Dealing with liquid ostomy output – OSTOMY TIPS (w/ video)

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I had previously written about dealing with thick ostomy output, but many ileostomates have the opposite problem: liquid output. In this post, I’d like to go over a few tips that you can use to thicken up your output. These tips apply to colostomates who have loose stools but are directed more towards ileostomates.

Video

Why Worry About Liquid Or Loose Output?

For the most part, there’s nothing really wrong with having liquid or loose output, but it does come with a few challenges:

  • liquid output is more likely to cause leaks.
  • liquid output can shorten the life of your wafer by speeding up erosion.
  • liquid output can clog pouch filters and/or leak through them.
  • emptying a pouch full of liquid can be messy (especially if you have mobility issues).
  • liquid output could lead to dehydration more easily.
  • a high-output stoma could mean that nutrients don’t have time to be properly absorbed.
  • you may need to empty your pouch more often than you’d like.

Causes of Liquid Ostomy Output

Ostomates with Short Bowel Syndrome are more prone to having liquid output with fast transit of their food through their small intestine, but there are other reasons which can cause it too.

Here are a few of the more common causes:

Dietary

The following foods and beverages can cause a dramatic change in your output’s consistency. You’ll likely be able to identify the culprit within hours of consuming them:

  • Coffee or tea
  • Sport drinks
  • Soda/Pop/Soft drinks (both diet and regular )
  • Fruit juices
  • Chocolate
  • Certain fruits (for me it’s cherries)
  • Artificial sweeteners
  • Alcoholic beverages (especially wine)
  • Fried foods
  • Hot/spicy foods
  • Non-vegan foods like dairy (or other lactose-containing food, if lactose intolerant)

For the most part, very few of the items listed are needed (or desired) in a healthy diet, so if you can cut them out, you’ll find benefits in more than one way.

Drinking with meals or drinking too much at one time can loosen your output too.

Laxatives, Medication & Supplements

Some medication or supplements can cause our output to become loose. If you are taking a laxative, it may also cause loose stools.

Antibiotics can cause liquid output (diarrhea) that tends to pass within a few days.  You may be asked to take a probiotic while you are on antibiotics to help balance out your gut flora.  Keep in mind that you should never stop taking antibiotics until you’ve completed the full course.

Viral or Bacterial

There are many types of bacteria and viruses that can cause diarrhea or liquid output. If you’ve experienced an unusual change in your output, you may fall into this category.

Blockage

When you experience a blockage, your body will try to flush out the blockage, which can result in liquid output. I didn’t have this at all for my last blockage, but many ostomates report having liquid output while they were obstructed. This will usually be accompanied by other symptoms that are typical for a blockage like abdominal pain, pain with peristalsis (this comes in waves as your gut tries to move things along), nausea and possibly vomiting.

If you suspect a blockage, you’ll want to contact your GI or head to your local ER.

For tips on preventing and dealing with blockages see THIS article.

Tips for Dealing With Liquid Output

Talk to your doctor if you suspect food poisoning or another bacterial/viral cause of your liquid output. As suggested above, if you suspect a blockage, you’ll want to contact a medical professional.

For “normal” causes, you might want to try the following tips:

Dietary

One of the most effective ways to deal with liquid output is to make a few dietary changes or modify the way you eat. Keeping your meals and beverages separate, or drinking throughout the day (rather than in one sitting) can help.

The following foods are also known to thicken ostomy output:

  • Starchy foods like pasta, potatoes, rice, white bread
  • Crackers
  • Potato chips
  • Applesauce
  • Bananas (especially when underripe and without spots)
  • Nut butters (peanut, almond, sunflower seed, etc)
  • Oatmeal

Most of these foods can be considered healthy, although don’t depend too much on the white bread, white pasta or chips if you don’t need to. I remember one fellow I spent a hospital room with had to consume several bags of potato chips plus Imodium to slow his output down because of his short bowel.

Gelling agents

A popular choice among ostomates is to use gelling agents in their pouch. These can come in tablets, powder, capsules (usually made with animal ingredients) or sachets, but they all work in a very similar fashion: Add the gelling product to your pouch as directed and it will thicken up when it comes in contact with your output. Here’s a demo of how gelling products work:

I’ve reviewed the ConvaTec Diamonds sachets, but I’ve also tried other products and they generally work well. You should be able to get samples to try.

