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.
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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 under ripe 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:
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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.
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.
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.
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?
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 couple days I have been having very loose output, which is not usual for me. The last two nights I have had to get up 3-4 times to empty my bag. Yesterday it thickened back up a bit but today it hasn’t. I take lomotil twice a day and drink premium protein every morning. I have tried the applesauce and bread trick and they may have helped a bit but I am still dealing with a ton of output as of now. I called my surgeons nurse and she suggested increasing my lomotil and to take a fiber supplement, which I went and got. I told her that I could see my stoma and it was also descending at times. There is also a lot of erosion on my wafer now. She assured me it was ok, that this was common. Of course it was my docs day off so she will have to fill her in in the morning. I just changed my bag yesterday, which is something that causes me great anxiety. The nurse suggested I change it again but 1) I can’t get my stoma to not be active and 2) I am worried about what it will do to my skin. I have no more adhesive removers, they come tomorrow. I do have stoma powder if I need. I am hoping this is a temporary problem and will clear up soon but how do I change a bag when my stoma is active and what about my skin. I have no support or anyone to talk to about it so I am hoping someone can reply. Thanks for listening.
Hi Sarah,
I think you’d find a lot of support and answers on my support forums: https://www.veganostomy.ca/community/
When my stoma is active and I need to do an appliance change I tend to do the following:
– I place a “kitchen catcher" bag off my pant waist so it can collect anything that comes out of my stoma.
– I wrap my stoma in gauze so it doesn’t wet the skin around it while I’m prepping the wafer.
This article and the accompanying video may be helpful: https://www.veganostomy.ca/how-to-change-an-ostomy-appliance-ostomy-tip/
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 stool but not runny. It is very loose and soft. I have lots of gas and have had to change my bag more often and have had gas blow outs. This is all new for me after the surgeries. I use the eakin seal but have a hard time often getting things to stick since I have a scar that just about closes us my navel. Any ideas on the gas production and type of stool
Hi Betty,
For gas, I would strongly suggest keeping a food diary to see if any specific foods make it worse, then either reduce or eliminate those foods.
I have other tips and suggestions in this article: https://www.veganostomy.ca/ostomy-pouch-ballooning/
The thickness of your stool may very well be “normal" considering you’ve lost some intestines. You may be able to thicken things up using dietary approaches (i.e. increase starchy foods), but it could also be related to medication (if any) you may still be on.
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.
I’m very sorry 😞 you have to go through all that. I hope you have some peace and safe. Pray for your happiness
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 control the liquid stools. It works so so. Besides the liquid output I also suffer from gas all the time which helps with the bag blows. It does not matter what I eat or do not eat it is a constant problem. We have been trying to find better bags but so far no luck with helping the situation. I had one episode where I went through 5bags in one day. Any suggestions?
Short Bowel Syndrome will nearly always create high-output, liquid stool, unfortunately.
I would suggest contacting an organization who supports people with SBS to see if they have any strategies that might help.
I don’t know what appliances or products you’ve tried, but many brands do offer high-output stoma bags that might help to at least manage the output. My last article talks about one from Coloplast: https://www.veganostomy.ca/sensura-mio-high-output/
Thank you. I actually have an appointment with the ostomy Clinic on Monday. They are trying to find some stuff and are going to try and help my constant burn rash. I will let you know what I find out. Again thank you for your reply.
My poor sister has the same problem and is now pretty much home bound because of it. She has no colon and very little small intestine left. She had the 1st illeostomy done in Dec. which at that time made her a Jpouch for later use. In April, the wen in to do reversal and the jpouch surgery was found to be a fail so they did the 2nd ostomy which is a nightmare from hell. She has a pic line and has to hook up to iv fluids daily to get a little hydration. Her ostomy runs constantly so between that and the pic line that can’t get wet, she hasnt bathed in months and says she is a freak. She is very ocd and NEAT/clean freak. This has caused her mental state to take a HUGE nose dive. Just no hope and no doctor wants to mess with her any longer. Oh did I say her problems began in 2007 when she had a botched gastric bypass and has had 17 surgeries since and 15 were life saving bowel obstruction surgeries. She is 54. 😭
Hi Pam, I’m so sorry to hear that your sister has been struggling. I hope she can find some support or solutions through her Healthcare team.
It sounds like she’s been through so much for so long.
w. But it is your decision.Hi Pam, I went through this for a good year–now into year 4. I go for I.V. fluids for dehydration also- IT is a long haul.. And I am the same way with “the clean thing" There are many medications out there, that may help her. I am now on Gattex injections. IT is new. helping me. But have some issues. If u go to “Marcie" member and read-she may feel at home about it. Not alone. Your health team or find another one–Which I have had to do also–Not every medications works for the same person- but start a study so you and Pam get to know what is going on with some of these — Some medications like Gattex took me a whole year of study- it is necessary to understand as much as u can so your questions are answered correctly. She may come out of this on her own. many do !! I emptied a good 30 times a day the first year. Now? on a good day 10-15. I advise sipping with a BIG WIDE straw of fluids. You get more into you than you think !! Do NOT drink just water!! All water washes out the salts in our bodies = dehydration too!.. I know what she is going through.. My life is going to infusion3 x a week.. And pray No E.R. visits during the weekend. I had a pic line also did this at home too- But on medicare and they pay in full for me to go to infusion. I now have a power port. So much to learn about our bodies and what they took out and what is left and what to do. I bathed with a pic line. Just if you sit nicely and soak.. Got to wrap it up well. Just have to be gentle with yourself. What I did was, after wrapping u the pic line- I tied a string at the middle and out it around my neck– Use no soap, or oils, At one time before the nurse came that week, i did this and added some salts to my bath- it was nice. and she cleaned it real good. So try this before the nurse comes in. Now the stomach tube? no- cant bath with that. had that too. But ask the nurse first. she may have something else to add to this trick of bathing in the tub. If u want to P.M. that will be fine. OR go to the lounge– I will look for you there also. She can get out– Grab a coffee can and go____ We r al in the same boat for travel– but some of us r in a different boat like Pam and I. Just got to find a way around it. She will enjoy her bath—— Also after a bath-change the pouch.. Best. Marcie.
Pam——–go to short bowel support group-she falls into this catorgory…….. I do also even tho I have my full small bowel. Go to Gattex support group also- that is an education also.. Pam will feel at home there also.. There is education out there and it is a must to know. Best to you both and she is lucky to have a sister that is in her corner. I was alone…… except this blog thank god!!! And other supports areas too- it is a help– IT is what we need.. We find it we learn it..
Paula I know this was posted a year ago but my dad has a very similar situation I was wondering if you are still suffering with dehydration or if you were able to find the right system of meds to control it?
i use hollister 11403 2 piece skin barrier with matching bag/hardly ever have leaks now
Bad leaks since J pouch surgery. inner ring helps a bit. Brands? food choice no help. awful itching and burn on burned skin.
If you can get them, the Coloplast protective rings are very good. Make sure it’s the Protective Ring, not their moldable rings. Some countries don’t carry them, unfortunately.
Eaken site doesn’t work, wanted sample gel.
It’s working fine for me. Try : https://www.eakin.eu/products/