Ileostomy - how to slow down output?

Well, its just 17 days post surgery. But i am having to empty bag every 1 - 2 hours at night, and plenty in the day. Very liquidy.

Imodium doesn't do too much.

Any tips? Is this normal at the beginning? Does it begin slowing down? I have been eating some rice porridge today in the hope of slowing it down.

Thanks everyone - this forum is great - couldn't have done without it.

my daughter finds that eating a banana every day slows her output down a lot. In fact, she is now only eating them like every other day or so because she said it's too thick.

But in the beginning, the first 3-4 weeks after her surgery, the out put was so much more, and the docs and stoma nurse all said that was normal, and will slow down. It did

Best of luck to you. How are you with your pain and other healing ?

Tracy, I want to pet that puppy in your Avatar! Adorable! (and you are too!)

Hopeful, I need to slow myself down as well, after all I cant live on immodium. I have heard marshmallows help, rice is good, well cooked as you are eating it, and yes, bananas. Bread is good for me as well.

But we are all different!

Thanks for the banana tip. Pain - more or less fine as staples are out - discomfort here and there. Wounded skin around the stoma - because the bottom of the stoma is recessed - still not managing it properly. The incision opened in two spots and is draining liquid from there - need to get it checked out sometime. Thanks for asking.

Misty, how much immodium do you take? I don't find that 4mg does much for me, and I don't know how high to go.

I rarely take it anymore. I did find the ones that disolve on your tongue work best. I took about 4-6 a day when I first had surgery. Didnt want to over do it, just slow it down. The reason I dont take them anymore is I have a stricture, so I just 'go with the flow' now, whether I like it or not! (and I drink ALOT of water) Drinking water helps with the big D as well.

PS...make SURE you turn the light on when you go in the middle of the night...oi veh the messes I can make!

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Tracy, I want to pet that puppy in your Avatar! Adorable! (and you are too!)

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Awe thanks Misty
I wish I was that cute ! That's my beautiful girl Gab, and the puppy is her aunt's. I agree though..I want to reach through that picture and play with that pup too! LOL

I was told that eating marshmallows and potato chips would help thicken up the output and slow things down a little.

Chips slow me down. I haven't paid much attention in the beginning because I had too many other things going on but I am emptying quite a lot during the day and at least 2-3 times during the night.
Did you try Benefiber or Metamucil to thicken it up?

Thanks Heike. I didn't try fiber as many say to follow a low fiber diet for first few months.

The issue isn't all fibre it's specifically insoluble fibre. Insoluble fibre will come ut whole, potato skins and what not. Soluble fibre doesn't digest but it absorbs liquid so it thickens things up and won't scratch.
Soluble is good, insoluble is bad.

in the leaflets my stoma nurse gave me it mentions a few times about thickening output with salted potato crisps and coke.. the crisps part makes sense but i wonder why it says coke specifically and not crisps and water? lol

Potato chips do the trick for me. Also make sure you are staying very hydrated! I can always tell when I am starting to get dehydrated because my output turns to pure water!

Coke? I would think the caffeine would cause more diarrhea - why would that work? Any experience with it?

littlefreebird said:

in the leaflets my stoma nurse gave me it mentions a few times about thickening output with salted potato crisps and coke.. the crisps part makes sense but i wonder why it says coke specifically and not crisps and water? lol

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Eat marshmallows and bananas, they should slow down your output a bit. If that doesn't work then add a bit of immodium. I wouldn't drink coke as the caffeine can dehydrate you a bit. Drink non-caffeinated beverages and a lot of them. Take care

How does anyone get a good nights sleep if emptying that often during the night? Eventually do you get to sleep through the night with an illeostomy?

spingirl said:

How does anyone get a good nights sleep if emptying that often during the night? Eventually do you get to sleep through the night with an illeostomy?

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I never have to empty my ileostomy bag at night.

