Our expert dietitian, Laura Coster, shares her top tips for eating ‘free from’ with a bowel stoma. ‘Free from’ refers to foods and drinks that don’t contain certain common ingredients people with specific dietary needs may choose to avoid e.g. in coeliac disease or the vegan diet. This guide focuses on those who are gluten free, dairy free, or vegan and that need to follow a low-fibre diet if they’re in the first 6-12 weeks after surgery.
Disclaimer: This advice does not replace any from your own medical professional. If you would like more support, please see your GP or dietitian.
General tips
• ‘Free-from’ products will often have their own section in a supermarket, especially those that are gluten free, dairy free, and vegan. In large shops, there will generally be a ‘free from’ section in the chilled, cupboard, and freezer aisles.
• ‘Free-from’ options often display a comment saying what ingredients they don’t contain e.g. gluten free
• Reading the ingredients label can help you check products are suitable for your ‘free from’ needs. Some ingredients are in bold if they’re common allergens e.g. “wheat (contains gluten)”, milk, or egg
• Sometimes ‘free from’ options are more expensive than the ‘regular’ version – supermarket own ‘free from’ brands tend to be cheaper than named brands
Gluten free with a bowel stoma
What is being gluten free?
A common reason people exclude gluten is because they are diagnosed with coeliac disease.
This condition can only be treated with a gluten-free diet.
Gluten is a protein found in certain foods and a gluten-free diet means they avoid it
Where is gluten found?
Gluten is found in the grains barley, rye, and wheat – it is in foods like bread and pasta.
How do I choose gluten-free options for my stoma?
It isn’t found in foods like rice, potatoes, meat, poultry, fish, fruits, or vegetables.
There is also gluten-free substitute foods available e.g. gluten-free bread or gluten-free pasta.
You can get gluten-free options in high-fibre varieties and they’ll often mention this on their packaging – based on your stoma’s output you can experiment to see if lower fibre works best for you.
This is not a complete list and I recommend you use Coeliac UK’s wide variety of online resources and their app which includes shopping lists of certified gluten-free products. They also have advice on eating out.
- Bread
- Couscous White or basmati rice
- Pasta
- Breakfast cereals
- Chicken Kiev, battered cod, and other breadcrumbed or battered foods
- Pizza or other pre-prepared meals like lasagne
- Flours e.g. self-raising flour
- Pearl barley
- Crackers, oatcakes, biscuits, and similar
- Stock cubes
- Pre-made sauces like ketchup
- Crisps
- Most ketchups, mayonnaises, and similar condiments
- Malt-drinks e.g. Ovaltine and Horlicks
- Beer, stouts, and ales Warm milk with some vanilla essence
- Hot chocolate
- Gluten-free bread e.g. those on NHS prescription from your GP or brands like Schar and Genius
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From about 12 weeks after surgery you may find you can manage brown rice and quinoa – cook it well and chew it wellOats Oats labelled ‘gluten free’
- Pasta labelled ‘gluten free’ – many lentil or chickpea pastas are naturally gluten free
- Breakfast cereals labelled ‘gluten free’ including supermarket own brands
- Non-breadcrumbed or battered foods. Those labelled ‘gluten free’ (most often found in the freezer section)
- Those labelled ‘gluten free’ or ones made at home from pre-bought or homemade gluten-free pizza bases or lasagne sheets
- Those labelled gluten free e.g. those on NHS prescription from your GP or brands like Dove’s Farm and supermarket own-brands.
- Once it’s been about 6-12 weeks after stoma surgery, you are likely to manage products that are higher in fibre. Try including these gradually to test your tolerance.
- Those labelled ‘gluten free’ e.g. those on NHS prescription from your GP there are also many supermarket own-brands.
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Crisps that are labelled ‘gluten free’ (they may say this on the front or back of the packet or under the ingredients on the back)
- Stock cubes that are labelled ‘gluten free’
- Beer, stouts, and ales labelled ‘gluten free’
- Cider is naturally gluten free
Dairy free with a bowel stoma
- Those diagnosed with cow’s milk protein allergy must avoid dairy products
- Some people who are allergic to cow’s milk products are also allergic to other animal milks e.g. sheep and goat
- Avoiding dairy is unnecessary unless you have a medical diagnosis, although some may choose to avoid it for lifestyle reasons e.g. veganism
- Avoiding dairy, for medical reasons, means avoiding the dairy proteins e.g. casein and whey
- Lactose intolerance is different to a dairy allergy, lactose is the sugar in animal milk products
- Dairy products are those that contain the milk from animals e.g. cows, goats, sheep
- Dairy food examples are cheese, yoghurt, and cream
- Dairy is also in drinks like milk and kefir
- It isn’t found in foods like rice, potatoes, meat, poultry, fish, fruits, or vegetables.
