If you’re an ileostomate who takes medication or dietary supplements this information will be important.

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One of the lesser known issues that most ileostomy face is the fact that some medications are designed to be “delayed” after ingestion, so they may not properly absorb into our gut; these end up passing through our system and lose their effectiveness.

If you were on medication before having your ostomy surgery, it’s important to talk to your doctor and/or pharmacist to find out if your medication will need to be switched or compounded differently.

For certain products like dietary supplements, vitamins or minerals, you can often find alternatives to these products in the form of drops, sublingual tablets, nasal sprays, skin patches, injections, or liquid forms.

For the most part supplements don’t tend to be delay-release, however, some of them are, and it’s best that you check the packaging or ask your pharmacist to make sure that the product is right for you.

The last thing you want is to have pills in your ostomy bag when they should be absorbing in your gut!

I do want to mention something called a “ghost pill”, which describes the casing on some medication that ends up in your stool (SOURCE).  

Seeing a “ghost pill” doesn’t mean the medication wasn’t absorbed, so it shouldn’t cause you to be alarmed, but if you do have an ileostomy or have had sections of your small bowel removed, it’s best to talk to your pharmacist to confirm that there’s no reason to panic.

For people, taking medication or supplements with food might be a way to slow down the transit time and give it enough time to absorb, but it also depends on the type of pill that you’re taking and whether it’s intended to be taken with food or not.  

Some medication should be taken without food, so follow the instructions given by your pharmacy.

So if you have concerns about whether your medication or supplements are going to work with your ostomy check with your pharmacist don’t guess.

References

• Why do we have to take some medications with food? (Science Alert): http://www.sciencealert.com/why-do-we-take-some-medications-with-food
• Prescribing for a patient with reduced intestinal length (Australian Prescriber: http://www.australianprescriber.com/magazine/36/4/136/8
• Tungaraza TE, Talapan-Manikoth P, Jenkins R. Curse of the ghost pills: the role of oral controlled-release formulations in the passage of empty intact shells in faeces. Two case reports and a literature review relevant to psychiatry.Therapeutic Advances in Drug Safety. 2013;4(2):63-71. doi:10.1177/2042098612474681.