...probably, but didn't know where else to post to get the most replies

[VeganFromSveden]

Hiya, has anyone got any advice for me on what food I can give a vegan, after they have returned home from surgery to reverse a stoma?

This person went plant based ten years ago, then four years ago developed a perforated bowel, via diverticulitis.

He was told he was unlucky to have the perforation, as it's only three/four percent who get this.

He was very ill, he lost weight down to 6.5 stone, and he also developed sepsis.

He has been unkindly told by some family members that his plant based diet must've caused all his problems.

So, is he safe to continue to not eat meat fish dairy?

Should he up his fibre intake now that the diseased part of his bowel has been removed, and will be using his anus normally instead of the ileostomy bag?

I realise that this is prob unreasonable of me to ask, but he's tried asking the hospital, and he's not had any useful help.

Thank you for any advice from those who have had similar experience.

It’s a good question! Thank you for caring about his needs and his feelings!

of course being vegan didn’t cause it, how unkind of people to say that! And he can go back to a normal vegan diet.

He will need to up his fibre but slowly - he should be given advice on this but if not there are good articles on medical websites from places that do the surgeries. I *think with a stoma you have to go lower fibre, avoid seeds, most nuts and some vegetables. Likely that can now be revised, but slowly.

Did the hospital not refer you to a dietitian? They really should have. Can you see a dietitian privately? He really needs a professional to put together a diet that will help him restore weight and get adequate nutrition with his altered digestive system.

Personally, I think being vegan is a terrible idea when someone has complex problems with their digestive system. It’s hard enough for a totally healthy person to get correct nutrition on a vegan diet. It would probably be much easier if he were willing to compromise on a vegetarian diet that includes things like eggs and dairy. Otherwise if that’s not possible, professional advice is really essential.

zero personal experience but I’d suggest using a good nutritional website like nutricheck or cronometer to enter food and assure he’s achieving satisfactory calories, vitamins protein etc to improve his health.

Thank you... yes very low fibre until he gets his reversal surgery, it's supposed to be very soon, but it's already been cancelled once this year, so fingers tightly crossed.

I've tried to find advice online, but not successful so far.

Yes it is so thoughtless to say such things, as now he's wondering if they are right, and he did "bring it on himself "...

Anyway those people are subject to a whole different thread.

I just want him to feel confident about what he's eating... especially as he's understandably concerned about going back to using the loo as he used to,.
He needs to know what will help him "go" but gently....
I so hope he will get good advice post op, BUT it seems that hospital dietary advice is aimed at non plant based people.

Thank you for your kind words

Oh whoops! He went down to 6.5 stone four years ago, but since he came home from having a colonoscopy, then last year an ileostomy (also with a bag), he regained his weight.

I think probably seeking advice from a plant based nutritionist is a good idea, hopefully one with knowledge of the kind of surgeries he's undergone and about to undergo.

Thank you

A vegan diet did not cause his problems.

In terms of continuing I think the key is to get enough protein that doesn't upset his digestive system so things like beans are a good example of veg protein but might upset his system.

Try to get him an appointment with a dietician. NOT a nutritionist, anyone can call themselves a nutritionist.

I don't think it matters whether someone is vegan or vegi or omnivore, it is important to have a balanced diet.

And you are obviously a caring person, I hope all goes well for your friend.

Sash, thanks for advising me to seek a dietitian rather than a nutritionist, for the reasons you explained.

I'm plant based too, and have some idea of a balanced diet without animals being used.... BUT
It's knowing what to avoid in the first days, weeks and maybe months following the reversal.

I want to help him make the transition back to life without a bag as pain-free, as possible, partly because he's gone through so much, both physically and emotionally,
and partly because I want his road ahead to be navigated with confidence re the aspect of food.

Thank you everyone for kindly posting

Gluten free

Can he have digestive enzymes? I have diverticulitis and I take lepicol plus I don’t eat meat but not sure if it’s vegan or not I would imagine it is

The stoma nurse may be able to give good advice.

My dad was in this situation and I know it was a specialist diet but I'm not sure what, sorry.

Does he have an allocated nurse?

Following with interest. DH who is a vegetarian has a ileostomy which will be reversed, hopefully. It seems as if it's a bit of a process to find what works best. Low residue to start with then gradually introducing more fibre. One tip DH has found that apple sauce made from cooking apples and minimal sugar has really helped along with Imodium to slow things down.

