Having been an ileostomate for more than half my life, I find this
subject to be of great interest. The major way in which the value of
consumption of whole grains differs in the ileostomate is that, in the
absence of the colon, there is a lessened need for dietary fiber as a
regulator of bowel function. Some ostomates (particularly those who
suffer from Crohn's disease) find whole grains to be gas-producing and
difficult to tolerate, and many "ostomy diets" recommend avoiding
high-fiber foods and whole grains:
"Foods that may cause gas include:
- Beans
- Vegetables; such as, broccoli, cabbage, brussel sprouts, onions,
artichokes and asparagus
- Fruits; such as, pears, apples and peaches
- Whole grains; such as, whole wheat and bran
- Soft drinks and fruits drinks
- Milk and milk products; such as, cheese and ice cream, and packaged
foods prepared with lactose; such as, bread, cereal and salad dressing
- Foods containing sorbitol; such as, dietetic foods and sugar-free
candies and gums."
Chicago's North Suburban Chapter United Ostomy Association
http://www.geocities.com/mr-ostomy/diet1.html
"Foods and drinks that can increase output and make diarrhea worse:
nuts and seeds caffeine
dried fruit whole grains and wheat bran
spicy foods rich foods like gravy and cream sauces
some dairy foods"
Vanderbilt University
http://www.mc.vanderbilt.edu/learning-center/pted/docs/hc0652.pdf
================================================
The value of whole grains (particularly oats, rye, and barley) in
cholesterol reduction is approximately the same in ileostomates as in
those who still possess a colon. Also the same is the potential for
helping to prevent and control obesity:
"Oat beta-glucan increases bile acid excretion and a fiber-rich barley
fraction increases cholesterol excretion in ileostomy subjects....
Nine ileostomy subjects were served four diets in random order, each
diet for 2 consecutive days. Four different kinds of bread, mainly
made from oat bran (OB diet, 12.5 g beta-glucan/d), oat bran with
beta-glucanase (OBE diet, 3.8 g betaglucan/ d), barley (B diet, 13.0 g
beta-glucan/d), or wheat flour (W diet, 1.2 g betaglucan/ d) were
added to a basal diet. The 24-h excretion of bile acids was 53% higher
in the OB diet period than in the OBE diet period (P < 0.05) and also
was significantly higher than in the B and W diet periods (P < 0.05).
Median (range) bile acid excretion was 851 (232-1550), 463 (123-1414),
755 (133-1187), and 606 (101-980) mg/d in the OB, OBE, B, and W diet
periods, respectively. The excretion of cholesterol was significantly
higher in the B diet period than in the OBE and W diet periods (P <
0.05), but the mechanism behind this effect of barley fiber is
unknown. In oat bran, however, beta-glucan mediates an increase in
bile acid excretion, which most probably explains the effect of oat
fiber in lowering serum lipids."
Imucell
http://www.imucell.com/imucell/pages/pdfs/cholesterol.pdf
================================================
"High fiber diet has several positive effects on human health. One of
them is helping to control body weight, probably in part because fiber
may decrease the availability of dietary energy.... In animal
experiments it has been found that exogenous fiber degrading enzymes
added to rye diet increase the amount of energy received from rye
(Petterson et al 1994, Boros 1995). From this it could be assumed that
the fiber in rye restricts the uptake of energy from the small
intestine. In a study with ileostomy subjects the intake of high-fiber
rye bran bread or wheat bread and a dietary regime (nibbling or
gorging) was investigated with an emphasis on the excretion of energy
and nutrients. The intake of rye bran bread increased the excretion of
all nutrients (fat, protein and carbohydrates) and energy in the
ileostomy patients... The soluble fiber in rye increases the viscosity
of food in the stomach, and thus delays the evacuation of stomach
contents into the small intestine. This prolonged stay of food in the
stomach increases the replete feeling, and thus helps in dieting
(Hagander et al 1887)."
Ryeheart.com
http://www.ryeheart.com/english/tutkimus_booklet_5potential.htm
================================================
Here are the abstracts of several studies that may be of use to you:
================================================
Int J Biol Macromol 1997 Aug;21(1-2):57-60 Related Articles, Links
Release of mixed linkage (1-->3),(1-->4) beta-D-glucans from barley by
protease activity and effects on ileal effluent.
Robertson JA, Majsak-Newman G, Ring SG.
Department of Biochemistry, Institute of Food Research, Norwich
Research Park, Colney, UK.