Right out of the hospital, I woke up 2-3 times each night to empty. This slowed down over the next couple of months to sleeping through the night with no issues of needing to empty or leaks. I think for most people it is only in the beginning that they get up at night to empty.

spingirl said:

How does anyone get a good nights sleep if emptying that often during the night? Eventually do you get to sleep through the night with an illeostomy?

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It gets better with time. I was up 2 or three times a night post-op, but now it's maybe once or never.

Sent from my SM-N910U

If you do end up with a high volume of output at night, you can still sleep. You can use a bigger bag (if you feel big bags are not discreet enough for you, you can use small bags during the day and switch to big ones at night), and if that's still not enough, you can get bags that drain like a catheter to use at night time.

But that's not usually necessary. It's not a bad idea to keep some large bags and whatever else helps with a very high output for emergencies, like stomach upsets, but they don't routinely give people with ileostomies things like this; according to my stoma nurses, getting up once or twice in the night is the norm. I think I'm lucky that I usually don't need to empty at night at all, though I have woken up to a very full bag on some occasions.

Well, now I get up probably once anyhow to pee...so I guess maybe I am over thinking it all. Although changing to large bag at night seems like a good idea but I thought you shouldn't change bag every day...it was rough on the skin? The draining thing sounds like a good idea if I was sick in bed for a bit but otherwise...sounds like it would mess with my head a little bit...but so good to know there are options.

I had my op just before Christmas and was initially up three times during the night, It's now down to once at around 6am, I do set my alarm to go off, but I seem to wake up when it needs emptying before the alarm.
My nurse advised taking two Imodium half an hour before eating, I've found this to be the only way to thicken things up, taking it after has no effect at all.

I know a lot of medical sites on stomas (e.g. patient guides on hospital websites) recommend not eating too late in the evening as a way to reduce night time output.

spingirl said:

Well, now I get up probably once anyhow to pee...so I guess maybe I am over thinking it all. Although changing to large bag at night seems like a good idea but I thought you shouldn't change bag every day...it was rough on the skin? The draining thing sounds like a good idea if I was sick in bed for a bit but otherwise...sounds like it would mess with my head a little bit...but so good to know there are options.

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I change my bag every day, not due to needing different sizes, just because I like to clean everything each day, and my skin is fine. Different people have different issues, some people have more sensitive skin than others, some solutions work for some people but not others, but usually you'll be able to resolve problems. Don't worry too much in advance, you may well be worrying about problems you'll never have.

I know...I need to learn to chill more and not Google too much too. I get myself worked up...

It's understandable, it would probably be more abnormal if you didn't worry.

UnXmas said:

I know a lot of medical sites on stomas (e.g. patient guides on hospital websites) recommend not eating too late in the evening as a way to reduce night time output.

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That's a common suggestion, but I'll be honest and say that I eat large meals past 10 pm and it makes little difference to overnight emptying. It does delay my stomas usual "quiet time" the next morning though.


Sent from my SM-N910U

VeganOstomy said:

That's a common suggestion, but I'll be honest and say that I eat large meals past 10 pm and it makes little difference to overnight emptying. It does delay my stomas usual "quiet time" the next morning though.


Sent from my SM-N910U

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Same here. My stoma is most active between 4 a.m. and 6 a.m. regardless of when my last meal was.

Me too, I've tried eating at different times and it makes no difference

I've found the same - when I eat makes no difference.

I guess we all settle into routines...this is really good to read. Thank you all for sharing.

As above it settles over time. However for the last 16 years I've woken 99% of nights at least once.

Eat salty stuff. One of the joys of an ileostomy is not needing to worry about adding salt to meals. We don't absorb salt apparently it thickens output. I've noticed similar effects with electrolyte drinks. Loperamide is an alternative to Imodium an works well.

R20 said:

As above it settles over time. However for the last 16 years I've woken 99% of nights at least once.

Eat salty stuff. One of the joys of an ileostomy is not needing to worry about adding salt to meals. We don't absorb salt apparently it thickens output. I've noticed similar effects with electrolyte drinks. Loperamide is an alternative to Imodium an works well.

