Diet and ileostomy: a qualitative comparison of patient and healthcare professional perspectives in the United Kingdom and Australia

Purpose
Ileostomy formation requires major dietary adjustments to prevent complications and maintain nutritional status, yet dietary advice is often inconsistent, and evidence guiding best practice remains limited. This study explored how people living with an ileostomy (ileostomates) and healthcare professionals (HCPs) experience and support dietary management, uniquely comparing UK and Australian perspectives.

Method
Fifty semi-structured interviews were conducted with ileostomates (n = 26) and HCPs (n = 12 stoma care nurses, n = 12 dietitians) across the UK and Australia. Interviews were recorded, transcribed and analysed using thematic content analysis guided by the Social Ecological Model (SEM).

Results
Seven main categories emerged, spanning intrapersonal, interpersonal, community, institutional and public policy factors. Ileostomates reported persistent dietary restriction, fear of food bolus blockages, and reliance on online forums when HCP follow up was limited. HCP transcripts highlighted variations in practice, constrained caseloads, and gaps in evidence underpinning dietary guidance. Country-specific differences were observed, with Australian ileostomates emphasising hydration and geographical barriers. HCPs in the UK highlighted reinforcement of advice from a stoma nurse or dietitian as being central to dietary reintroduction, whereas their Australian counterparts prioritised a patient-led approach.

Conclusion
Findings reveal systemic gaps in dietary support across both countries and highlight the need for individualised support, improved professional training, and integration of digital or telehealth solutions to enhance accessibility and continuity of care.