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Crohn's Disease Forum » Surgery » Stoma Subforum » Dealing with thick ileostomy output


 
06-23-2015, 05:30 AM   #1
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Last edited by UnXmas; 07-25-2015 at 06:20 AM.
06-23-2015, 07:44 AM   #2
Dukeis
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When my output is real thick I drink grape juice. That will usually thin it up pretty quickly.
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06-23-2015, 12:57 PM   #3
glum chump
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Hi UnXmas

I usually have thick stools when I eat carbs. The less carbs I eat, the more watery my output. Low residue diet usually thickens my output. In my case, it's not so much fibre that makes a difference as much as carbs.

I also swish water around in my bag when I'm emptying. I open my bag, use a small water bottle to add water to my bag, swish it around and then empty. I usually use a little bit more water and swish it a second time, and my bag gets empty and clean.

Hope this helps!

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06-23-2015, 02:15 PM   #4
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Interesting, I found the opposite, on a low residue diet I was eating plenty of carbs - white bread, white rice, biscuits, lots of things like that, and my output was watery and easy to empty and clean. When I google for tips to loosen it, I keep finding advice to eat more fibre, and that's just not working for me.

I have tried washing out the bags, I find it icky. Maybe I have unrealistic expectations, I want to empty it and have it be completely clean, but that was how it used to be for me!

I will try grape juice. I read prune juice can help also. I'm thinking of trying laxatives though. I know with an ileostomy they can lead to dehydration, but that really doesn't look like it will be an issue for me. It's like the consistency of playdough.
06-24-2015, 04:06 AM   #5
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Maybe increase your liquid intake ?.
I find mine gets really thick if I haven't drank enough.
The thing that really makes mine liquid is stout, so much so that I avoid it.
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06-24-2015, 06:13 AM   #6
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I drink quite a lot already. Not stout though.
06-24-2015, 07:31 AM   #7
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The other reason I've considered taking laxatives with my ileostomy before is that I get so full, not just my stomach due to eating, but my bowel seems full and uncomfortable all day, and I have no output, then in the evening I finally get output and get more comfortable, so I've thought about taking something to move things along and get comfortable earlier.

So yesterday evening I took a stool softener, docusate sodium (the only kind of laxative I had in the house). I didn't bother checking how long it takes to work as I know my digestive system doesn't follow guidelines. I felt as usual over night and this morning, with hardly any output this morning (as usual). Eating lunch I felt more full than usual, I finished lunch about half an hour ago, and my bag has now rapidly filled up with watery output. I guess that's a good result. I still feel full and uncomfortable, so I think there's more to come. I'm not sure if I'd say it's an improvement on the fullness, as I feel worse so it depends how long this lasts before it all gets out. But I definitely can't complain that it's too thick, so hope when I empty it in a minute it will wash out nicely. No dehydration or anything either, it's only a bag of output so far so I don't think it's too much fluid loss.

Of course I also know that this evening I could take the exact same dosage of the exact same stool softener and have something completely different happen from this time round.
06-24-2015, 11:12 PM   #8
glum chump
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Good luck with it, UnXmas. I hope all of the effects sort themselves out, and all you get is a loose output!

The other thing that gives me watery stool is wine. Goes right through like water. Fruits and vegetables are the foods that give me a watery output. By the way, did you try Metamucil at all? I'm not sure how that works with an ileostomy, but I'm wondering if it might loosen your output somewhat.

Fingers crossed that you can come up with a solution so you don't have to deal with an icky bag!

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06-25-2015, 05:34 AM   #9
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I don't drink alcohol - well I have literally one drink at Christmas, New Year's, etc., so I'm not sure my stomach would like wine or stout.

The docusate sodium did give me watery output, but I'm not sure it was worth the stomach discomfort it gave me. I might try it again though, or another laxative. I'm not sure about Metamucil as that's a fibre supplement, and eating fruits and vegetables and other fibre foods isn't loosening it so I'm not sure a fibre supplement would either.

