Thickening stoma output

If you have an ileostomy, the part of the bowel that would normally reclaim water has been bypassed, so output arrives looser and more often. Certain foods reliably firm it up. This is a different axis from fibre altogether, and it is worth keeping the two apart in your head, because a food can be fine on one count and unhelpful on the other.

What thickens

Refined starch that absorbs water and slows things down. White rice, white pasta, mashed potato, white bread and toast, and ripe banana. A bowl of congee does the job better than any of them on its own, because the rice has broken down completely and is carrying a lot of liquid with it.

How to use them

Spread them across the day rather than eating one large starchy meal. Eat and drink separately, sipping fluid between meals rather than washing food down with it, because liquid taken with a meal moves everything through faster.

Then treat the fluid itself as part of the plan. Plain water in quantity can make output worse rather than better, because a hypotonic drink pulls salt and water back out. The guidance points to isotonic drinks or an oral rehydration solution instead, and to salting food generously rather than sparingly, which is a rare instruction to hear.

The cue

You are watching the bag rather than the pan. Output that has gone from watery to the consistency of thick porridge is the change you are looking for.

Common mistakes

Loading up on thickeners while still drinking a lot of plain water, tea or coffee. Assuming that thick means fixed, and stopping the fluid and salt side. Reaching for oats, which some hospitals recommend for exactly this purpose and the leaflet this book follows does not allow.

If output stays high, if you feel dizzy or your urine turns dark and scant, or if a stoma stops producing anything at all, that is a call to your stoma nurse or team rather than a change of recipe. See a high-output stoma.