Loose Stools and Increased Output Some foods will loosen your stools and can increase output after you eat them. If you believe a certain food has caused a change in your stools, do not eat it for a while, and then try again. These foods may make your stools looser: Milk, fruit juice, and raw fruits and vegetables.
In order to loosen your stoma output to prevent pancaking, you can try to drink prune or grapefruit juice. Also, you should limit food that thickens your output like bananas.
Make sure that you are drinking plenty of fluids – this can help to soften the stool and reduce any risk of pancaking. Water is the best for hydrating, however, some fruit juices such as prune, apple and grape are effective at loosening stool. Make sure that you eat plenty of fibre.
Normal output for an ileostomy
Over time, the small bowel gradually adapts and absorbs more water so your stoma output should thicken up (to a porridge-like consistency) and reduce to around 400-800ml per 24 hours.
Ostomy pancaking is when stool overflows from the stoma. It leaves a thick, pancake-like mass of stool at the top of the bag. This can be unexpected and unpleasant, but there are a few things you can do to help prevent this from happening.
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.
What is pancaking? • Pancaking happens when there is a vacuum in the stoma bag and the bag sticks together. This stops the output from dropping to the bottom of the bag and can block the filter. There is then a risk that the pouch will be pushed off the abdomen and cause a leak.
❒ Making changes to the types of foods you eat and fluids you drink, and when you eat and drink will help control your stool output.
A snug fit is key
When it comes to fitting your ostomy baseplate, the hole should be cut so that it fits the diameter and shape of your stoma exactly. A good rule is 'not too loose, not too tight'.
Try several different body positions, such as a knee-chest position, or lie on the side of your stoma with knees bent, as it might help move the blockage forward. Massage the abdominal area and the area around your stoma. Most food blockages occur just below the stoma and this may help dislodge the blockage.
Try to include a low fibre starchy food (bread, potatoes, pasta, rice) and protein food (peanut butter, eggs, meat, fish, cheese) at each meal and snack. This will help to slow down the digestion of food through the bowel allowing more time for your body to digest and absorb.
Average ileostomy output ranges from 800 - 1,200 milliliters (mL) or 3 - 5 cups per day. Right after surgery, output may be watery. During the first few weeks after surgery the output should thicken to the consistency of applesauce. It is normal to empty your ileostomy bag 6-8 times per day when it is half full.
What is a high stoma output? If your stoma produces more than 1L of fluid per day, then it is considered to have a high output and you may be of risk of getting dehydration. As well as obtaining nutrients from food, the bowel has an important role in absorbing fluid and electrolytes (salts).
This is usually due to the filter becoming wet or blocked from stoma output.
Foods that are reported to help thicken the stoma output include apple sauce, bananas, buttermilk, cheese, marshmallows, jelly babies, (boiled) milk, noodles, smooth creamy peanut butter, rice, tapioca pudding, toast, potatoes and yoghurt.
Most stoma pouches have charcoal filters built into the bag. These allow the wind to be released. However, if the filter capacity cannot handle the amount of wind produced, or if the filter has become wet or blocked by the stoma output, ballooning can occur.
Not enough fiber in the diet. Irritable bowel syndrome. Ignoring the urge to have a bowel movement. Changes in habits or lifestyle, such as travel, pregnancy, and old age.
Permanent ileostomy – the small intestine cannot be reconnected and closed back together. Regardless of whether the rectum has been removed, you may feel the need to have a bowel movement (phantom sensation). This is normal and should ease with time.
To help prevent the pancaking, the stoma nurses will suggest using a small amount of baby oil or olive oil within the pouch that can help drop the contents into the pouch, and also using rolled-up toilet tissue can stop the pouch vacuuming against the stoma.
A Parastomal Hernia (Stoma Hernia) is a weakness or protrusion in the muscle wall of the abdomen at the site of a Stoma which allows the abdominal contents to bulge out. The bulge often protrudes more when coughing or undertaking physical activity.