The behaviour of barley beta-glucans in the upper gut has been
assessed using ileal effluents recovered from a barley-based test
meal. Results have been compared to in vitro treatments used to
extract beta-glucans. In vitro, exposure to endogenous proteases led
to a solubilisation of beta-glucan, ranging from 28% in the untreated
to 83% following NSP isolation. In ileal effluent 60% of the
beta-glucan was solubilised, similar to the in vitro treatment.
However, the viscosity of the ileal effluent was low, comparable to a
mucin standard. Although beta-glucan can be solubilised in the upper
gut its viscosity would appear to have only a limited potential to
affect nutrient bioavailability.
PMID: 9283016 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9283016&dopt=Abstract
================================================
Postprandial lipemia in relation to sterol and fat excretion in
ileostomy subjects given oat-bran and wheat test meals.
Lia A, Andersson H, Mekki N, Juhel C, Senft M, Lairon D.
Department of Clinical Nutrition, University of Goteborg, Sweden.
agot.lia@medfak.gu.se
To investigate the mechanisms behind the serum cholesterol-lowering
effect of oat fiber, we simultaneously measured postprandial lipid
responses, serum lathosterol concentrations, and small bowel excretion
of fat and sterols in ileostomy subjects given test meals high or low
in oat fiber. Six ileostomy subjects (three women and three men) were
served an oat-bran test meal (OB; 16.3 g fiber) and a wheat test meal
(6.3 g fiber) in random order. After the postprandial 7-h period, a
controlled, low-fat, cholesterol-free diet was served and ileostomy
effluent was sampled throughout the 24-h period. Bile acid and fat
excretion (24 h) increased by 93% and 146%, respectively (P < 0.05),
and total and endogenous cholesterol excretion decreased by 14% and
19%, respectively (P < 0.05), after the OB test meal. The change in
hepatic cholesterol synthesis was strongly related to the change in
bile acid excretion (Spearman r = 0.89, P < 0.02). The postprandial
chylomicron lipid concentration tended to be lower after the OB test
meal (-43% for cholesterol, P = 0.07) whereas there was no difference
in cholesterol absorption measured by isotope in five subjects. The
main effect of the viscous oat beta-glucan seems to be related to
increased bile acid excretion and subsequent changes in synthesis and
endogenous excretion of cholesterol. An additional effect may have
been a delay in the micellar lipid solubilization process and a
consequent reduction in the secretion of chylomicrons into the
circulation.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 9250115 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9250115&dopt=Abstract
================================================
Substrates available for colonic fermentation from oat, barley and
wheat bread diets. A study in ileostomy subjects.
Lia A, Sundberg B, Aman P, Sandberg AS, Hallmans G, Andersson H.
Department of Clinical Nutrition, University of Gotborg, Sweden.
Nutrients not absorbed in the small bowel will form substrates for
microbial growth in the colon which may have implication for the
development of colon cancer. The aim of the present study was to
investigate whether fibre-rich oat and barley diets increase the
excretion of energy-supplying nutrients from the small bowel compared
with a low-fibre wheat diet, and whether a possible increase could be
related to the beta-glucan content. Nine ileostomy subjects were
served four types of bread together with a low-fibre basal diet (12 g
dietary fibre/d). The breads were based on either wheat flour (W diet,
7 g dietary fibre/d), oat bran (OB diet, 29 g dietary fibre/d), the
same amount of oat bran with addition of beta-glucanase (EC 3.2.1.4)
(OBE diet, 19 g dietary fibre/d) or a fibre-rich barley fraction (B
diet, 35 g dietary fibre/d). An increased ileal excretion of starch
was observed with the barley diet but no effect of the oat beta-glucan
on starch recovery was found. The NSP + Klason lignin in the ileostomy
effluents accounted only for 24, 31, 24 and 35% of the gross energy
excretion in the W, OB, OBE and B diet periods respectively. A large
part of the dry weight and energy (30, 21, 28 and 27%, in the W, OB,
OBE and B diets respectively) in the effluents could not be identified
as fat, protein, total starch or NSP + Klason lignin. This
unidentified part was probably made up of oligosaccharides, endogenous
losses and nutrient complexes. Methods for identifying and analysing
these components should be developed and their role as substrates for
colonic fermentation and colon cancer development ought to be
investigated.
PMID: 9014649 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9014649&dopt=Abstract
================================================
Am J Clin Nutr 1996 Dec;64(6):878-85 Related Articles, Links
Mixed-linked beta-glucan from breads of different cereals is partly
degraded in the human ileostomy model.
