Diet and Nutrition

Surgery can include removing part of the bowel (resection) or draining an infection.

Surgery becomes necessary when medications are ineffective (medically refractory disease) or if complications arise, such as fistulas, abscesses, scarring and narrowing of the bowel, or if dysplasia (precancerous cells) or cancer of the colon is detected. In most cases, the diseased section of the bowel is removed, and the two ends of healthy bowel are joined together in a procedure called an anastomosis.

In some cases, an ostomy, an ileostomy or a colostomy (depending on the location of the operation), may be required when surgery is performed for Crohn’s disease when there is no healthy bowel to connect. This may happen in patients with disease of both the rectum and the colon.

After the surgeon removes the diseased bowel, the colon or the small bowel is brought to the skin, so that waste products may be emptied into a pouch attached to the abdomen. Ostomies can be permanent or temporary depending on the procedure. Learn more about living with an ostomy.

After your surgery, you will not have to change what you eat too much, but you will want to eat a balanced diet so you can get stronger. Here is some helpful information:

• Eat smaller, lower fibre meals

• Chew foods thoroughly and eat slowly

• Eat foods higher in potassium (bananas, oranges and potatoes) and sodium (soups, tomato juice, and salted crackers) to replace what is lost in the stool

• Foods that absorb water will thicken stool and slow the output (yogurt, bananas, applesauce, white rice and toast, crackers, and oatmeal)

• Drink 9-12 glasses of fluid each day.

Certain foods may cause a blockage, diarrhea, gas, or odour. You may want to avoid:

• Raw vegetables

• Fruit peels and skins

• High-fibre foods, such as wheat cereals and breads

• Corn and popcorn

• Nuts and seeds

• Beans, lentils, and peas

• Brown rice

• Foods high in sugar

• High fat and fried foods

If you have an internal pouch, you may notice irritation caused by spicy foods, coconut, and certain fruits.

If you have had your ileum – the last part of your small intestine where it joins the colon – removed, your body’s ability to absorb vitamin B12 and bile salts as well as your ability to digest fats may be impaired. You may require B12 supplements since the ileum is responsible for absorbing this vitamin.

If you have a short bowel (less than 200 cm), you may require a specialized diet or parenteral nutrition (delivering nutrients through IV) in order to absorb nutrients that would have otherwise been absorbed by your bowel.

If you have had a colostomy surgery, constipation may become a problem. You may gradually introduce foods higher in fibre. 

Your dietitian will help you sort through what to eat after surgery.