I will keep experimenting though, thank you for the suggestions.
06-25-2015, 09:53 AM   #10
Dukeis
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You do know that using laxatives with an Ileostomy can be dangerous. You can become dehydrated quickly and the with laxatives in your system you are most liking not able to catch up on fluids without an IV.
06-25-2015, 10:41 AM   #11
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Yes I know, dehydration never seems to be a problem for me though.
06-27-2015, 07:47 AM   #12
2thFairy
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High sugar stuff, like grape juice, is good to thin out stuff. High fiber foods will definitely thicken up the output.

I would avoid laxatives. Sugar-free candy gives me super watery output really quickly and has caused me to be dehydrated more than once. Miralax is made from the same chemicals as sugar-free sweeteners.
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06-27-2015, 07:56 AM   #13
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So it's not just me who finds fibre thickens things? I keep reading guides that say fibre should loosen it.
06-27-2015, 09:57 AM   #14
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Sugar and artificial sweetners don't loosen my output, so I don't think grape juice is going to help either. I would be annoyed to have to go back on a low fibre diet, having been on it for years until quite recently, but it seems my options if I want thin output are either low fibre or laxatives.
06-28-2015, 07:28 AM   #15
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I tried some lactulose - that's working! But I'm going to cut back on fibre, hopefully I'll be able to still have some fruit and whole grain crackers and things, but I'll probably start with hardly any at all (which I know how to do, since I spent so long having to avoid all fibre, I'm familiar with it) and assuming that thins the output, I'll then add it back in gradually until it begins getting thick again.

Or I'll just keep taking lactulose. And yes, if I read that anyone else with an ileostomy was taking that I'd tell them it was dangerous, but I honestly have no signs of dehydration. And given my stoma output is usually like cement, perhaps the amount of fluid I lose with the lactulose is actually closer to what most with ileostomies lose? Normally I go all day with no output, then get about one bagful in the evening and then another half-bag overnight. Today with the lactulose I've had one half-bag this morning and another after lunch. It's watery but I'm not loosing a huge amount of fluid. Though I'll also have to see how predictable it is. It's so easy to empty though! My stoma is prolapsed most of the time, 15cm last time I measured, and it actually curves round back up to the top of the bag again, so the output goes all over the stoma, which is not good when it's thick as it just sticks to it.
06-28-2015, 08:30 AM   #16
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My stoma is prolapsed most of the time, 15cm last time I measured, and it actually curves round back up to the top of the bag again, so the output goes all over the stoma, which is not good when it's thick as it just sticks to it.
Output on your stoma, thick or thin, is not harmful to your stoma. It is harmful to skin, but not your stoma. I understand that you don't like it, but medically it is okay. A stoma is intestine and intestine is made to be in poo all day.

I'm glad you are happier with the lactulose!
06-28-2015, 01:52 PM   #17
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I really am liking the lactulose - I'd forgotten what it's like to be able to just open the bag to empty rather than having to squeeze it all out and still be left with a bag coated in output! And it's not been out of control, I've only emptied three times today so far (it's now evening here). I know it's not bad for the stoma, but the rational side of me that knows that doesn't seem as strong as the irrational, OCD side that thinks it must all be clean.
06-28-2015, 02:10 PM   #18
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I can appreciate that! My OCD side is the whole reason I thought I would absolutely HATE having a stoma in the first place. It is amazing how giving back even just a little bit of health can change your outlook.
06-29-2015, 05:51 AM   #19
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I'm still pleased with the lactulose. I took none yesterday evening because I didn't want my bag filling too much during the night, but woke up this morning with a bag of really thick output so I will experiment more with doses and timings. I'm cutting back on fibre too, I don't want to stop eating it completely though.
06-30-2015, 02:01 PM   #20
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I've taken a break from the laxatives because we're having a heat wave. I'm sure our temperatures here in England are not hot compared to where some forum members live, but I'm not good with heat and not risking dehydration.
07-02-2015, 11:13 AM   #21
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Heat wave over (that's as long as they last here ) I'm hoping that taking lactulose again today will get things moving because I am so full and bloated and have had hardly any stoma output.
07-03-2015, 08:01 AM   #22
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I'm concluding that lactulose solves my thick output problem without me having to give up fibre. So I just have to be certain it's not causing dehydration. Can it cause problems absorbing calories? With the lactulose I'm having to empty my bag about four times a day, and it's watery, sometimes with bits in, or it's semi-liquid. With no lactulose I emptied twice a day and it was practically solid.

