Short bowel syndrome (SBS) happens when your small bowel (intestine) is not able to digest and absorb enough nutrients from foods and beverages to support your health. SBS can result from surgery that has removed any segments of the small bowel or can also result from poor function of the small bowel. Learn more about short bowel syndrome.

What is a small bowel ostomy?

A small bowel ostomy is an opening from the intestine to the skin. An ostomy is named for the location within the intestines used to form the stoma, for example jejunostomy or ileostomy.

A jejunostomy high in the gastrointestinal (GI) tract will have more output compared to an ileostomy that is further down the GI tract. Small bowel ostomy output can be as thick as toothpaste or oatmeal, or it may be liquid. What you eat and drink will affect your ostomy output. 

Getting started on a small bowel ostomy diet

Every ostomy is different, and it can take time to find the foods that work best for you. Some foods may thicken the output while others may cause more gas or bloating. It is helpful to keep track of your ostomy output as you eat different foods.

Try new foods one at a time. Avoid foods that cause watery output. Include foods that thicken your output. Write down the foods that you do well with and the ones that cause discomfort or problems.

Eating healthy on a small bowel ostomy diet

The longer food and drinks stay in your intestine, the more you will absorb water and nutrients, and the less you will empty from your ostomy. The following instructions will help to slow the speed that foods and drinks move through your intestine.

  • Eat many small meals throughout the day. Start with 5 – 6 meals per day after surgery.
  • Eat at least 1 starchy food with each meal (crackers, noodles, potatoes, rice, oatmeal or unsweetened applesauce).
  • Choose foods moderate in fat (approx. 10-15 gm per meal). Avoid fried or greasy foods.
  • Use salt on your food.
  • Chew, chew, chew! Cut your food into small bites and chew your food very well.
  • Sip recommended fluids between meals. Gulping or guzzling fluids will cause food and drinks to move through your GI tract too quickly.
  • You may need at least 8 – 10 cups of fluids each day.
  • Sip oral rehydration solutions (ORS) as your main fluids. Water can increase ostomy output and cause dehydration. Learn more by reading short bowel syndrome (SBS): oral rehydration solutions.
  • Avoid sugary foods like syrup, sorbet, candy and popsicles.
  • Avoid sugary drinks like juice, sweet tea, lemonade and soft drinks.
  • Sit quietly for 15 – 30 minutes after each meal.
Recommended foods
Grain

Breads, crackers, rice, pasta, cereals, pretzels, chips (may need to avoid nuts and seeds in breads and cereals)

Protein

Tender meats, poultry, fish, eggs, hummus, smooth nut butters, tofu

Fruit

Avocado, bananas, melon, mango, peeled apples/pears/peaches, unsweetened applesauce, fruit canned in juice (may need to avoid fruit with seeds and fruit peels)

Vegetables

Soft-cooked carrots, green beans, peas, potatoes, stewed tomatoes, chopped soft greens (may need to avoid vegetable skins)

Dairy

Milk (cow, almond, soy, rice, pea), cheese, yogurt (may need to limit lactose-containing foods)

Beverages

Oral rehydration solutions, water, diluted juice, unsweetened coffee or tea

Complications of a small bowel ostomy diet

High ostomy output can cause acute or chronic dehydration. Dehydration is when you don’t have enough water in your body. Over time, dehydration can lead to kidney injury. It is very important to recognize signs of dehydration and treat it quickly. It is best to prevent dehydration from happening.

Signs of dehydration

Low urine output, dark urine, dizziness, fatigue, thirst, dry mouth, headache, weakness, muscle cramps

Resources for a small bowel ostomy diet

Parrish, CR. A Patient’s Guide to Managing a Short Bowel, 4th edition. Go to “Sign Up” and register for a free book. https://www.shortbowelsyndrome.com.

Now it is time to meet with a GI-expert dietitian. To get more information about this topic, find a dietitian in your area using our Find a Health Care Provider tool.

Written by

Jessica Younkman, RD, CDN, CNSC, and Elizabeth Wall, MS, RDN-AP, CNSC
DIGID Short Bowel Syndrome Workgroup ©2022