Output from an ileostomy is generally liquid or loose, but some of us have thick ostomy output which can be difficult to manage. Colostomates also tend to have thicker output, but it’s generally drier, formed and far less frequent.
Because I have an ileostomy, I’ll be focusing on ways in which I’ve handled thick output. These may or may not work if you have a colostomy (or you may not have the same challenges).
Causes of Thick Output
There can be several factors which can thicken your output. Sometimes they are intended, but other times they may be a result of factors that you have little control over. Some of the most common reasons are listed below:
It’s no surprise that the foods and beverages you consume will have an impact on your output.
Here are some foods that tend to thicken ileostomy output:
- Starchy foods like white rice, potatoes, pasta.
- Processed foods like white bread, potato chips, crackers.
- Nut butter (peanut, almond, etc.).
- Bananas (I find them to be especially more thickening when they are under-ripe).
- Non-vegan foods like milk, cheese, marshmallows.
It’s not only the type of food but also the quantity consumed that can make a difference.
Medication, Supplements, OTC drugs
Some medications we take can also affect the speed at which our food passes through our system. Some ostomates use Imodium to intentionally slow down their output while others may use fiber supplements in the form of stool bulking agents like Metamucil. Be sure to let your doctor know if you’re taking anything like these.
When we don’t drink enough fluids, little water passes through our digestive system and the result can be thicker output. Some ostomates reduce their fluid intake on purpose, but this isn’t recommended and can increase the risk of dehydration.
Problems Caused by Thick Output
Thick output may sometimes be desired by some ostomates, as it can reduce the risk of leaks or premature wafer erosion, but there are a few drawbacks as well:
- can cause “pancaking“, which means stool gets stuck around your stoma and doesn’t drop down to the bottom of the pouch.
- can put pressure on the pouch causing it to come off in some cases (more of a problem at night).
- can increase the chance of blockages if things are too thick and slow.
- can make it difficult to empty or clean your pouch.
- can make wearing an ostomy wrap a bit uncomfortable.
- can make some liquid pouch deodorants more difficult to work.
Ways of Dealing With Thick Output
Fortunately, there are several ways in which you can remedy thick output or at least make it more manageable. Here are several that I’ve found to work:
Some foods and beverages can help loosen up your output. You may have to experiment with a few to find one that works. Here are a few that have been known to work in a majority of ostomates:
- Fruit juices (especially prune, apple, and/or grape)
- Coconut water
- Sports drinks
- Warm water
- Fruits (canned, cooked or raw)
- Artificially sweetened drinks.
Prune juice works really well for me, and it’s a great source of potassium. If I only want to loosen my output, then I’ll have about a cup worth of prune juice; if I want to really flush out my system, then I’ll have about a liter worth and simply wait about an hour. I’m not a coffee drinker, but coffee is often the culprit when an ostomate complains of loose output. You don’t have to chug a bunch of these liquids at once; simply having 1/3 – 1/2 cup at a time and throughout the day is enough to keep things moving.
I don’t recommend the use of artificial sweeteners as they are known to cause more harm than good.
You can also reduce or eliminate the foods which that are known to thicken output (I posted a list earlier in the article). I try not to limit healthy foods like bananas or potatoes, but if you drink cow’s milk or consume cheese, it might be worth eliminating them from your diet and replacing them with better plant-based alternatives (soy milk, almond milk, hemp milk, oat milk, coconut milk, etc.).
Also, try eating smaller meals more frequently throughout the day. This may not be an option for you, but it’s something to consider if you’ve had trouble with thicker output.
Ostomates need to pay particular attention to their hydration, especially if they have an ileostomy since the colon is what would normally reabsorb fluid back into the body. Over time, the small intestine adapts and will compensate for some of the fluid loss, but it’s still important to drink enough water (and fluids in general) to keep hydrated.
Drinking throughout the day, or consuming water-rich foods like watermelon, tomatoes, or cucumber will help keep your hydration in check, but it will also aid in loosening your output. If you find that certain meals (i.e. starchy meals) cause your output to thicken too much, consider drinking water with your meal.
Lubricating your pouch
This is an easy option that doesn’t require any modification of your diet. It’s important to note that lubrication your pouch won’t loosen your output, but it will make emptying your pouch a little easier. I’ve reviewed several Lubricating pouch deodorants already, so feel free to check them out or try samples of a product that you have easy access to. A bonus with these products is that they tend to also eliminate pouch odors!
Some people will opt for do-it-yourself solutions, rather than purchase ostomy pouch lubricants (likely because of costs). I do caution on the use of some of these methods, as they may have unintended consequences to your pouches wear-time. There’s also a risk of these products being absorbed into your body through your stoma. If you are adventurous, here are few ideas that I’ve come across through various ostomy forums:
- Cooking oil, including olive oil, vegetable oil, canola oil, etc. (add several drops to your pouch)
- Pam cooking spray
- KY-Jelly (or other personal lubricants)
- Baby oil
- Essential oils (be careful with this one, you may burn the lining of your stoma!)
- Coconut oil (is solid at room temperature and liquefies in your pouch)
Just Add Water!
If pouch lubricants aren’t working well, you can try adding a bit of water to the inside of your pouch.
I’ve experimented with approximately 1 tablespoon worth of water, and it helps to losen up thicker stool, making it easier to manage.
Of course, you can add more or less water until you find a sweet spot that works for you!
An advantage of using water instead of a lubricating deodorant is that it’s cheaper, but also less viscous which means it will flow better and mix easier with your stool.
Talk to your doctor or pharmacist about medication or laxatives
If you are on medication or painkillers that are known to slow down and thicken your output, you might want to see if there are other alternatives that you could use instead. Also, don’t use products like Imodium, laxatives or fiber supplements without your doctor’s knowledge.
Some people use laxatives or magnesium supplements (i.e. Natural Calm) to help with thick stools. You shouldn’t be taking either without your doctor’s knowledge as they may cause electrolyte imbalance and other potential complications.
- Wear an ostomy accessory belt overnight to give you a little extra support if your output has a tendency to push your pouch out.
- Avoid wearing ostomy wraps or anything that might put pressure on your stoma if you have thick output. Wearing them increases the chance of pancaking and leaks.
- Always try to seek guidance from your ostomy nurse. While they may offer the same suggestions, they can also offer you a solution based on your personal circumstances.
While there are many reasons why your output could be thick, there are just as many solutions you can try to make life a little easier. Each one of us is unique, so experiment to see which suggestion works best for you. Good luck!