I tried grape juice on the two days of heatwave when I didn't take any lactulose, and that seemed to have no effect at all. How much grape juice do people generally need to consume for it to work? Is having three or four glasses spread out over a day enough? Or do you have to down a litre in one sitting or something?
07-03-2015, 08:30 AM   #23
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Two glasses of grape juice usually does it for me. I react pretty quick to high-sugar stuff like grape juice, maple syrup, corn syrup, etc., though.

Concerns over nutrition and calories comes in if your output is coming in high quantity and rapidly after you eat. In other words, after a meal, do you see that food coming out soon afterwards or is it several hours after? The longer it stays in your system, the more you are absorbing, so rather than thick or thin output being better for nutrition, its more about how much time your intestines are getting to absorb the food.
07-03-2015, 10:25 AM   #24
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Thanks, that makes sense. The majority of my output still comes in the evening and overnight, the rest has been more randomly timed. Today I emptied after eating breakfast, but I've had no output since, even having eaten lunch a few hours ago. I'll see how it goes.

I guess sugar just doesn't have that effect for me.
07-05-2015, 05:21 AM   #25
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Is it possible to become tolerant to lactulose? It doesn't seem to be working so well.
07-14-2015, 05:20 AM   #26
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So apparently it is possible to quickly become tolerant to lactulose, or at least it is for me. Maybe it would still work ok if I increased the dose, but I don't want to end up drinking a litre of lactulose syrup a day. So, today I'm back on stewed apples and mashed up vegetables, hopefully this will help, though I am wondering if it's the amount of food as well as the amount of fibre that makes the difference.
07-14-2015, 03:38 PM   #27
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Hi unxmas. Im mandy and new here. I had a loop ileostomy just over 12 mths ago (now reversed). I found fresh orange loosened mine a bit. But eating bananas , potatoes, jelly, marshmellows , peanut butter made it thicker. If you look up crohns low residue diet, it should tell you which foods etc thicken and loosen output. Hope this helps. Best wishes
07-15-2015, 04:08 AM   #28
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Thank you mandy, I've looked at some guides online, but my stoma output doesn't seem to always react to foods the way most people's do, so I think I just have to keep experimenting.
07-15-2015, 04:20 AM   #29
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Your welcome , unfortunately it is somewhat a guessing/trial and error thing this Crohn's. Ye just keep trying different things im sure the right thing for you will come along. It's just no fun while trying to find it though. Fingers crossed for you and if i can find anything that may help il let you know. Best wishes.
07-17-2015, 06:26 AM   #30
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I've cut down my fibre intake a lot but the output is still thick (I've not been taking the lactulose) so that can't be the problem. Maybe something else changed when I had the new stoma? I can't think why changing to an end ileostomy or having a bit of small bowel removed would result in much thicker output though. Another thing that's changed is that I'm eating a lot more food now than I had done for the first six months of having a stoma, but the increase in food began with my hospitalisation for weight gain at the start of July last year, and the thick output didn't begin for a while after that. But the extra food may be having a long-term, delayed effect on my digestion, I don't know how that would work, but eating a lot over a long period (weeks and months) has had delayed, long-term effects on my digestive system many times before.

So my options are put up with it; see if increasing the lactulose works; or try another laxative. I'm putting up with it at the moment but I'll think about the laxatives some more.

At least I can go back to eating raw fruit again.

Last edited by UnXmas; 07-17-2015 at 12:33 PM.
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