Can you eat cheese with a stoma?

Having a stoma can significantly impact your diet and the foods you are able to eat comfortably. One common question many ostomates have is whether it’s possible to eat cheese with a stoma. The short answer is yes, you can absolutely still enjoy cheese in moderation with the right precautions.

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What is a Stoma?

A stoma is a surgically created opening in the abdomen that allows waste to exit the body and bypass a diseased or damaged part of the digestive system. There are different types of stomas:

Colostomy: Connects the colon to the abdominal wall

Ileostomy: Connects the last part of the small intestine (ileum) to the abdomen
Urostomy: Connects the ureters to the abdomen and diverts urine

With an ostomy, you wear a pouching system over the stoma to collect waste. Learning to manage a stoma takes time, and you’ll need to figure out what foods work for your unique digestive system.

Can You Eat Cheese With a Colostomy?

Many colostomates can enjoy cheese in moderation. Here are some tips for eating cheese with a colostomy bag:

Go low-fat: Try low-fat cheeses like mozzarella or cottage cheese to minimize gas, diarrhea, and blockages.
Avoid constipation: Cheese can be constipating for some, so stay hydrated and balance it with high-fiber foods.

Mind portion sizes: Eat cheese in limited amounts to assess tolerance.
Beware strong flavors: Pungent, aged cheeses like blue cheese may irritate the stoma.
Watch for blockages: Cheese can thicken ostomy output. Chew thoroughly and stay hydrated.

If you experience bloating, nausea, cramping, or blocked digestion after eating cheese, you may need to avoid or limit it. But many colostomates find they can incorporate cheese into a balanced diet with proper hydration.

Can You Eat Cheese With an Ileostomy?

Those with ileostomies may also be able to eat cheese in moderation. Here are some pointers:

Stick to soft, mild cheeses: Hard cheeses like cheddar take longer to digest, while soft options like cottage cheese pass through more easily.

Avoid cheese with seeds/nuts: These can obstruct an ileostomy.
Limit gas-producing cheeses: Cheese can lead to gas and bloating. Monitor your tolerance.
Stay hydrated: Cheese can thicken ileostomy output, so drink plenty of fluids.

Talk to a dietitian: They can provide ileostomy-specific cheese recommendations.

Due to shorter transit time, those with ileostomies may need to be more mindful of cheese intake. But following the above tips can help minimize risks.

Can You Eat Cheese With a Urostomy?

A urostomy diverts urine rather than stool, so cheese tolerance depends more on your personal preferences and dietary needs.

There are no specific cheese restrictions with a urostomy. But those with a urostomy do need to stay hydrated to avoid urinary tract infections. Drink plenty of fluids if enjoying cheese to stay hydrated.

General Tips for Eating Cheese With an Ostomy

Here are some general tips to remember when eating cheese with any type of ostomy:

Reintroduce slowly: After surgery, introduce small amounts of soft cheeses and monitor effects.

Mind the serving size: 1-2 oz servings are a good starting point to assess tolerance.
Stay hydrated: Drink water before, during and after eating cheese.
Chew thoroughly: This allows cheese to digest easier.

Avoid right before pouch changes: The odor can transfer to the pouch.
Consider supplements: Probiotics can aid digestion of cheeses.
Keep a food diary: Track cheeses that aggravate symptoms.

Ask your doctor: Get individualized guidance from your healthcare team.

Best Cheeses to Try

Wondering where to start when slowly reintroducing cheese? Here are some top options ostomates tend to tolerate well:

Cottage Cheese: High protein, low fat, and easy to digest.

Feta: Mild flavor and crumbly texture.
Mozzarella: Mild tasting, moist, and low lactose.
Farmer’s Cheese: Spreadable and digests easily.

Cream Cheese: Soft, smooth, and rich.
Ricotta: Light, mild, and low lactose.
Monterey Jack: Semi-soft and mild in flavor.

Parmesan: Sharp taste but lactose-free when aged over 10 months.

Try small amounts of these milder, lower fat cheeses and see how your body responds. Then slowly expand your cheese horizons from there.

Worst Cheeses for Ostomates

On the flip side, here are some cheeses ostomates tend to tolerate poorly:

Cheddar: Hard texture and strong flavor.
Swiss: Contains “eyes” or pockets of air that can cause gas.
Provolone: Hard, aged, and strong-flavored.

Brie: High fat content and potent flavor.
Blue Cheese: Crumbly and pungent.
Goat Cheese: Difficult to digest due to high fat.

Aged Gouda: Hard and strong-flavored.
Parmesan (not aged): Lactose-rich.

These firmer, more pungent cheeses often exacerbate ostomy issues like gas, bloating, and blockages. Get your system accustomed to milder cheeses first before experimenting with stronger varieties.