Sundberg B, Wood P, Lia A, Andersson H, Sandberg AS, Hallmans G, Aman
P.
Department of Food Science, Swedish University of Agricultural
Sciences, Uppsala, Sweden. Birgitta.Sundberg@lmv.slu.se
The purpose of this investigation was to study the degradation of
beta-glucan in the small intestine and the molecular weight of
beta-glucan in the excreta of nine ileostomy subjects after
consumption of different diets based on bread made with oat bran (oat
bread), a fiber-rich barley fraction (barley bread), or wheat flour
(wheat bread) as the main ingredients. Oat bread with enzymatically
degraded beta-glucan was also used (oat + enzyme bread). The
beta-glucan intake from the four diets was 12.5, 12.9, 1.1, and 4.0
g/d, respectively. On the basis of dry matter, the night effluents
accounted for approximately 15% of the total amount of the excreta,
with the highest proportion (22%) being for the wheat-bread diet. A
notable loss of beta-glucan (0.7-2.4 g/d, or 13-64%) was found when
intake was compared with excretion. In vitro, a higher viscosity
development with time for dispersions of oat bread compared with
barley bread was noted, which could be related to the higher molecular
weight of the beta-glucan in this bread. There seemed to be a
depolymerization of the beta-glucan both during bread making and
transit through the upper gastrointestinal tract.
PMID: 8942412 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8942412&dopt=Abstract
================================================
J Nutr 1996 Jun;126(6):1594-600 Related Articles, Links
Erratum in:
J Nutr 1996 Dec;126(12):3143
Intake of rye bread ileostomists increases ileal excretion of fiber
polysaccharide components and organic acids but does not increase
plasma or urine lignans and isoflavonoids.
Pettersson D, Aman P, Knudsen KE, Lundin E, Zhang JX, Hallmans G,
Harkonen H, Adlercreutz H.
Department of Food Science, Swedish University of Agricultural
Sciences, Sweden.
The excretion of starch, enzyme-resistant starch, dietary fiber
components and organic acids (short-chain fatty acids plus lactic
acid) as well as plasma and urine lignans and isoflavonoids was
studied in eight ileostomists consuming mixed diets with wheat bread
(low fiber diet) or rye bread (high fiber diet) in a crossover design.
Average ileal excretions of enzyme-available starch were 3.5 g/d
during the low fiber period and 4.1 g/d during the high fiber period.
The excretion of enzyme-resistant starch was approximately the same
(2.3 g/d) in both periods. In comparison with intake, similar amounts
of total fiber residues were excreted both by subjects receiving the
low fiber diet (3.4 g/d) and by those receiving the high fiber diet
(2.7 g/d). However, subjects excreted significantly more of certain
polysaccharide residues (fucose, galactose, and uronic acids) than
they ingested. On average, the excretion of organic acids was 18.6
mmol/d during the low fiber period and 30.2 mmol/d during the high
fiber period. No significant differences in plasma lignans were
observed between the high fiber and the low fiber dietary periods. The
present findings indicate that enzyme-available starch is highly
digested and that a microbial breakdown of dietary fibers and probably
other carbohydrates occurs in the small intestine. However, the
bacterial activity in the ileostomists was not sufficient to cause an
increased level in plasma lignans even when subjects consumed the high
fiber rye diet.
PMID: 8648433 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8648433&dopt=Abstract
================================================
J Nutr 1995 Sep;125(9):2341-7 Related Articles, Links
Starch and dietary fiber components are excreted and degraded to
variable extents in ileostomy subjects consuming mixed diets with
wheat- or oat-bran bread.
Aman P, Pettersson D, Zhang JX, Tidehag P, Hallmans G.
Department of Food Science, Swedish University of Agricultural
Sciences, Uppsala.
