Providing dietary advice for the individual with a stoma

Concerns over diet and nutrition are common among ostomists and their carers. It is important for healthcare professionals involved in the care of patients with a colostomy, ileostomy or urostomy to appreciate that stoma surgery changes the body's usual processes of nutritional absorption and excretion, so that informed support and advice on diet can be provided. A considerable proportion of patients admitted to hospital in the United Kingdom are malnourished, or at risk of becoming so. Patients undergoing gastrointestinal surgery resulting in stoma formation are at particular risk as a result of the potential for preoperative malnutrition caused by the effects of their underlying disease and prolonged periods of fasting during the immediate pre- and postoperative period. Screening and monitoring of the nutritional status of individuals with a stoma should be an ongoing process, beginning preoperatively and continuing after discharge from hospital. This article will examine the effects of stoma formation on diet and consider ostomists' potential for altered absorption of nutrients. Current issues relating to patient nutrition in the hospital setting, their relevance for stoma patients and the role of the nurse in the provision of nutritional care will also be discussed.