The normal amount of output from an ileostomy in a 24 hour period is between 500mls – 1 litre. Depending on your stoma bag size, this may be the same as emptying the bag when it is 1/3 – 1/2 full 4-6 times a day. Anything above 1 litre in 24 hours is considered a high output.
What is a normal ileostomy output? A normal ileostomy output should be 400-600ml over 24 hours.
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.
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.
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).
An oral rehydration solution e.g. dioralyte, may be recommended to help your bowel absorb more fluid and salt, which will reduce your stoma output.
This is usually due to the filter becoming wet or blocked from stoma output.
Keeping hydrated is an important aspect of living with a stoma. For many people it is just making sure you are drinking plenty throughout the day. You should try to drink 6-8 glasses of water each day along with any other drinks such as tea or coffee.
Stool and gas will leave your body through your anus, as they did before surgery. At first, you will have more frequent bowel movements, up to 15 per day. You may have mild bowel control problems and may need to wake up from sleep to pass stool.
If you allow it to get too full, the weight of the stool may pull the pouch away from the skin. A person with an ileostomy will need to empty the pouch about five or six times in a 24-hour period. If you have a colostomy, you will need to empty the pouch two or three times in a 24-hour period.
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.
Drink oral rehydration solutions throughout the day. (recipes for oral rehydration solutions are below) • Water, tea and coffee can increase your output. Oral rehydration solutions will help to replace the fluid and minerals (sodium and potassium) lost in high outputs to prevent dehydration and help absorb the fluid.
You need to empty a drainable pouch when it gets to be about one-third full. Don't let it get more than half full. This keeps the pouch from bulging under your clothes.
A blockage, also known as a bowel obstruction, leads to the output from your stoma slowing down or even stopping completely. The latter can happen suddenly. Blockages can occur either in the small or large bowel. A blockage can be described as partial or complete.
It is important to avoid carbonated and caffeinated beverages, which tend to cause irritation, gas, and bloating, leading to discomfort. Decaffeinated tea and coffee are both safe to drink.
Avoid drinks that cause bloating
There are certain alcoholic beverages which can cause bloating and ballooning of stoma bags. These include lager, beer, prosecco and any other fizzy alcoholic drinks.
You must still include fibre in your diet. Choose some foods from the following list daily: Wholemeal bread. High fibre cereal e.g. Weetabix, porridge.
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.
When you are first discharged from hospital after your stoma surgery, you will feel tired and find everyday tasks such as having a shower exhausting. This is normal and will improve over time.
Will my bag 'inflate' on the plane? The cabin pressure on a plane shouldn't have any effect on your stoma or inflate your bag.
Eating and drinking directly before bed can cause your stoma to be more active overnight and will result in a full bag. If you find that, regardless of what you do, your stoma is very active at night, you can try taking something like Imodium to slow down your output.
One major issue to watch out for with a stoma is the laxative effect of some chocolates. The caffeine and fibre within the chocolate can increase the rate of motility (which is the contraction of the muscles in the digestive tract that encourage bowel movements).
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.
Caffeine can increase the speed at which foods and fluids move through the bowel. Consider choosing decaffeinated drinks. Avoid sorbitol, xylitol or mannitol (sweeteners) or foods and sweets that contain them. They can increase your stoma output and cause wind/bloating.