Stoma nurse, yes, or (aka) the Colo-rectal nurse specialist.
If I were he, I would insist on seeing her/hospital dietician before leaving hospital.
This is EXACTLY what they are there for.
God help the man...at 6. 5 stone...( he's done well to regain the weight, I would have thought he'd have needed TPN ( Total Parenteral Nutrition, delivered directly in the heart's bloodstream).
I agree that it has to be a dietician, run a mile from 'nutritionists'. This is a specific and highly specialised area.

Nb. He most definitely didn't cause this by his vegan diet, completely unfair and wrong to say this; he was just unlucky.
He DOES need specialist advice though.

Full Marks to you for caring about this.

Hi everyone, I'm touched by the kindnesses shown in your replies, and I will be sharing with him everything said.

I do tell him, that although I'm not a health professional, that I felt pretty damn sure, that a plant-based lifestyle wasn't to blame for his condition.
However it's easy for him to think that I'm being protective of him, and that I'm saying those things to cushion the hurt he's felt from certain family members saying that he's caused it for himself.
He's an intelligent person, and I believe if he wasn't so emotionally bashed from dealing with everything in the last four years, he wouldn't have thought twice about believing the (cruel) words said to him.

He has had a stoma team (from the hospital) looking after him where needed.
They have been so good regarding everything (bar advice on food) regarding best ways to care for his condition.

When his weight started dropping off him leading up to the initial life saving surgery, I attended with him an appt to see the hospital dietitian.
I'm afraid that was a disappointing twenty minutes.
This was I admit before he was diagnosed with the perforated bowel, but the dietitian seemed unfazed that he had gone from nine and three quarter stone to seven and a half at that point, he continued to lose weight up to the surgery.
To lose over two stone in a matter of weeks, bearing in mind he was far from overweight pre illness, is in my opinion, a big percentage loss.
Also he had been very strong, but his muscle mass was depleted too.
All in all, both of us walked away from that appt feeling pretty down.
So to go see a dietitian re questions on what he should eat directly after the reversal, is making him somewhat sceptical.
It was he that asked me to ask all you mumsnetters for your opinions, in case anyone had either any personal experience, or had close association with the condition.
He does appreciate everyone's experience can be different, but there must be similarities.
Thanks everyone.

You might get more responses if you had put a clue in your title.

Surelysmartie, you may well be right, but if the title could be changed to say "please help on a stoma reversal", I really don't know how to do that, if indeed it was possible.

I’ve shown all your messages, advice and thoughts with the person that’s been offered the ileostomy reversal, and he too was so grateful for the responses.
He was so chuffed, and I too am happy that he’s starting to realise that it’s not just “me being biased” re the thoughts that of course he didn’t cause his own condition.
In fact due to some of your comments, we looked up the Cronometer app, which has great reviews.
That also led us to looking up something more (the internet is like a rabbit hole leading to more aspects than previously known about a subject), and we’ve seen info that has helped him even more.
I think from what we know so far, that he may need to see a dietician outside of the NHS, because we keep coming up with food advice based on a standard diet.
We did learn that post op, for roughly six weeks to adopt a B.R.A.T diet, and even better, an
I.F.F.G.D. diet that provides more nutrients than BRAT.
He also had decided to compile a list of his concerns to the consultant surgeon, and the info your suggestions have led to, has made that list longer and more precise….
He is so mindful that he doesn’t want to do anything that may lead him down the wrong path post op, because the surgeon previously told him, that there was only “just” enough good part of his bowel left to enable the reversal to come.
He also is having a hernia repair simultaneously, as hernias are a common problem for stoma patients, especially as his first op four years ago was in the large bowel. then last year moved to the small bowel (loop ileostomy), and that will be a relief to him greatly as well, because although his surgeon described it as a “small hernia”, it’s large enough to be heavy, and that weight sticking out is pretty uncomfortable.
We saw that a PP’s husband is also awaiting a reversal, so to him and anyone else going through this awful condition, we send our good luck wishes, and pray that all outcomes to surgery will bring a better quality of life.
it’s true what they say, in that it’s so hard to understand an illness or condition (and it’s physical/emotional effects) until you have either got it/had it/cares for a person with it.
Anyway huge thanks from us both.