Can individuals with an ileostomy (surgical creation of an opening in the intestine) safely consume marshmallows?

Marshmallows and Ileostomies: Dietary Management

Yes, individuals with an ileostomy can safely consume marshmallows, and they are actually recommended as a food that helps thicken ileostomy output. 1

Benefits of Marshmallows for Ileostomy Management

• Marshmallows are specifically listed in clinical guidelines as a food that helps thicken ileostomy output, making stoma management easier 1
• Research shows that consuming marshmallows leads to a statistically significant reduction in ileostomy output volume (median reduction of 75 ml per day) 2
• In a randomized crossover trial, 71% of participants experienced reduced ileostomy output when consuming marshmallows (three marshmallows three times daily) 2
• Patients reported fewer ileostomy bag changes when consuming marshmallows (median five per day vs. six in the control period) 2
• The gelatine contained in marshmallows appears to thicken small bowel fluid, which helps manage output consistency 2

Dietary Management for Ileostomies

Foods That Help Thicken Output

• Besides marshmallows, other recommended foods for thickening ileostomy output include:
  • Bananas 1
  • Pasta 1
  • Rice 1
  • White bread 1
  • Mashed potato 1
  • Jelly 1

Managing High Output

• For high ostomy output (>1.5 L/day), marshmallows can be used as one of several bulking agents to help reduce output 1
• Antimotility agents like loperamide (1-2 tablets, 2-4 mg) taken 30 minutes before meals can further help reduce output 1, 3
• Fluid intake management is crucial - patients should avoid chronic dehydration by consuming 2-2.5 liters of fluids daily 1
• Caution should be exercised with hypotonic (e.g., tea, water) and hypertonic drinks (e.g., fruit juice) as these can increase stoma output 1

Foods to Approach with Caution

• High fiber intake can increase loose stools, flatulence, and bloating in ileostomy patients 1
• Patients should be cautious with fruit and vegetable skins, sweetcorn, celery, and nuts as these may cause stoma blockages 1
• Many patients avoid specific foods due to concerns about stoma blockages, which may negatively affect overall nutritional status 4, 5

Nutritional Considerations

• Initial dietary advice for ileostomy patients should include small, frequent, nutrient-dense meals/snacks 1
• Sodium intake is important - patients are advised to sprinkle extra salt onto meals (0.5-1 teaspoon per day) to prevent dehydration 1
• Potassium intake should be increased if serum potassium is low 1
• Vitamin B12 monitoring is recommended for ileostomy patients 1

Evidence-Based Recommendations

• 68% of participants in research studies stated they would use marshmallows in the future if they wanted to reduce or thicken their ileostomy output 2
• While many dietary recommendations for ileostomy management are based on expert opinion, the use of marshmallows is supported by clinical research 2, 5
• After the initial healing period (6-10 weeks post-surgery), foods should not be automatically excluded unless found to be problematic after reintroduction 6

In conclusion, marshmallows are not only safe for individuals with an ileostomy but can be beneficial in managing stoma output by helping to thicken the effluent and potentially reducing the volume of output.