You may be given Loperamide (Immodium) and/or Codeine Phosphate. These help reduce the volume of fluid in your stoma/fistula. They are usually taken 4 times a day. Try to take them ½ -1 hour before meals and before bedtime.
If your stoma output is high add extra salt to meals and opt for salty food such as crisps, marmite, salted biscuits, smoked meat or fish, Bovril, stock cubes etc. this will help reabsorb some fluid. Try to avoid drinking before, with, or 60 minutes after a meal. Restrict fluid intake to 500-1000ml a day.
The first drug of choice to reduce stoma output is loperamide. Loperamide is important in the management of colostomies or ileostomies, to reduce the volume of effluent and is preferred to opiate drugs (for example, codeine phosphate) as it is not sedative, addictive, and does not cause fat malabsorption.
If you normally eat later in the evening or soon before you go to bed, this could be increasing your night time output. If this sounds like you, then varying your meal times could help to reduce stoma bag leakages during the night as your stoma is less active.
Foods and drinks that can increase the wind passed by your stoma include beans, beer, broccoli, brussel sprouts, cabbage, carbonated drinks, cauliflower, cucumber, eggs, fruit, green vegetables, mushrooms, nuts, onions, peas, spinach, sweet corn, fatty foods (pan- fried or deep-fried foods) and rich creamy foods.
Protein foods include meat, fish, cheese, peanut butter and eggs. through your intestines giving your body more time to digest them. Add extra salt to your meals or include salty snacks such as crackers, chips or cheezies. Helps you to absorb fluids better.
Ostomy output of more than 1,500 mL, or about 6 cups of stool in 24 hours, is high ostomy output. High ostomy output can put you at risk for dehydration, poor nutrient absorption, and weight loss. Measure and log output (urine and ostomy). Bring log to your clinic visit.
Aim to eat your main meal before 7pm in the evening to allow your stoma to do all the work before you settle for bed. Another option is to eat a lighter meal of an evening and the heavier meal mid-day as this will help with the output slow down overnight.
Occasionally the high output stoma will continue – this is normally because very large amounts of bowel have been removed, resulting in the bowel being shortened. When it is shortened below 2 meters there may not be enough bowel left to have normal bowel function.
Most fluid is absorbed in the lower bowel. If this has been removed or is disconnected from the upper bowel by a stoma, you are more likely to experience a high output from your stoma. A high stoma output can lead to poor absorption of nutrients, salts and fluids which can lead to dehydration and weight loss.
People who have had descending or sigmoid colostomies, leaving much of their colon intact, may be able to predict when they will have a bowel movement and only wear a pouch during those times. They also may be able to induce regular bowel movements through a process called colostomy irrigation.
Colostomy irrigation
Irrigation is an alternative to wearing a colostomy appliance. It involves washing out your colon with water either every day or every other day.
You might want to choose different candies or ask your doctor for different medications. Certain medications such as Loperamide, Diamode, Ultra A-D, Imodium® A-D, and Questran can slow down output; check with your physician on dosage and frequency.
Diarrhoea (frequent loose watery output) can be caused by several factors, including illness, stress, diet and some medications.
What is pancaking? Pancaking is when a vacuum occurs in the stoma bag and the bag sticks together, preventing the contents from dropping to the bottom. Faeces remain at the top of the bag which can potentially block the filter, and the bag can also be forced off the body. This can happen with an ileostomy or colostomy.
Everyone needs daily exercise to stay healthy and for the body to function well. An ostomy should not keep you from exercising and playing sports. In fact, people with ostomies are distance runners, weight lifters, skiers, swimmers, and take part in most sports.
It normally takes about 6 to 8 weeks for the bowel to settle down after surgery. After this, most people can go back to eating the foods they used to eat before their operation. Your stoma nurse will give you advice about what you can eat and drink shortly after your operation and in the long term.
The best position to sleep in when you have a stoma is on your back, or on your side.
Ballooning occurs when your stoma bag blows up with wind. This is usually due to the filter becoming wet or blocked from stoma output. This can cause the bag to come away from the body. Please note: Stoma ballooning can happen with a colostomy or occasionally with an ileostomy.
The stomatal openings remain closed at night as photosynthesis is not conducted without sunlight. They are closed to prevent water loss via the stomatal pores. The gaseous exchange required at night doesn't occur via stomatal openings and is conducted by diffusion.
In emergency surgery a stoma may be a lifesaving procedure to control sepsis during the acute illness, this normally get reversed when the patient has fully recovered. Due to time constraints pre-operative counselling and planning are not possible especially when operating out of hours.
Skin irritation
This is the most frequently observed complication with all stoma types [2, 7, 12].
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.