The study was conducted to determine if the excretion of starch and
dietary fiber components varies in ileostomy subjects consuming diets
high or low in dietary fiber. Excretion of starch, enzyme-resistant
starch and dietary fiber components was studied in nine human subjects
with ileostomies, who consumed (in a crossover design) a wheat
bread-based diet (daily intake 274 g starch, 2.4 g enzyme-resistant
starch and 14.4 g total dietary fiber) and a high fiber diet based on
oat-bran bread (daily intake 243 g starch, 2.7 g enzyme-resistant
starch and 40.2 g total dietary fiber). Food and excreta were
collected on d 3 and 17. No significant differences in excretion of
starch, enzyme-resistant starch or dietary fiber components were found
on these 2 d in each dietary period. When subjects consumed the wheat
bread-based diet they excreted (mean +/- SD) 3.3 +/- 1.7 g starch and
2.4 +/- 0.4 g enzyme-resistant starch daily, whereas when consuming
the oat bran-based diet they excreted 4.5 +/- 3.1 g starch and 2.5 +/-
0.4 g enzyme-resistant starch. During both dietary periods subjects
excreted significantly greater amounts of certain dietary fiber
polysaccharide residues (fucose, galactose and uronic acid) than they
ingested. This indicates a contribution of endogenous and/or microbial
material to the dietary fiber value in ileostomy effluents. However,
significantly less excretion of some dietary fiber polysaccharide
residues, especially glucose residues, during the oat-bran bread-based
dietary period was also noted. This was presumably caused by a
degradation of mixed-linked (1,3),(1,4)-beta-D-glucans.
Publication Types:
Clinical Trial
Randomized Controlled Trial
PMID: 7666251 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7666251&dopt=Abstract
================================================
Am J Clin Nutr 1995 Jan;61(1):75-81 Related Articles, Links
Influence of the physical form of barley grain on the digestion of its
starch in the human small intestine and implications for health.
Livesey G, Wilkinson JA, Roe M, Faulks R, Clark S, Brown JC, Kennedy
H, Elia M.
Institute of Food Research, Norwich Research Park, Colney, UK.
It has been suggested that incomplete digestion of cereal starch
explains the low energy values of certain cereals of large particle
size. We used human subjects with ileostomies to investigate the
digestion of barley and to determine whether the physical form of
barley affects stomal excretion of starch, glucooligosaccharides,
nitrogen, fat, and calculated energy. Only 2 +/- 1% of starch remained
undigested after finely milled barley was eaten, but after flaked
barley was eaten 17 +/- 1% resisted digestion, partly as
oligosaccharides (G1-G10) but largely as intact unpitted starch
granules bound by intact cell walls. The calculated energy excretion
from the stoma was three times higher after flaked than after milled
barley [51.5 decreasing to 15.3 kJ/g nonstarch polysaccharide (NSP, P
< 0.001]. NSP, starch, and fat made almost equal contributions to the
higher energy excretion. It is concluded that possibly the botanical
source of cereals and certainly processing, other than retrogradation
of the starch, are important determinants of starch digestibility and
energy value. Possible clinical implications are introduced.
PMID: 7825542 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7825542&dopt=Abstract
================================================
Am J Clin Nutr 1994 Feb;59(2):389-94 Related Articles, Links
Effect of rye bran on excretion of bile acids, cholesterol, nitrogen,
and fat in human subjects with ileostomies.
Zhang JX, Lundin E, Hallmans G, Adlercreutz H, Andersson H, Bosaeus I,
Aman P, Stenling R, Dahlgren S.
Department of Pathology, University of Umea, Sweden.
The excretion of bile acids, cholesterol, dry matter, nitrogen, fat,
and energy in ileostomy effluent, and plasma lipid concentrations were
studied in eight subjects with ileostomies. The subjects consumed a
wheat bread-based, low-fiber diet (LFD) for 3 wk and a rye bran
bread-based, high-fiber diet (HFD) for 3 wk. The ileal excretion of
dry matter, nitrogen, fat, and energy was higher during the HFD
period. The daily excretion and the percentage of conjugated bile
acids were significantly higher and the percentage of free bile acids
lower in the ileostomy effluents during the HFD as compared with the
LFD period. No significant difference in the excretion of cholesterol,
net cholesterol, sterol, or net sterol was noted between the HFD and
LFD periods. No significant differences in plasma concentrations of
HDL-, LDL-, and total cholesterol, and apolipoprotein A-I and B were
observed between the two 3-wk dietary periods.
PMID: 8310990 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8310990&dopt=Abstract
================================================
Am J Clin Nutr 1992 Jul;56(1):99-105 Related Articles, Links
Effect of oat bran on plasma cholesterol and bile acid excretion in
nine subjects with ileostomies.
Zhang JX, Hallmans G, Andersson H, Bosaeus I, Aman P, Tidehag P,
Stenling R, Lundin E, Dahlgren S.
Department of Pathology, University of Umea, Sweden.