Here’s a video of the Diamonds sachets in action:

Anti-Diarrheal Medication

Many ostomates will be told by their doctor or stoma nurse to take a product like Imodium to slow down their output. I would personally try this last if all other options failed, however, if you have a very high-output stoma which is causing ongoing nutritional problems or dehydration, this might be an option you’ll want to try until things get stabilized.

Fibre Supplements

This is not an option I’d recommend, nor is it something that your doctor is likely to recommend either. There are fibre supplements which can bulk up stool but they carry a risk of causing a bowel obstruction too. Do not try this unless explicitly told by your doctor.

Guar Gum

Guar gum is made from guar beans, but it’s been used as a thickening agent in various products for quite some time. There are claims that it has eight times the water-thickening effect compared to cornstarch, which is pretty impressive!

As a supplement, this often comes in tablets, but you should consult with your doctor to see if it’s a good option for you. Like fibre supplements, there’s a risk of slowing things down too much.

Consider Using a High-Output Appliance

If you find that your liquid output is difficult to manage when you’re wearing a traditional ostomy pouch, consider a high-output appliance.

These styles of pouches have larger capacities and are designed to better manage liquid output.

Coloplast Sensura mio high output click front
Front of the two-piece high-output appliance.

The product in the photo above is one of Coloplast’s high-output appliances. I did an overview of them HERE, and it may be an option worth considering.

Closing Thoughts

Some ostomates don’t mind liquid or loose output, like my IBD blogger friend and ostomate, Marisa from the blog JournalingIBD (a.k.a Keeping Things Inside is Bad for My Health). But if you’re one of the people who find liquid output to be problematic, then I hope the suggestions listed will come in handy.  In addition to the tips included above, you may also want to try using barrier rings or moldable wafers to help prevent liquid output from leaking under your appliance.

QUESTION: What do you do to thicken your output?
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Member

Hi Dawn, you have adopted a great approach to help yer Mom and others as well. I wish you all the best

Member
Sarah

I have had my ileostomy since the beginning of December. I had a hysterectomy and the surgeon perforated my bowel, unbeknownst to me. I didn’t show any signs until about 4 days post surgery. By that time I was so septic I had stool all the way up in my mouth. Needless to say, I had to have massive abdominal surgery and a loop ileostomy put into place. I was in a coma for 3 days and the hospital for almost the whole month of December, which I barely have any recollection of. Getting to my point: for the last… Read more »

Guest
Betty O'Melia

I got a colostomy 15 years ago due to anal cancer. I had 35 radiation treatments and 3 rounds of chemo. No problems until last year. Had an emergecy surgery for a low bowel obstruction. Didn’t fix it or it happened again. I ended up using nutritutional supplemants thru a pic line and had another surgery 6 months after the first one. At that surgery they took out even more of my intestines. My stool have always been loose and I had a left decending ostomy. After the surgeries it was worse. Now I seem to have soft and liquid… Read more »

Guest
Carmen

You can find some products to stick on your bags and take the gas out. air release vent for ostomy pouch. Online exprés medical supply, inc.
That are great. You will find great product there.

Member
Paula

I do not know if I am a special case or not. My doctor’s tell me I am special. I have trouble with watery output all the time and dehydration. I have more than short bowel syndrome. I was diagnosed with colon cancer in June 2016. They did surgery in October 2016 and removed the last 3 inches of my colon and put an ileostomy in. Due to prior surgery in 2004 I have less than 8 ft of small bowel and I has 3 inches of colon. The doctor put me on Lopramide and Tincture Opiate to try and… Read more »

Member
Claire E Bennett

Bad leaks since J pouch surgery. inner ring helps a bit. Brands? food choice no help. awful itching and burn on burned skin.

Member
Claire E Bennett

Eaken site doesn’t work, wanted sample gel.

Guest
Christine

HI, my mum had an ileostomy 15 months ago.She has a permanent watery out put.She doesn’t eat well and has to take 2 ensure compact drinks [600 cals] a day.She takes immodium up to 16 capsules a day to no avail.She tends to be getting a lot of leaks or the bag bursting.She also gets lots of wind. Do you think the acid in the output could cause a weakness in the bags? She’s 84 and is hopeful it can be reversed but she is not strong enough yet in my opinion.

