Life with bowel cancer

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Diet After Surgery/Ileostomy Reversal

I'd be really interested to hear other people's experiences with food after surgery and after ileostomy reversal. It's been 6 weeks since my reversal, which happened a lot quicker than expected as my small bowel was damaged. Luckily my rectum was completely healed (removed tumour from rectum and pretty much all the rectum when putting in the ileostomy). So, Surgeon and Oncologist agreed a reversal would be best, but at the same time they removed a length of small bowel.

I've been on a very basic diet. Basically no fibre, but I'm aware I need to start introducing it. I've finally started to notice my bowel isn't so explosive, so I'd like to try and be a bit more brave with food. I had lettuce yesterday for the first time and I was OK - I was very nervous! I know it's mostly trial and error and different for everyone, but I'd really like to hear what other people experienced. It might make me a bit more determined!

Thank you ;D

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Hi Hannah,

It seems we all have a very individual recovery from such surgery. I tend to go along with the idea that we should introduce gentle foods (ones we can digest and process easily) and take it from there. If you're adding foods to your diet without any problem then good for you. I would carry on doing this but maybe keep a diary of what your eating. I'm some 18 months post a reversal but still avoiding many foods including dairy, gluten, and raw, but as said we all seem to recover at different speeds

Kind regards


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Hi Holly

Thanks very much for the links, shall have a look :)

Speak soon


This is obviously something that varies a lot from one person to the other, and even in the same person from day to day, in my experience!

I hope you settle down. I remember it being very hard at first, but that was three years ago -- and since then I have had another op to take away even more of my gut, so I only have a bit of colon left now, and not rectum at all .. ....

YET I manage quite well with a very healthy diet with lots of fruit and veg and loperamide!

I aim to eat this way cos I am far more concerned to get good anti-cancer nutrients into me than I am about belly-ache / frequent loo trips .. but we all have to find our own way with it ...


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Thanks for the replies, they definitely reminded me there's no "set" recovery and that I must just listen to my body and keep a note of things. I've really improved since posting and am now adding fibre to my diet. It's still not what I would consider a healthy amount and nowhere near the amount I once ate, however I know I must do things in stages. My main issue at the moment is remembering to drink a lot as I can really suffer if I don't. I'm attempting to eat out for the first time on Saturday with a friend. I'm nervous as not only will it be my first meal out, it will also be my first night out since May, before the operation. Fingers crossed the menu isn't all spice and red meat!!

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I found this on the net. There seems to be a lot of good advice:

Following colorectal surgery, there may be a change in bowel function due to the change in the anatomical structure of the colon or rectum, or both. This may necessitate a bowel management program that is based on the same basic principles but needs to be individualized for each person. There is all the reason in the world to believe that your bowels can be managed after colorectal surgery.

These are the prerequisites for managing bowel control:

* Be committed to the program and be willing to follow specific directions.
* Seek guidance from a professional when you are not achieving the goals of your program.
* Keep your sense of humor.

Following colorectal surgery, many people find themselves having several stools per day. Bowel movements may be clustered at certain times of the day, and often there is an inability to fully empty at one specific time. The normal frequency of bowel movements in a healthy population varies from 3 bowel movements per day to 3 per week. The goal is to return to no more than 3 bowel movements per day.

Transit Time of Food Through the Gastrointestinal Tract
Eating a large meal or drinking a hot liquid will cause a normal peristaltic push down in the gastrointestinal (GI) tract. When frequent bowel movements occur, drink less fluid with your meals, drink more fluids between meals, and avoid hot liquids.

Medicinal Fiber to Change the Transit Time
If you are having frequent stools, then introducing psyllium, a medicinal fiber also known as Metamucil (sold as Lepicol in the UK, available in Holland & Barrett & all health food shops), can slow down transit through the GI tract. Most people take psyllium for constipation or to speed up transit time through the GI tract; however after colorectal surgery, your goal will be to slow down the transit time. To do this, take the prescribed amount of fiber right after a meal in very little fluid, approximately 2 oz., and no more fluid for 1 hour immediately after a meal. This allows the fiber to act like a sponge in the GI tract, soaking up excess fluid in the digestive system and thus slowing things down. One teaspoon should be taken after the same meal each day for 3 to 5 consecutive days. Then increase to 1 teaspoon psyllium 2 times per day. Gradually increase the fiber by 1 teaspoon every 3 to 5 days until the GI tract transit time slows down a bit.