A higher excretion of dry matter, fat, nitrogen, energy, and total
bile acids in ileal effluents; a lower plasma low-density-lipoprotein
(LDL) and total cholesterols (12.1% and 9.0% lower respectively); but
no change in plasma high-density-lipoprotein (HDL) cholesterol or
apolipoproteins A-I and B were observed in nine subjects with
ileostomies when they consumed an oat-bran, bread-based, high-fiber
diet (HFD) as compared with a wheat-flour, bread-based, low-fiber diet
(LFD) for 3 wk with a crossover design. Of the nine subjects only the
subjects with a low daily excretion of bile acids had an elevated
excretion of total bile acids during the HFD compared with the LFD.
Total cholesterol, LDL cholesterol, and apolipoprotein B in plasma
also decreased by 11.3%, 15.3%, and 10.7%, respectively, after
consumption of the HFD for 3 wk.
Publication Types:
Clinical Trial
Controlled Clinical Trial
PMID: 1319111 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1319111&dopt=Abstract
================================================
Search terms used:
grains
whole grains
ileostomy
ileostomate
ostomy
================================================
I hope this is helpful. If anything is unclear or incomplete, or if
any of the links do not function, please request clarification before
rating my answer; I'll be glad to offer further assistance.
Best regards,
pinkfreud |
Clarification of Answer by
pinkfreud-ga
on
10 Mar 2003 22:57 PST
Here are three medical studies concerning vitamins and minerals in
relation to colectomy and ileostomy:
================================================
Scand J Gastroenterol Suppl 1997;222:20-4 Related Articles, Links
Metabolic consequences of total colectomy.
Christl SU, Scheppach W.
Medical Dept., University of Wurzburg, Germany.
Colectomy is performed for inflammatory bowel disease, familial
polyposis syndrome and colorectal carcinoma. Surgical procedures are
ileostomy with or without pouch, ileorectal anastomosis or ileal
pouch-anal anastomosis. One of the major functions of the intact large
intestine is to absorb water and electrolytes. After colectomy, as
much as 400-1000 ml of nearly isotonic ileostomy fluid may be
excreted, resulting in a chronic salt and water depletion. This is
compensated for by an activation of the renin-angiotensin-aldosterone
system. Reduced urine volumes may cause kidney stones. Both
dehydration and renal sodium retention are probably less frequent in
patients with ileal pouch-anal anastomosis. Absorption of nutrients in
general is not impaired by colectomy. The large intestine salvages
energy from malabsorbed organic matter through absorption of the
short-chain fatty acids produced in bacterial fermentation. In
ileostomy patients, fermentation is negligible, which leads to a
significant loss of energy in the ileostomy fluid. Pouches are
colonized by a bacterial flora similar to colonic bacteria. In these
patients conservation of energy from malabsorbed substrate may be
similar to healthy subjects. Resection of ileum and bacterial
colonization may lead to malabsorption of vitamin B12 and bile acids.
The latter may cause increased incidence of biliary cholesterol
stones. Pouchitis is a frequent problem which may be caused by a
deficiency of short-chain fatty acids and glutamine in the pouch
contents. It is concluded that although the colon is not essential as
a digestive organ in man, colectomy results in a number of metabolic
changes. The ileal pouch-anal anastomosis may in part substitute for
the functions of the large intestine.
Publication Types:
Review
Review, Tutorial
PMID: 9145441 [PubMed - indexed for MEDLINE]
Medline Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9145441&dopt=Abstract
================================================
Acta Chir Iugosl 1995;42(1):17-20 Related Articles, Links
[Enteral nutrition in patients with ileostomies and jejunostomies]
[Article in Serbo-Croatian (Roman)]
Zarkovic M, Milicevic M.
Institut za endokrinologiju, dijabetes i bolesti, metabolizma, KCS
Beograd.
Jejuno- and ileostomy are common surgical procedures. Due to
shortening of effective bowel length intestinal failure, or short
bowel syndrome develops. Degree of intestinal failure depends upon 1.