Member

Christine….I too am a 60 Yr. old Lady going thru some of the same things. I have had my bag since 2009 . I have learned that we really have to take extra time to allow for care of our bag system. Every time I tinkle, I empty my bag, every time I empty my bag in between tinkleing I tinkle! I get up on average once a night to empty my bag as my output is also atery and I wonder if the liquid gets into the mouth of the hole we cut in our bag and the acid… Read more »

Guest
Dawn

Hi Christine, My mom as well has had an ileostomy since August 2017. She was between the hospital and rehabs from 8/17 until 2/18, when she finally came home. This has been the ostomy from hell – leaking up to 5 times a day while she was in the hospital and rehabs, with trained people changing the bag! My sister and I took over, not allowing anyone to touch the bag except us because her poor skin was blood raw from all of the acid and changes. She was on 2 ‘stool thickeners’ which added up to 360 pills a… Read more »

Member

Christine…In regards to your mom. When I became so ill I could not absorb vitamins or nutrients at all, my doctors had me drinking the same drinks your mom is drinking. They said it does not happen often but in my case it did. The “drinks” were giving me vicious diarrhea. I was always changing my bag. At least 8 times a day. My skin suffered badly. I had no appetite during that time and being hospitalized for 13 1/2 months, I was on a pic-line and those yellow fluid bags full of calories and vitamins and such. When I… Read more »

Member
Brenda

Eric I can’t thank you enough for all your videos and for the work you do! I suffered from UC for 17 years, tried every medication, infusion, injection, they have and nothing has worked for me. In August I had an emergency colectomy and permanent ileostomy. I woke up from surgery and had no idea what it was or what to do. I knew nothing and was not at all prepared. However I did know my pain was gone and replaced by hope. I got my life back! I am doing things and going places I haven’t been able to… Read more »

Member

Eric, I deal with a lot of muscle spasms and pain due to the Fibromyalgia 18/18. If you re not sure about theFM thing, there are 18 trigger points qused when diagnosing a patient with this muscle and nerve problem. 18 is as high as the scale goes. I was one of the first diagnosed with this when it first came about . The rhuematologist , when I was told what was going on with my body and tht there was a name for it besides yuppy flu and such insulting diagnoses, handed me the kleenix bov because I could… Read more »

Member

I think you may have the wrong person or I dded something in the wrong place…sorry, I avoid oatmeal unless I am growly hungry and need a snack at night to feel full so I can sleep. In the cae of which, I then will eat and cook only about a 1/4 cup of oats nd drink a big gladss of milk to go with it.

Member
Linda

Excellent video and information!! Many thanks! However, I got so jealous hearing about you eating oatmeal!! I love it but not long after eating it, the gas and high output begins so I stopped eating it for a while and tried again and the same issue. I did use a little bit of milk with it – about 1/4 cup. Tried without mik, same result :( And gas is frequently an issue, no matter what I eat! I’m getting up at least 2-3 times during the night and feel homebound during the day. And I’ve had my colostomy for 7… Read more »

Member
Ed Brickfield

I was operated on just two weeks ago and I have to empty my bag every hour except at night and then when I wake it is nearly bursting full. I have an ileostomy with crohns. I am taking two imodium in the morning and two at night and one before each large meal. Can you tell me what I may be doing wrong? I feel like a prisoner in my home as I have to drain bag every hour. My output is well over 1,000 per day.

Guest
Paulette Stamp

I was diverted from my j-pouch to a permanent ileostomy 4 months ago. I won’t be going back to my j-pouch in the future. I wasn’t mentally prepared for that big surgery. Now I wish I’d had it removed. I have been wrestling with my output from day one. In the beginning it was nice and thick but I think that was due to the 3 hours my surgeon spent lysing my adhesions during the surgery. I think they were sluggish or something because as I recovered my output increased. I have had a problem staying hydrated ever since I… Read more »

Guest
Joyce

Hi, thanks for you r videos, they are very helpful. I have high output ileostomy. My stoma is quite low to the skin. My nurse recommended a moldable convex insert. I am trying it, but what happens is after a day and a half, since it designed to “swell” up around the stoma to prevent leaks, it seams to swell up so good as to make the opening in the insert and wafer smaller. Then, the output must go somewhere, so it starts seeping through the wafer.Any suggestions? Perhaps mold the opening larger when I apply it? But then it… Read more »

Guest
don

I have a very high output yet I also suffer with my kidneys so I have to drink lots but this is affecting my liquid stoma output.

Guest
Cathi

This is wonderful information. Thank You

Guest

Thanks for this! Really useful information.