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. This can lead to dehydration and increase your risk of malnutrition.
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.
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.
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.
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.
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.
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.
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.
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.
Usually, up to 4 regular stoma bags worth of stool, with a brown colour is normal. Colour changes can be related to food e.g. red colouring from beetroot. The texture will vary depending on the type of procedure you've had.
Bile that cannot be reabsorbed in the intestine can cause a yellow or green stool color, especially when diarrhea or rapid bowel action occurs.
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.
If the stoma does not protrude above the skin, the stool may get under the pouch seal and cause leakage. A convex pouching system can provide some pressure around the stoma to force output to get into the pouch and not under the skin barrier seal.
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.
High-output syndrome (HOS) is a complication of small-bowel stoma, which can cause dehydration or renal dysfunction and affect quality of life.
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.
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.
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.
A healthy stoma is pinkish-red and moist. Your stoma should stick out slightly from your skin. It is normal to see a little mucus. Spots of blood or a small amount of bleeding from your stoma is also normal.
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.
It is important to call your doctor if the stoma is not healing properly, changes colors, becomes dry, oozes pus, or shows others signs of infection. The same applies if the skin around the stoma becomes painful, changes color suddenly, or develops sores or chafing. Ongoing diarrhea is also a concern.
It occurs when the blood supply to/ from the stoma is impaired or interrupted, resulting in partial or complete stoma tissue death. As blood flow and tissue perfusion are essential for stoma health, deficient blood flow to the stoma will lead to necrosis.
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.