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.
What does this mean? If your stoma output is loose and watery for more than 24 hours nutrients, electrolytes (eg. Salt) and fluid are not absorbed properly.
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.
This is usually due to the filter becoming wet or blocked from stoma output.
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.
Certain foods may make your stoma output more liquid especially if eaten in large quantities e.g. fibrous foods (wholemeal bread, wholegrain cereals, pulses, leafy green vegetables, raw vegetables, sweet corn, fruits and nuts), spicy foods, alcohol, drinks containing caffeine (e.g. coffee, tea, cola), fruit juices and ...
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.
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.
The first sign of a stoma infection may be a pus-like discharge, unusual swelling, increasing redness, or color changes. Some may notice an abscess or an ulcer. A Wound, Ostomy, and Continence Nurse (WOCN) or your doctor will be the best source for medical advice on this issue.
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.
It is also important to keep the wound properly moist during the stage of wound epithelialization. If the wound surface is dry, it will delay cell regeneration and thus delay the wound healing process. Therefore, keeping the wound warm and moisturized after operation can promote wound healing.
If your stoma bag does not fit snugly around your stoma, it can cause leaks which affect adhesion and harm the skin, which in turn makes it harder to get a good seal. Re-measure your stoma using the backing paper of the adhesive as a guide. You may want to stand in front of a mirror to do this.
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.
Find a sleeping position that works for you
If you prefer to sleep on your stomach, this will be fine at the beginning of the night but increases the chances of leaks as the night progresses and your bag fills. To overcome this, you can modify your sleeping position by bending the leg on the side with your stoma.
Drink sports drinks (such as Gatorade or Powerade) and oral rehydration solutions (such as Pedialyte). These drinks will help replace your fluid loss quickly, especially if your ostomy output is high. A high output is more than 1000 milliliters (about 34 ounces) per day.
A high-output stoma (HOS) or fistula is when small bowel output causes water, sodium and often magnesium depletion. This tends to occur when the output is >1.5 -2.0 L/24 hours though varies according to the amount of food/drink taken orally. An HOS occurs in up to 31% of small bowel stomas.
Signs of Stoma Problems
The stoma is no longer beefy red or pink but pale in appearance. The stoma is no longer moist in appearance but seems dry. Your stoma turns dark red, purple, or even black in color. Your stool from the stoma is always watery or diarrhea.
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.
A colostomy is an operation to divert 1 end of the colon (part of the bowel) through an opening in the tummy. The opening is called a stoma. A pouch can be placed over the stoma to collect your poo (stools). A colostomy can be permanent or temporary.