access, but have concerns about odor? There are certain foods or drinks that will cause an increase in output, gas and a potential embarrassing smell. Check out tips and tricks for diet here, but keep in mind that everyone will react differently; so you will need to try things out. I don’t entirely follow all the “food rules”, but I do limit carbonated drinks and monitor how much I eat. I’m lucky, my stomach can handle most foods. I do not get blockages and am not too concerned about potential odors.

If you fear odor that may accompany emptying your pouch, I recommend carrying a small bottle of odor eliminating toilet spray. You spray it in your toilet before you empty, and it helps hide the odor. Now that doesn’t solve the problem entirely, but in combination with a lubricating deodorant you can empty with more confidence.
If you do end up having a little more output than expected without access to a bathroom, I find using one of the Ostomysecrets® wraps to both hide the potential bulge from your shirt or leverage extra support in case you fear an accident. The wrap can also prevent self-consciousness if your shirt “accidentally” comes off during the date or evening.

If you are hoping to avoid the bathroom altogether, keep in mind, how much you eat will also drive output. If you eat a lot, then you could potentially be in and out of the bathroom all night.

Bottom line: plan ahead thinking about where you’re going, what your plans are and you’ll be able to face the evening with even more confidence!
~
Randy Snyder

 

Editor’s note: This article is from one of our digital sponsors, ConvaTec. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.