Unexplained diarrhoea with ileostomy

As those of you who've read many of my posts will know, I have been lucky enough to have a stoma with a very low output, which is almost always of the "toothpaste consistency" that those of us with ileostomies are regularly told we should be aiming for. For the three months that I've had my ileostomy, it's kept to a very regular schedule of needing to be emptied a couple of times in the evening, and maybe producing a little more output overnight.

Well I've changed nothing in terms of diet or medication or anything else, and I don't feel abnormal for me in any other way, yet for three days now my ileostomy has been producing water-consistency output many many times throughout the day and night.

The only other time my output has changed at all was when it was watery due to a partial-blockage, but this time I've not eaten anything I shouldn't and have no pain (with the blockage I had severe pain and nausea), and there is such a big increase in the volume of output that didn't happen with the blockage.

Any ideas as to the cause? I'm also uncertain whether this diarrhoea means I'm not absorbing food properly as I'm very underweight - does anyone think that is likely with this level of output from an ileostomy? I don't feel ill enough to seek medical advice on a weekend, though I'll check in with either a GP or ring my stoma nurse on Monday if it's still on-going then.

(On the positive side, I much prefer this quick, painless diarrhoea with the ileostomy than the awful time I'd have with diarrhoea before the ileo. )

Being a newbie to this whole thing, I don't have any answers for you (sorry, really helpful there!), I hope you can figure it out, and if in doubt definitely speak to your doc on Monday. Good luck!

I really wouldn't worry about it too much...our stomas are little buggers sometimes and just change things up for the heck of it! I know that I get diarrhea for no reason at all sometimes, and it just clears itself up with time. Sorry, this isn't helpful either! Hope you get back to normal soon...try not to worry.

Hey unxmas,
A couple of times I have had similar to what you are suffering, generally I have quite a high output. I guess maybe 6 or 7 times a day, 3 in the evening and if I'm lucky a couple overnight. I eat a fair bit so I'm not that concerned about the regularity although a couple of times I have had nothing but watery and eggy smelling outputs. Same as you it was 10 plus times a day and a bit worrying. In your previous posts you have always said you have a low output and go for a wee lots during the day. This to me would say you are definitely absorbing fluids so in turn should be digesting food too. At these times when we are emptying lots I would imagine we are probably not absorbing so much as normal.
Are you weeing less too and is your output smelly?
It could be something as simple as a stomach bug or a possible flare. I have found since my ileostomy flares take on a different feel to what I used to get. The last time I had watery output I was put on pred. To be honest it knocked it not shape real quick.
If it is still there on Monday go get it checked out but in the mean time try not to worry too much!

Sorry for the heavy output. I've had my ielo for 23 years. The last 5 years I have been emptying my pouch atleast 10 - 12 × a day. It wears me down you need to call the doctor maybe they will give you Lomotil to help. Just don't worry!

Are you weeing less too and is your output smelly?
It could be something as simple as a stomach bug or a possible flare.

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Thanks for the reassurance - it's only because I've had such low output until this point that it feels odd; going from emptying twice a day to ten times a day it feels something's not quite right. I really don't tend to pick up bugs and don't feel ill at all. I think I'm weeing as normal, and the output is no smellier than normal. I'm sure it's nothing major, just concerned that this is going to knock my weight down even further.

How are you doing now? It is 2 days since your last post. It sounds like either a bit of a flare or a bug, to me. I would recommend drinking 2-3 bottles of Ensure Plus Calories throughout one day and see if this helps. Also take in plenty of fluids to replace fluid loss and don't restrict salt intake. I have used an over the counter product called Gastrolyte to replace electrolytes caused by diarrhea.

Let us know how you are doing.

MicheleM said:

How are you doing now? It is 2 days since your last post. It sounds like either a bit of a flare or a bug, to me. I would recommend drinking 2-3 bottles of Ensure Plus Calories throughout one day and see if this helps. Also take in plenty of fluids to replace fluid loss and don't restrict salt intake. I have used an over the counter product called Gastrolyte to replace electrolytes caused by diarrhea.

Let us know how you are doing.

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Thanks for checking in. I still have diarrhoea. My GP prescribed some loperamide but didn't know what's causing it, and I have no other signs of an illness, no temperature or anything. Also I'm getting a codeine prescription again soon which may help things too.

Edit: codeine arrived so I took some, after a while of detoxing and reducing my tolerance - I came off codeine after my surgery last October because I had ileus and couldn't risk it slowing my digestion down, so the effects of the codeine should be quite strong. Plus I really like that I get to have codeine again. I know it's addictive and I'll only have to reduce my tolerance again later... but it is going to make me feel good!