resection length, 2. resection location, 3. function of the bowel
remnant, stomach, pancreas and liver, 4. adaptive capabilities of the
bowel remnant and 5. the disease that was cause of the surgery. In
majority of these patients adequate nutrition can be achieved using
enteral nutrition. Water and mineral absorption differs between
jejunum and ileum. Jejunal mucosa is permeable to sodium and water,
causing jejunal content to be isoosmolar to plasma. When sodium
concentration in jejunal content is less than 90 mmol/l secretion of
sodium into the lumen occurs. Ileal sodium absorption takes place
against concentration gradient. Potassium concentration of jejuno- and
ileostomy effluent is fairly constant at about 15 mmol/l. Main
therapeutic problem is water and mineral loss. In jejunostomy patients
hyponatremia is a major concern. Urinary sodium concentration of less
than 5 mmol/l is a sign of sodium deficiency. This group of patients
should have daily urinary output of more than 800 ml, and urinary
sodium concentration of more than 20 mmol/l. Another important problem
is malnutrition. Weight changes, albumin and trasferin are important
follow-up parameters. Often neglected problem is large stomal effluent
volume, that can incapacitate patient for the usual life. All these
problems can be prevented by the adequate nutritional support. Oral'
fluids should have minimal sodium concentration of 90 mmol/l. Intake
of sodium poor fluids should be restricted. If plasma or urinary
sodium are low intravenous sodium supplementation is warranted.
Magnesium and zinc should be monitored and supplemented. Addition of
vitamin D can improve their absorption. Vitamins B12 and K must be
given parenteral, because their resorption is severely impaired.
Patient should eat usual food rich in carbohydrates and proteins, but
exact menu must be individualized, and reached by trial and error
process. Fat absorption is proportional to fat intake. Fat does not
increase stomal effluent, therefore there is no reason to restrict
intake. In order to reduce stomal effluent volume and bowel motility
H2 blockers, proton pump inhibitors and antidiarrhoeal drugs (codeine
or loperamide) should be used.
PMID: 8975521 [PubMed - indexed for MEDLINE]
Medline Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8975521&dopt=Abstract
================================================
Digestion 1983;26(3):131-6 Related Articles, Links
Calcium metabolism in subjects living with a permanent ileostomy.
Kennedy HJ, Compston J, Heynen G, Kanis JA, Merrett AL, Truelove SC,
Warner GT.
Several indices of calcium metabolism have been studied in 39 subjects
living with a permanent ileostomy after proctocolectomy for ulcerative
colitis, and in a control group of 39 healthy volunteers, matched for
age and sex. No significant differences were found in plasma levels of
calcium, phosphate, magnesium, parathyroid hormone, calcitonin and
25-hydroxy-vitamin D nor in the urinary excretion of calcium and
phosphate, but the alkaline phosphatase was raised in the
ileostomists. The bone density of the ileostomists was rather low, but
the difference from the control subjects was not statistically
significant. The absorption of calcium was measured by means of a
total body counter. The ileostomists retained significantly more
calcium than expected. It is suggested that this may represent the
correction of a state of calcium deficiency at the time of
proctocolectomy, due to the effects of the colitis and its medical
treatment with corticosteroids.
PMID: 6852394 [PubMed - indexed for MEDLINE]
Medline Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6852394&dopt=Abstract
================================================
(Whew. After I read a certain amount of medicalese, I get a bit
dizzy.)
Here's a good summary of the nutrient values of various whole grains:
It's a Grey's World
http://www.itsagreysworld.com/diet/grains.htm
Note that barley and buckwheat are sources of folic acid. Folic acid
is of extra importance to the ileostomate, since it is an essential
element in the bioavailability of Vitamin B12. B12 is absorbed only by
a small area of the bowel at the end of the ileum. Some ileostomates
(like me) have lost this section of bowel, and must take B12 by
injection, since our bodies are no longer able to absorb it from
foods. If your surgery has necessitated that you receive B12
injections, it is imperative to maintain an adequate intake of folic
acid, since the two work together.
Amaranth, kamut, millet, oats, rye, spelt, and wheat are sources of
potassium, and I probably don't have to emphasize how important it is
for an ileostomate to maintain a good potassium level.
From what I've read online, and what I've learned in the three decades
that I've lived with my ileostomy, unless there is an ongoing disease
process such as active Crohn's, the majority of ileostomates are quite
able to absorb most nutrients from their food, with the possible
exception of vitamin B12, as mentioned above.
If you are a recent ostomate, I highly recommend that you join a local
chapter of the United Ostomy Association. It can be a wonderful boost
to meet other people who are walking the same road, and living active,
full lives. In addition, you can pick up lots of hints and tips about
appliances and stoma care from the people who really know about these
things. When I was newly 'ileostomatized', I learned more from the
folks at the UOA meetings than I ever learned from my doctors.
United Ostomy Association
http://www.uoa.org/
I'm going to prowl around some more on the matter of nutrition,
ileostomies, and whole grains, and if I find anything really germane,
I'll post it for you tomorrow.
~pinkfreud
|
