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

Dealing with liquid output
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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

https://youtu.be/M97eBxJpV2s

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:

http://www.youtube.com/watch?v=pOALPqnrc_A&feature=youtu.be

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.

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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23 thoughts on “Dealing with liquid ostomy output – OSTOMY TIPS (w/ video)

  1. 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 not believe there was a name for all the pain I had nd the lack of sleep and all I was going thru. She was amazing. Comforted me as needed! At any rate, I have to drink at least thee large glsses of Homogenized milk a day s the short bowel thing affects me also. We live in the Okanagan, Canadas only desert, we had a terribly hot and smokey summer, so much so tht it affected our gardens badly and the way we felt the heat. On the rare day the heat was actually felt from the Sun, we noticed a difference rather then the way it felt when we had smokey days from the massive amounts of forest fires around us. The heat on days with smoke was like being in an oven, verses the days without smoke when the heat wasmore direct from the sunshine. Does that make sence? At any rate, between working in the garden and hot days, I realized tht I was hydrating after the work, not so much as during the work. I did not want to have to clean up from garden to go in the house and use the toilet, thus resulting in less frequent visits to the can, or Ralph, the big while telephone! Now that you have a bit of history…have you ever noticed that taking Mgnesium, 250mg half a tablet with meals helps prevent blockages as to which I had three of this summer. In my healing time I pondered fequently what I had done differently to end up with blockages after 8 years without. Then I realized that not eating regularly, small meals, I always chew my food tons, and not drinking the same as in winter may have caused the blockages. I refused NGs due to a past zigzagging experience, I chose t [puke my guts out rather then have then drained…which led to more nausea but I really did not care. Anyways, the other thing I noticed was that because I wastoo hot to eat, I had lso not been taking the magnesium and when I started again, my gut returned to normal. Now I watch very carefully all over again about wht and when I eat something. Because I find useing public washrooms can be a some what horrid experience, I choose not to eat the morning I have to go into town for several errands and running around, because of the public washroom thing…what is it with people who do not respect the use of a public facility anyways…wake up and leave the place as clean as you find it or go home!!! My hugest question is about the magnesium… I have a very short gut and will often find some meds in my bag, and also is it bad to do the Magnesium before meals. When I do use the magnesium, it has kept my stool looser and I do not get mudpies around my stoma thus preventing material getting under the plate and burning the skin and also prevents blockages. Have you any info. on this matter?
    I love what you re doing here so much, you have made it so we can talk and ask about something so personal without embarasment and also it helps others who may not be able to ask these questions or are in search of any info. to elp them. Thank you so very much and then some. You are the first sight I searched for when I was desperate to have answers and I read as much as I can on what you write. Your amazing!

    Sincerely,

    Linda

    • 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.

    • Hi Linda,

      I’ve used magnesium before, but not to prevent blockages. I do believe it acts as a laxative,however, dosing and timing should be discussed with your pharmacist. You should also mention that you’re seeing meds in your bag – they may be able to give you a version of the meds that dissolves further up in the gut.

      Good luck.

  2. 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 years!

          • Yes. In 1974 I succumbed to self mutilation (anything to be thin!) and had an ileojenunal bypass for weight loss which resulted in a large portion of small bowel to be surgically bypassed. Lost 100 lbs fairly quickly, but gained mainy problems due to malabsorption and ultimately the weight back as well. I’ve had diahrrea my whole adult life and thus the same holds true with the ostomy. But I still find the oatmeal a mystery!! That procedure for weight loss was so brutal and was short lived. Many died from it.

            • Ah, I see. I’m sorry that you’ve had to go through all that, including the persistent issues that followed. I don’t think there’s any way around making oatmeal work for you, as I’m sure it has more to do with how your insides have been rearranged than the oatmeal itself. Are you still able to enjoy it once in a while as a treat?

              Warm regards,

              Eric Polsinelli *VeganOstomy Blog: IBD, ostomy, veganism, life* https://www.veganostomy.ca

              *Visit the new VeganOstomy Community Forums!
              *

              Support me and my efforts: https://www.veganostomy.ca/support/

  3. 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.

    • Hi Ed,

      Frequency and consistency of our output is really inconsistent in the first month or two. Usually, our output will be about equal to the volume of food and beverages we consume.

      A few things to consider :

      – your diet likely isn’t back to normal yet (you should get the OK at about the 4-6 week mark. Things will become more predictable after that point.
      – keeping a food diary could help you identify foods that increase your output.
      – check in your surgeon or stoma nurse about those hourly bathroom trips. Most ileostomates will empty their back 5-9 times a day, but there are many factors that can change this number.
      – starchy foods should help to slow your output down a bit more.

  4. 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 got the j-pouch 5 years ago and it’s worse now. Plus I have an uneven, flabby, abdomen from abdominal surgeries and getting a wafer to last longer than 2 days has happened once. My stoma nurse told me to start taking Loperamide, prescription Imodium, again. I added capsules of Metamucil into the mix too. I have had several obstruction/partial obstructions and appreciate your warning about Metamucil. I have not been taking the max dose of 8 Loperamide daily but really need it. I have to empty my bag too many times daily. I have continued using electrolyte tabs, no sugar, like NUUN or similar powders as well as highly concentrated electrolyte liquids to add to water. They help with dehydration but not as well as they did before my stoma. Do you or anyone else here know if they are affecting my output? This topic was what I really needed to read tonight. Thank you for all you share with us.

    • Hi Paulette,

      I’m so sorry that you’ve been having so many problems, and I know how frustrating a high-output stoma can be.

      I haven’t used the product that you’ve mentioned, but if it has no added sugar (and no artificial sweeteners), then it’s likely not increasing your output. If you go a few days without it, does the frequency of your output change?

      It may help to find a support group (online or off) that focuses on people with short bowel syndrome, as they’d be dealing with very similar issues (high-output stoma), and may be able to offer you more tips.

      Good luck!

      Eric

      • Thank you Eric,
        I’m in many online support groups and they have been fantastic. I’ve even watched many u-tubes on things such as how to empty our bags while sitting on the toilet and how to keep everything dry or not to wet when showering and bathing – etc. I appreciate your help here as nowhere did I find such specific helpful information.

        I went off of Metamucil caplets and ate oatmeal for 2 days – like substituting. Today I am back to adding a 3 vs the 6 serving size caplets. It is easier for me to swallow the caplets and as we are to take in less water than people with colon’s, it is easier for me to take them. I am going to continue with oatmeal and try adding the generic metamucil caplets until I figure how many. I was just doing it willy nilly so am more deliberate.

        Thank you for responding and I will try groups with short bowel syndrome.

  5. 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 may not cover close enough to the stoma to protect the skin. Any answers to my issue?

  6. 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.

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