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 typically 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).
Table of Contents
Video
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:
Diet
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).
- Applesauce.
- 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.
Dehydration
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:
Dietary considerations
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
- Coffee/tea
- Warm water
- Fruits (canned, cooked or raw)
- Artificially sweetened drinks.
- Wine
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.
Coffee can affect some people more than other, and many ostomates will report loose output when they drink it. Even though I’m not a big coffee drinker, I find that it has no effect on my 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.
Hydration
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 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 on 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 a 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.
Tips
- 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.
Closing Thoughts
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!
Hi Becky & welcome to VO! YOU’RE SAFE HERE & Have folks who understand & will share their stories if we think it will help you. But know we all welcome you here. No question or experience is a dumb one.
I have some things to tell you but its the end of a very tiring day for me & my eyes are giving my issues, but I’ll come back & chat with you. I’ve had very similar experiences starting at age 10 & want to share some with you what I think may help. Make tea or coffee bcuz I can get a bit long winded! Lolol!
There are ways to handle Doctors & GI’s that will help you thru appts, but i may need a bit more info to go on. Bavk in the late 70’s I nursed as obe of the first care aides in Geriatrics for a few years & came out of that knowing things the average person does not know. But, I do share them here if appropriate. My guts were wierd & very nasty too, so I and others here know it is not a smooth ride getting answers. Hang tight! Maybe if your comfy with it, start a new forum & introduce yourself & tell us a bit about yourself & how you came to have a stoma. I think you said Ileostomy. ,This will help get the replies that might help you too. If you have an appt. before I get back to you, as I need to rest my old eyes, take someone you trust with you right into the exam room. You’ll be very surprised at the difference in how you are listened to & treated. Tell whoever you take that you need them to back you up on everything you say even if they haven’t heard of all the private parts of your suffering & keep them there for the exam too
I’ll be back tomorrow if my old wacky eyes cooperate… lol!
Why my stoma not working all of a sudden used to get bag full morning now it needs waking up I drink well water peppermint tea and warm boiled water everyday then mid morning it there thick out put what would you advice scarry
For me, a single large biscuit of shredded wheat for breakfast is just the right amount of fiber to keep me regular. At times when I don’t eat properly, a non stimulant gentle stool softener works very well and overnight for me. Consult with your doctor or stoma nurse if the problem continues though!
Hello Susan and welcome to Vo! My first question is have you been eating regular meals and drinking the same amount of fluids every day as much as possible?? Any changes in your regular eating and drinking routine can give you changes in your output the next day and even as quickly as the same day.
I would suggest you drink extra fluids when you think there may be something changing in your output. Keep up with extra fluids and see if that helps. If you start to have any pain then you should see a doctor.
I have an ileostomy with short gut syndrome but still went thru a bad time of blockages. It does help us to give you the right side of tips if you share with us what type of an Ostomy you have.
Very helpful I go from thick to loose I eat starch to stop then I end up with thick then pancake I don’t feel I should have to set this like a baby 2years in can’t form a good life style. Will I ever I’m always worried. ?????
Hi Geri, I find that it helps to be consistent with what I eat to help avoid those swings between liquid output and thick output. It can certainly help to ease your mind when you are worried about what’s coming next. Try to balance out your meals throughout the day and see if it helps.
Geri, I find that a teaspoon of Metamucil in my cereal every morning helps with my output consistency. I also have to watch my fibre intake; I seem to be sensitive to fibre. Just a suggestion that works for me. Good luck.
Laurie
I feel the same way. 2 years and then found a parastomal hernia on CT in the ER. Didn’t look huge. Scheduled surgery for 2 weeks later. It got so bad my surgery got moved up. He said I had an abdomen full of hernias. I just knew fixing the hernias and moving my ikeostomy would help…it did for only 2 weeks then back to normal. I don’t eat starchy foods at all. I even buy expensive flour and sugar substitutes and rarely use those…just fir a craving every once in a while..surgeon decided maybe it was a digestion issue. Went to see a new agi Dr who wouldn’t entertain the idea or do any imaging. I asked for a barium study. I’ve never even had one. He was trying to put me on multiple IBS-C drugs…nope…the last Dr tried that…I did my own research the night before and suggested a motility disorder. He said well that could be it….do I have to be the d…
Dr here. He says 1 medicine we can try and guess what insurance won’t pay for it…not on my plan it’s not A PA ordeal even. So now I have to go through a patient assistance program to try to get it bc not working I don’t have $600 a month for medicine. Every record I have says I may actually have Chrons. Well nobody will do a study on my small intestine. The other problem I have is my ostomy swelling. If it’s swollen nothing goes through it. I had UC and it spread through the whole colon. Drugs stopped working and I am a surgical tech so I texted the colon surgeon and told her if it was back take it out. My GI Dr knew I did that before he even scored me. Lol. She had already said let me know what it says and already grabbed him at 5am telling him she better know asap. Still working with all those doctors for all those years…nobody knows. According to them all it’s rare to be constipated with an ikeostomy on a daily basis. Told me to eat more fiber and that made it 100 times worse. I’m at a lost. I can’t even blend carrots or potatoes and eat them. And then when. I do keep the many partial blockages I get dehydrated from my body trying to get it out. Ant win for losing. I asked my PCP to chexk my electrolytes and it was like pulling teeth. He finally did just to make me shut up…funny thing is he got to wipe the looking at me like I’m stupid off his face when they called the next day bc my labs were a mess and they needed to do more. I swear. Why don’t they make doctors like they use to. Use to on my old insurance I could ask for a lab or test and they knew I work in medicine and did it and would always find something. They were always amazed at how I was so in tune with my body. I hate this insurance.
Thank you for sharing, Becky. Sounds like an incredibly frustrating situation made worse because insurance isn’t helping.
It’s a common situation that so many people find themselves in, and I wish I had some solutions to share.
It also sounds like the doctor(s) you’ve seen have not been very cooperative, and in those cases I always suggest looking for another.
Good luck! I do hope you find some relief soon.
k
Eric, THANK YOU! That was perfect. I was going to say in my entry to squeeze the life out of the remaining center, but because I get eczema and the OJ burns it when wet by OJ, I just take the cutting board I used, grab a fork, jab the remains and slide the back of a spoon across the rest to get all those great vitamins. Eric, your so awesome! Does anyone else think Eric is awesome?