Table 1.

Dietary management program for patients with preventive ileostomy.

Item	Content
Diet type selection and recording	1. Within 1 week after discharge, patients can consume semi-liquid diets and gradually transition to regular diets, following principles of low residue, low fat, and low fiber. Avoid spicy, irritating, and fried foods, maintain nutritional balance and dietary diversity to establish dietary tolerance and navigate the dietary transition period. 2. Use tools such as 24-h dietary recall forms, food diaries, or food frequency questionnaires to record patients' dietary intake types, quantities, and frequencies.
Nutrient selection	3. Energy supply: determine energy supply based on patient needs. If HOS occurs, the patient's energy target should be increased by at least 30–50% above normal intake to compensate for intestinal losses. 4. Energy composition: 40–50% from carbohydrates, 20% from protein, and 30–40% from fat. 5. Consume starchy foods such as rice and noodles; limit high-monosaccharide foods like candy, honey, jam, jelly, and high-sugar beverages. 6. Increase protein intake: protein requirement is 1.5–2.5 g/(kg·d). 7. Use medium- and short-chain fatty acids instead of long-chain fatty acids, ensuring adequate essential fatty acids and fat-soluble vitamins. 8. Limit dietary fiber intake. Recommend soluble fiber foods such as viscous, non-fermentable, gel-forming soluble fiber supplements (e.g., psyllium husk). Reduce insoluble fiber intake from high-fiber foods (e.g., celery, asparagus), indigestible fiber peels (e.g., apples), corn, raw cabbage, dried fruits, nuts, popcorn, casing meats, mushrooms, coconut, etc., to avoid obstruction. 9. Recommend oral multivitamin and mineral supplements, such as vitamin B12, iron, calcium, liquid magnesium, zinc, manganese, and selenium.
Fluid management	10. Oral fluid intake: 1,500–1,700 mL. If HOS occurs, increase daily intake by 500–750 mL above the average recommended intake for the general population. 11. Types of oral fluids: limit hypotonic fluids (e.g., water, tea, coffee, alcohol) and hypertonic fluids (e.g., fruit juice, cola) to < 1,000 mL per day. If HOS occurs, oral rehydration salts can be used.
Dietary behaviors	12. Eat small, frequent meals to maintain appetite. Divide meals into 5–6 times, scheduled during the daytime to reduce nocturnal stoma output and ensure nighttime rest. 13. Avoid eating too quickly during meals; take small bites, chew thoroughly, and avoid drinking water during meals.
HOS assessment and monitoring	14. Stool assessment: assess and record daily stoma excretion characteristics and volume. If stoma output >1,500 mL/day, consider HOS. 15. Urine assessment: record daily urine volume and color, ensuring urine output >1,000 mL/day. 16. Dehydration assessment: monitor for signs and symptoms of dehydration (e.g., dry mouth, decreased urine output, dark concentrated urine, dizziness when standing, significant fatigue, abdominal cramps). Seek medical attention if symptoms occur. 17. Weight monitoring: weigh at least once weekly.