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Loperamide and Imodium are the same medication; Imodium is a brand name for loperamide. (But you're right in the sense that Imodium is different as Imodium is more expensive, and certain versions contain other ingredients as well as loperamide.)

Co-phenotrope (brand name Lomotil, at least in the UK, I think the names may be different elsewhere) is another anti-diarrhoea med that may help slow output.

I hadn't heard of salt slowing output though. I'd read about needing salt because we don't absorb as much, but it's a perk that's wasted on me because I have a sweet tooth. I may well follow your tip next time I get watery output, which I do get every now and then.

I have high blood pressure...does that mean that if salt isn't absorbed as much that perhaps that might get better? What about cholesterol? Can you take vitamins? Would they even work? Liquid vitamins perhaps? I have thought about switching to those now but haven't done so yet. I have a friend that is a homeopath who says she can help with my strictures from scar tissue. I find that a bit far fetched. Not sure if I should let her have a go or not. Sometimes I wonder what I have to lose - besides my colon - right? Wish my PCP and/or GI Dr. were a bit more holistic. I also am not sure my friend knows how severe my condition is. I will have to see if i can find a thread on this subject.

spingirl said:

I have high blood pressure...does that mean that if salt isn't absorbed as much that perhaps that might get better? What about cholesterol? Can you take vitamins? Would they even work? Liquid vitamins perhaps? I have thought about switching to those now but haven't done so yet. I have a friend that is a homeopath who says she can help with my strictures from scar tissue.

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Because salt is usually absorbed in the colon, people with an ileostomy absorb less salt (but it still gets absorbed). If you have HBP, you'll need to have your doctor monitor your sodium levels so you are getting enjoy to keep proper electrolyte balance without increasing your BP.

What about cholesterol?

Vitamins can be taken, but make sure you stay away from "extended-release" tablets - liquid, powder and capsules are usually fine.

I would be very wary of what that naturopath says - ask them for referrals from people they've treated and see if their strictures were resolved.

I've read that because the typical diet includes too much salt, people who have their colon removed generally don't have to make a conscious effort to eat more. So it may be something you need to pay attention to only if you already take care to avoid too much salt. As VeganOstomy says, if you've high blood pressure or other health problems influenced by diet and absorption, it's probably best to ask your doctor for advice specific to you.

Before I had the surgery, I'd worried about whether I would be absorbing meds properly once I got my ileostomy, as I'd read a few times that it can be an issue with certain meds (or forms of meds), but could find very little information on which meds this applies to. Personally, I've noticed no reduction in the effectiveness of any meds I take (and I take a lot ). My GP said usually you'll know if it's a problem by seeing pills or capsules in your stoma output. She said if your food comes out looking like it does when it goes in you'll need to pay attention to whether your meds are still effective too. We actually had a thread on this on the forum a while back with some links to good information on it - I'll see if I can find it.

Here's the thread: http://www.crohnsforum.com/showthread.php?t=68301&highlight=medication+ileostomy

I think I concluded from that discussion that it varies from person to person, but there are some meds more likely to pose a problem than others, time-release ones like VeganOstomy mentions being one of the main ones.

UnXmas said:

Here's the thread: http://www.crohnsforum.com/showthread.php?t=68301&highlight=medication+ileostomy

I think I concluded from that discussion that it varies from person to person, but there are some meds more likely to pose a problem than others, time-release ones like VeganOstomy mentions being one of the main ones.

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Having a short-bowel can also greatly impact absorption from meds or supplements.

The only pills I have had needed to change are my calcium tablets. They were ginormous and didn't dissolve completely, so I changed to gel-filled calcium capsules. Everything else I take doesn't appear to be a problem.

I have short gut syndrome and my nurse told me to try Rice Krispie treats BEFORE I eat and to limit my liquid intake when I eat. It helps with some meals.