American Gastroenterological Association. 2 American gastroenterological association medical position statement: short bowel syndrome and intestinal transplantation. 2003.

Protocol for the detection and nutritional management of high-output stomas. 2015.

Bakewell L Management of high output stoma. CN. 2017; 17:(3)11-14

Beating Bowel Cancer. Types of bowel surgery to remove tumours - beating bowel cancer. 2018. (accessed 15 August 2022)

Rehabilitation and stoma care: addressing the psychological needs. 2009.

British Nutrition Foundation. Fibre. 2018. (accessed 15 August 2022)

Psychological stress impairs early wound repair following surgery. 2003.

Burch J Stoma care.: John Wiley & Sons; 2008

Collins JT, Nguyen A, Badireddy M Anatomy, Abdomen and pelvis, small intestine.Treasure Island (FL): StatPearls Publishing; 2022

Cotrim H, Pereira G Impact of colorectal cancer on patient and family: implications for care. Eur J Oncol Nurs. 2008; 12:(3)217-226

Cuerda C, Pironi L, Arends J ESPEN practical guideline: clinical nutrition in chronic intestinal failure. Clinical Nutrition. 2021; 40:(9)5196-5220

de Oliveira AL, Boroni Moreira AP, Pereira Netto M, Gonçalves Leite IC A cross-sectional study of nutritional status, diet, and dietary restrictions among persons with an ileostomy or colostomy. Ostomy Wound Manage. 2018; 64:(5)18-29

Di Gesaro A Self-care and patient empowerment in stoma management. Gastrointestinal Nursing. 2012; 10:(2)19-23

Doughty D Principles of ostomy management in the oncology patient. J Support Oncol. 2005; 3:(1)59-69

Excellence in stoma care – the value of stoma care nurse specialists. 2019. (accessed 23 August 2022)

A guide to caring for patients with a newly formed stoma in the acute hospital setting. 2008.

Lomer M Advanced nutrition and dietetics in gastroenterology.: John Wiley & Sons; 2014

Successful management of chronic high-output ileostomy with high dose loperamide. 2015.

Nutrition and fluid optimization for patients with short bowel syndrome. 2013.

Provision of dietary advice for people with an ileostomy: a survey in the UK and Ireland. 2020.

Dietary management in people with an ileostomy: a scoping review protocol. 2019.

National Institute for Health and Care Excellence. Omeprazole. 2022. (accessed 15 August 2022)

National Institute for Health and Care Excellence. Short bowel syndrome. 2022. (accessed 15 August 2022)

Small Bowel and Nutrition Committee of the British Society of Gastroenterology. Guidelines for management of patients with a short bowel. 2006.

Teaching stoma-management skills: the importance of self-care. 2005.

Short bowel syndrome and intestinal failure: consensus definitions and overview. 2006.

Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery. 2002.

Hospital to home: smoothing the journey for the new ostomist. 2005.

Ileal recovery of starch from whole diets containing resistant starch in vitro and fermentation of ileal effluent. 1995.

St. Mark's Hospital. Electrolyte mix (e-mix). 2014. (accessed 15 August 2022)

Stress, optimism, and social support: impact on immune responses in breast cancer. 2007.

Diet and stoma care

02 September 2022
Volume 27 · Issue 9


This summative article has been written using literature based on the impact that diet can have on the management of stomas in the community. With more focus on ileostomy care, this article aims to provide information on the types of stomas and surgeries to create an overview of intestinal anatomy, how stoma formation may affect nutrient absorption and guidance on the management of stoma output, hydration and nutritional status based on current evidence. The strength of the evidence base behind the literature will be critically analysed and recommendations for future research made.

More than 21 000 people per year in the UK have a stoma formed (Elliston et al, 2019), often due to conditions such as:

A stoma is an opening that connects part of the bowel to the outside of the body, so waste products can be excreted into an external bag attached to the skin. The bowel consists of the large and small intestine. The large intestine (otherwise known as the colon) is made up of the caecum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum. Its main functions include: the absorption of water, electrolytes and short-chain fatty acids and moving colonic contents towards the rectum for defaecation. The small intestine consists of the duodenum, jejunum and ileum. The average length of the small intestine is 3–5m, with an even larger surface area due to its surface folds, villi and microvilli. Its main functions are to digest food and absorb fluid, electrolytes and nutrients (Lomer, 2014; Collins et al, 2017).

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