- If a product is dairy free it will be lactose free too
- Many ‘free from dairy’ products mention on the front of their package they are dairy free Options like soya yoghurt and oat milk are naturally dairy free.
- Yoghurts made from animal milk
- Cheeses made from animal milk
- Milk
- Milkshakes, smoothies, or coffees when eating out
- Butter and margarines
- Single or double cream
- Crème fraiche
- Ice cream
- Vegan yoghurts made from soya, oat, almond, cashew, coconut (in the cartons not tins) – choose options without granola if you’re in the first 6-12 weeks after surgery
- Cheeses that are labelled as ‘dairy free’ – choose ones without nuts, seeds, or dried fruit if it’s been less than 6-12 weeks since stoma surgery
- After about 12 weeks of having a stoma, chewing plant-based cheeses with the above ingredients very well is likely to be manage
- Tip: Be mindful of how much of these you have as large portions of these higher fat options can cause very liquid stools.
Drinks
- Drinks made from soya, oat, almond, cashew, coconut (in the cartons not tins)
- Ask the shop/restaurant if the product can be made dairy free e.g. with soya milk
- Coconut milk or cream (in the tins), soya cream, ice cream labelled as ‘dairy free’
Others
- Butter or spreads labelled as ‘dairy free’
A vegan diet with a bowel stoma
- Avoiding all foods and drinks containing animal products e.g., meat (including fish, shellfish, and insects), dairy products, eggs, and honey
- People may follow a vegan diet without being a vegan
- Products that are vegan may not be suitable for those who have a dairy allergy
- Animal containing products: honey, meat, poultry, fish, eggs, dairy products like cow’s milk
- These ingredients can sometimes subtly be in foods e.g. egg is often in fresh pasta
- Vegan options that are moderate or high fibre: wholegrain foods like granary bread and wholewheat dried pasta, lentils, beans, nuts, many seeds.
- Vegan options that are lower in fibre or easier to digest: ‘white’ bread and similar foods, potatoes without the skin, tofu, falafel, the fruits and vegetables in the low irritant table in our Nutrition Guide.
Protein foods that aren’t vegan OR can be tricky to digest for those with a bowel stoma
Non-vegan
- Meat, chicken, fish
- Non-vegan: Animal milks, yoghurts, and cheeses e.g. cow’s milk
- Vegan: Nuts and seeds
Vegan swaps
- Tofu, tempeh, falafel, hummus, bean dip (puréed beans with your choice of spices), nut butters, soy mince, mycoprotein products e.g. Quorn™ and similar items
- Soya milk and yoghurt, oat milk or nut milks and yoghurts, cheeses labelled ‘vegan’ or ‘dairy free’
- Nut butters like peanut butter, ground nuts, chia seeds and soft seeds e.g. de-shelled sunflower seeds
- About 6-12 weeks after surgery: Chickpeas, beans, lentils
- Plant-based yoghurts and cheeses that contain fruit chunks
- About 6-12 weeks after surgery: Whole nuts
Our plant-based recipes
Lentil Nut Roast and Roasted Vegetables
Useful resources
For some more recipe examples, please see our Recipe Guide
Coeliac UK – a charity for people who need to live without gluten
The Vegan Society – a charity supporting those who are vegan or want to learn about it
Our plant-based eating guide for those with a bowel stoma
Registered Dietitian Laura Coster is dedicated to supporting individuals in feeling empowered and at ease while managing their health, all while discovering happiness through the food they enjoy.
With a background in both NHS and private practice, Laura provides personalised nutrition guidance through one-on-one consultations and engaging nutrition workshops across the UK. Her extensive experience includes holding senior dietitian positions within the NHS, where she has worked closely with patients undergoing stoma-formation surgery.