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.
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:
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
- 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.
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.
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:
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
- Potato chips
- Bananas (especially when underripe and without spots)
- Nut butters (peanut, almond, sunflower seed, etc)
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.
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:
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.
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 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.
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.
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.