Serving and Cooking Tips

How you prepare and serve cheese can also impact digestibility. Here are some tips:

Grate vs. slice: Grated cheese is easier to break down than slices.
Cook it: Melting cheese makes it easier to tolerate.

Pair with fibers: Fruits, vegetables and whole grains aid digestion.
Avoid deep-frying: Frying makes cheese heavier and harder to digest.
Limit breaded cheeses: Breading also makes cheese harder to break down.

Combine with probiotic foods: Yogurt, kimchi and fermented items provide gut-healthy bacteria.

Preparation method can be key. Try grating cheese over dishes instead of eating thick slices. Melting cheese into sauces, casseroles and soups also increases digestibility.

Lactose Content in Cheese

One other factor to consider is the lactose content of different cheese varieties. Lactose is the natural sugar in dairy products. Some ostomates are sensitive or intolerant to it.

In general, firmer, aged cheeses are lower in lactose than soft, fresh cheeses. Here’s a quick overview of lactose levels based on cheese type:

Cheese Type	Lactose Content
Soft and Fresh	Highest in lactose
Soft Ripened	Moderate lactose
Firm	Low lactose
Blue Cheese	Low lactose
Hard and Aged	Very low to no lactose

Softer, fresher cheeses like mozzarella, ricotta, and cream cheese tend to be higher in lactose. Aged cheeses like cheddar, parmesan and Swiss are lower in lactose. This is because the aging process converts lactose into lactic acid.

If you are lactose intolerant or sensitive, stick with small amounts of harder, aged cheeses. You can also take lactase enzyme supplements to improve dairy digestion and tolerance.

High Protein Cheese Options

Cheese can be an excellent source of protein after ostomy surgery. Getting adequate protein helps with wound healing, maintaining muscle mass, and fighting infection.

Some high protein cheese options to try include:

Parmesan (10g protein per ounce)

Romano (10g protein per ounce)
Swiss (9g protein per ounce)
Cheddar (7g protein per ounce)

Mozzarella (6g protein per ounce)
Cottage Cheese (6g protein per 1/2 cup)

Aim for 1-2 servings of these protein-rich cheeses daily as part of a balanced, high protein diet. This provides your body with sufficient protein for healing without overloading your system with too much dairy.

Cheese Alternatives

If you find you don’t tolerate any types of dairy cheese well, alternatives are available:

Vegan “Cheese”: Made from nuts, soy, etc. No lactose.
Lactose-Free Cheese: Real cheese with lactose removed.

Nut Cheese: Made from cashews, almonds or macadamia nuts.
Sheep or Goat Cheese: Lower lactose than cow cheeses.

Try small amounts of these non-dairy or lactose-free cheese alternatives to see if you have better tolerance. You can also ask your doctor about taking lactase enzymes before consuming dairy products.

When to Avoid Cheese Completely

In some cases, cheese may need to be avoided altogether after ostomy surgery, including if you have:

Sever lactose intolerance or dairy allergy
History of recurrent blockages from cheese

Underlying conditions like Crohn’s, colitis, or bowel obstructions
Had recent ostomy surgery or complications
Very high ostomy output

New and struggling ostomates should also steer clear of all dairy including cheese until their digestion regulates. Introduce cheese slowly and carefully only when your doctor gives the green light.

Sample 1-Day Meal Plan with Cheese

Here is a sample menu showing how cheese can be included as part of a balanced low-residue ostomy diet:

Breakfast:

1/2 cup cottage cheese
1/2 sliced banana
1 egg scrambled with 1 oz cheddar, onions, spinach

Lunch:

Turkey and mozzarella sandwich on white bread with lettuce, tomato
1/2 cup low-fiber vegetable soup

Dinner:

4 oz salmon baked with lemon, dill
1/2 cup white rice

1/2 cup roasted carrots

Snacks:

1 string cheese stick

5 whole wheat crackers with 1 tbsp cream cheese

This provides a nice mix of soft, low-fat cheeses for balance. The overall diet focuses on low-fiber, binding foods that are easy to digest. Be sure to drink fluids throughout the day as well.

Conclusion

Having an ostomy doesn’t mean giving up your favorite dairy foods. With the proper precautions, many people with ostomies can still enjoy cheese in moderation.

Stick to mild, low-fat varieties in small portions. Softer, low-lactose types tend to be best tolerated. Monitor your individual reactions. Cheese may need to be limited or avoided if it consistently exacerbates ostomy issues.

Pair cheese with probiotics, fiber, and fluids to support digestion. Work closely with your doctor or dietitian to fine-tune your cheese intake in a way that works for your unique system.