The average daily output of a colostomy is about 500 ml per day, with a range of about 200-700ml. You should learn to monitor the amount and consistency of your bowel movements.
The stomal output from an ileostomy may reduce over several months as adaptation occurs; however, patients with a jejunostomy (less than 200 cm small bowel remaining) do not generally show any improvement in absorption with time. The normal ileostomy output, when established, is 600–1200 mL/24 hours.
A high output ostomy is when your ostomy output (the amount of waste coming out of your stoma) is more than 1.2 litres (about 5 cups) in a day. Signs of a high output ostomy include: • having to empty your stoma bag more than 8 times a day. • having watery output.
The amount of faecal waste removed through the stoma is called the stoma output. Typical volumes are 400–800ml per day and should ideally not exceed 1,000ml. Controlling the volume of stoma output may require pharmacological intervention.
What is a normal ileostomy output? A normal ileostomy output should be 400-600ml over 24 hours. Output should have the consistency of porridge or toothpaste.
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.
Some people have 2 or 3 movements a day, while others have a bowel movement every 2 or 3 days or even less often. It may take some time after surgery to figure out what's normal for you. While many descending and sigmoid colostomies can be trained to move regularly, some cannot.
High Output Defined
A normal, mature ileostomy should only make about 1200mL of output each day (Table 4). Jejunostomies can initially put out up to 6 L, but this too will decrease with the help of medication. On the other hand, colostomies usually only put out 200-600mL/day.
The colon usually absorbs water from the waste as it moves along towards the rectum, so the consistency of output will depend on where your stoma is sited: the further along the colon, the thicker the faeces coming out of the stoma will generally be.
A larger size stoma bag while sleeping, e.g., one which can hold around 650 ml of waste. This will help them to avoid leakage, because they cannot control or predict the volume of their nightly waste output. A small stoma bag during their waking hours, when it can be changed as needed.
Continuous nausea and vomiting. No ostomy output for 4 to 6 hours with cramping and nausea. Severe watery discharge lasting more than 5 or 6 hours. Bad odor lasting more than a week (This may be a sign of infection.)
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.
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.
If you have an ileostomy
Especially right after surgery, you may lose some fluid due to the relatively large amount of stool (750-1300 ml). Thus it's recommended that you drink at least 2 litres of water per day plus the equivalent of what you lose via the stool.
Keeping hydrated is an important aspect of living with a stoma. For many people it is just making sure you are drinking plenty of fluids 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.
If you do not have any output for several hours, have abdominal pain and/or you are vomiting, your abdomen is distended (swollen), and the symptoms continue, or your stoma is edematous (swollen) or the color of the stoma has significantly darkened; follow step two. Stop eating and drinking. Call your doctor.
Stoma output volumes greater than 1500ml in 24 hours for more than 3 days should be treated as a high output. - AIM: stoma output approximately 1000ml and able to maintain own hydration / fluid and electrolyte balance with PO intake. - Newly formed stoma – seek advice from senior clinician / surgeon.
Loose, watery stools may cause you to change or empty your stoma bag more often than usual. Diarrhoea may be caused by illness, tummy upset, or even food poisoning. You may find it helpful to wear a drainable stoma bag due to the increased watery output from your stoma.
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.
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.
High outputs are more common in small bowel (ileostomy or jejunostomy) versus large bowel (colostomy) ostomies. This handout will provide you with some suggestions on how to manage high outputs through diet modification. If diet does not help, you may need to discuss a medication with your physician.
Immediately after your surgery, your anus may continue to expel poop and other fluids that were left inside. But new poop will now exit through your stoma. Most people will be able to feel their bowels move and know when poop is about to come out. But you won't be able to control it anymore.
Keeping hydrated with an ileostomy, colostomy and urostomy
You should try to drink 6-8 glasses of water each day along with any other drinks such as tea or coffee. Top tips to keep hydrated would be: In warmer weather if you are perspiring more you will need to drink more water.
Colostomy bags and equipment
A colostomy bag is used to collect your poo. How often it needs to be changed depends on which type of bag you use. 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.