Ensure you drink enough fluid (at least 2 litres a day). Oral rehydration drinks can be useful. Have regular meals and eat a normal balanced diet. Separate your food and fluids at each main meal if you have a high or watery stoma output.
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.
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.
A large survey conducted in established ileostomy patients found the foods most known for causing watery output to be rhubarb, alcohol, fried fish, and fruits and vegetables, such as apples, beets, lettuce, and onions.
If the stool is loose and watery, it means that the bowel is moving too quickly. As a result, you will not be absorbing valuable nutrients from your food and may also become dehydrated. Loose stools may also increase the risk of leakage from the appliance which can lead to sore skin around the stoma.
What is a high output ostomy? A high output ostomy is when you have more than 2 litres (8 cups) of fluid from your ostomy in a 24 hour period. The output is usually very watery and needs to be emptied 8 to 10 times or more a day. The output may also be very difficult to pouch and often leaks.
This is usually due to the filter becoming wet or blocked from stoma output.
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.
Dehydration. Having an ileostomy makes it harder to stay hydrated. If you notice signs of dehydration such as fatigue, dry mouth or lots of poo coming out of your stoma, speak to your stoma nurse or another healthcare professional to get advice.
You may find that after your operation the output may be increased and it may be a fluid consistency. This will thicken to become a thick paste (toothpaste/ porridge consistency) in the following weeks as the rest of the bowel starts to take up more fluid than it used to.
Eat foods that thicken the stool such as: rice, pasta, cheese, bananas, applesauce, smooth peanut butter, pretzels, yogurt, and marshmallows. Drink 2 or 3 glasses of fluid that will replace electrolytes like sports drinks, fruit or vegetable juice and broth but limit these items.
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.
Bile that cannot be reabsorbed in the intestine can cause a yellow or green stool color, especially when diarrhea or rapid bowel action occurs.
Ascending colostomy.
This type of colostomy is done near the beginning of the large intestine. This means the stool is usually liquid, because very little water has been absorbed in the colon. This is a rare type of colostomy.
Some common complications of stoma include poor siting, parastomal hernia (PH), prolapse, retraction, ischemia/necrosis, peristomal dermatologic problems, mucocutaneous separation, and pyoderma gangrenosum. Each will be discussed separately in further detail.
Many people find that the volume of stool they empty from their stoma will vary from day to day. This is normal and will depend on what you eat and drink, medications and many other factors. A 'High Output' is generally considered to be over 1000ml (1 litre) in 24 hours.
Taking a Skin Break
Many people enjoy leaving their skin uncovered for 15 to 30 minutes after taking their pouching system off. This is called a skin break. Taking a skin break can help with irritation or keep it from happening. You can decide if you want to take a skin break.
Closed bags may need changing 1 to 3 times a day. There are also drainable bags that need to be replaced every 2 or 3 days. These may be suitable for people who have particularly loose poos.
When the skin becomes infected it can start to look inflamed and the infection tends to cause some swelling around your stoma. The skin colour often changes from a healthy pink/reddish colour, to pale, bluish purple or even black. If there is any discharge of blood or pus this is often a definitive sign of infection.
Eat some salty foods, such as pretzels, soup, and sports drinks. Eat some high potassium foods, such as bananas, potatoes without the skin, and fruit juices.
The most common causes of a loose poop are things like viruses, food allergies and medication side effects. Some chronic conditions can, too: Crohn's disease. Ulcerative colitis.
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.