Bowel Training
Once your stools become better formed and the transit time has been slowed down, the next step is bowel training, with the goal of emptying the colon fully at an expected time each day. Pick a meal of your choice around which you'll bowel train yourself. Bowel training is done around a meal since a big meal causes a push down the GI tract to make room for the food taken in. Choose a time when you can consistently follow the program. Then,

* Before that meal drink 1 oz. of prune juice.
* Eat the big meal.
* Drink a hot liquid. If this does not produce results,
you may try using a glycerin suppository after the hot liquid.
* Do this for 3 straight days. If you don't empty as planned,
substitute the glycerin suppository with 1/2 bisocodyl suppository.
* If this is effective, stay with the program for 2 weeks
and then stop using the suppositories.

By this time, the stimulus for your bowel to empty will be the prune juice, big meal, and hot liquid.

Adjusting the Bowel Management Program
Since each person's body reacts a little differently, don't get discouraged if your program doesn't immediately help. Problem solving is the key to success, and little changes made after trying something for 3 days will help you determine what will work for you. Overall bowel management involves a gradual balancing of food, fluid, fiber, and medications.

Food: If your bowel is stimulated by a big meal, eat 1 big meal per day and 4 smaller meals. Certain foods affect people adversely, and you need to be aware of what you eat that may cause increased bowel movements. (High-fat and/or spicy foods seem to affect many people.)

Fluid: Fluid with meals tends to increase peristaltic push-down. So, drink fluid in between meals instead of a large amount with meals and avoid hot liquids.

Fiber: Adjust the amount of fiber gradually to determine how much fiber is required to slow down or speed up transit time through your GI tract and maintain soft, formed stool.

Medications: If you are taking anitdiarrheal medications such as Lomotil or Immodium, as you gradually increase the amount of psyllium, try to decrease the amount of Lomotil/Immodium.

Most people get good bowel control just by the use of fiber. However, keep yourself comfortable during the process of defining your maintenance bowel management program. Be patient with yourself. Remember, there is hope for bowel management, the goal being a high quality life after colorectal surgery.


hiya Richard
welcome to the forum

I would like to ask you your personal context for this sort of issue? You seem to have very clear ideas about it all! Or did you mean you found this advice on the net? In which case what is the source of it?

One thing that puzzles me in these suggestions is the need for anything to stimulate me to evacuate after a meal, I dont need prune juice, just eating a meal sends me immediately! It cannot be written for ppl with virtually no gut left!

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Hi Suze
I had a tumour/part of my colon removed followed by an ileostomy a year ago. I am due to have the reversal next week, so I've been doing a bit of research/preparation for the aftermath. I've heard & read about the difficulties, diarrohea, wind, pain etc, and wanted to be fully prepared. The article I posted made a lot of sense to me in my particular circumstance and I wanted to share it with others in a similar position. It not only mentioned what to eat, drink etc but gave a detailed program to follow.


Good luck with yr reversal. How long is it since yr surgery? Mine was 18 months post surgery. I think the longer you leave it the more re-adjustment time you need.

I had some really bad pain in my anal area for a while which was severe when i needed the loo And felt so tied to the loo at first that I wonderrd if I had made a mistake in going for it. :'(
The good news is that was all very short lived. :)
6 weeks after my reversal I felt confident enough to fly to Croatia for a holiday!

I will print this off later to study it more closely. Hard to fathom it on the phone. I certainly think i could benefit from trying to increase the volume of stuff i evacuate at any single go. I doubt i need any additional fibre though. Nor prune juice Gawd!! My gut is very short so i feel bloated very quickly and my hernia sticks out like i am pregnant!

Keep us informed of yr own progress. Are you doing pelvic floor exercises already? You need to reherase clenching again. ;D. If you do this before your op it helps.