Liquid ileostomy output won't stop!

Hi Knowledgeispower20

I'm sorry to hear that mum is still having high output from her stoma.

If necessary the Loperamide dosage can be increased, under medical supervision, to 16mg four times a day and should be taken ½ an hour before food which can often be a problem in hospital as I've found that medication can arrive with food or after food.

The ward staff should be monitoring the output to the fluid intake and checking the ratio.

It could be that mum needs to be on a low fibre diet which be difficult in hospital and needs intervention by the hospital dietitian to authorise this, I would check to see if a dietitian has been called if not ask for one to visit your mum which ideally be when you are visiting.

I have note information about low fibre diet at the foot which includes possible meal plans and advice of choosing food as some foods, that you would not think, do have an added fibre content.

I do hope that your mum gets sorted out soon as it is very sole destroying being plagued with high output which I know will be affecting her quality of life.

Ian

Knowledgeispower20, this is taken from an American stoma information site, hence the difference in spelling of some words but I hope it will help.

Purpose

Your doctor may prescribe a low-fiber diet if:

• You have narrowing of the bowel due to a tumor or an inflammatory disease
• You have had bowel surgery
• You are having treatment, such as radiation, that damages or irritates your digestive tract

As your digestive system returns to normal, you usually can slowly add more fiber back into your diet.

A low-fiber diet limits the types of vegetables, fruits and grains that you can eat. Occasionally, your doctor also may want you to limit the amount of milk and milk products in your diet. Milk doesn't contain fiber, but it may contribute to discomfort or diarrhea, especially if you're lactose intolerant.

The ability to digest food varies from person to person. Depending on your condition and tolerance, your doctor may recommend a diet that is more or less restricted.

If you're eating a low-fiber diet, be sure to read food labels. Foods you might not expect — such as yogurt, ice cream, cereal and even beverages — can have added fiber. Look for foods that have no more than 1 gram of fiber in a serving.

Foods that are generally allowed on a low-fiber diet include:

• White bread without nuts and seeds
• White rice, plain white pasta, and crackers
• Refined hot cereals, such as Cream of Wheat, or cold cereals with less than 1 gram of fiber per serving
• Pancakes or waffles made from white refined flour
• Most canned or well-cooked vegetables and fruits without skins or seeds
• Fruit and vegetable juice with little or no pulp, fruit-flavored drinks, and flavored waters
• Tender meat, poultry, fish, eggs and tofu
• Milk and foods made from milk — such as yogurt, pudding, ice cream, cheeses and sour cream — if tolerated
• Butter, margarine, oils and salad dressings without seeds

You should avoid:

• Whole-wheat or whole-grain breads, cereals and pasta
• Brown or wild rice and other whole grains, such as oats, kasha, barley and quinoa
• Dried fruits and prune juice
• Raw fruit, including those with seeds, skin or membranes, such as berries
• Raw or undercooked vegetables, including corn
• Dried beans, peas and lentils
• Seeds and nuts and foods containing them, including peanut butter and other nut butters
• Coconut
• Popcorn

If you're eating a low-fiber diet, a typical menu might look like this.

Breakfast

1 glass of milk, if tolerated

1 egg

1 slice of white toast with smooth jelly

1/2 cup canned peaches

Snack

1 cup of yogurt if tolerated, without seeds or nuts

Lunch

1 to 2 cups of chicken noodle soup

Crackers

Sandwich of drained tuna with mayonnaise on white bread

Canned applesauce

Flavored water or iced tea

Snack

White toast, bread or crackers

2 slices of cheese or 1/2 cup of cottage cheese, if tolerated

Flavored water

Dinner

3 ounces of lean meat, poultry or fish

1/2 cup of white rice

1/2 cup of cooked vegetables, such as carrots or green beans

White dinner roll with butter

Hot tea

Prepare all foods so that they're tender. Good cooking methods include simmering, poaching, stewing, steaming and braising. Baking or microwaving in a covered dish is another option.

Try to avoid roasting, broiling and grilling — methods that tend to make foods dry and tough. You may also want to avoid fried foods and spices.

Keep in mind that you may have fewer bowel movements and smaller stools while you're following a low-fiber diet. To avoid constipation, you may need to drink extra fluids. Drink plenty of water unless your doctor tells you otherwise.

Eating a low-fiber diet will limit your bowel movements and help ease diarrhea or other symptoms of abdominal conditions, such as abdominal pain. Once your digestive system has returned to normal, you can slowly reintroduce fiber into your diet.

Risks

Because a low-fiber diet restricts what you can eat, it can be difficult to meet your nutritional needs. You should use a low-fiber diet only as long as directed by your doctor. If you must continue eating this diet for a longer time, consult a registered dietitian to make sure your nutritional needs are being met.

Hi Ian, thank you....the low fibre advice is really useful. The doctor has ordered her to start eating lots of jelly babies now! Her fluid balance is down again and kidneys once again not happy, so she was re-cannulated today ( they just about managed to get one in). The dietician is visiting her regularly, but because she has a soya allergy, I have to bring food in as they can't accommodate her needs! I am managing to buy a soya free ham white sarnie and half a sachet of complan plus  homemade jelly as the hospital ones are vegan and Ritz crackers and baby Bel as snacks and some lunch from the hospital.......usually  tuna pasta bake.....and she has to pick out the peas! They can't really deal with an ostomy diet, and she is in the digestive disease ward of one of the biggest teaching hospitals in the country.........seems crazy!!!!!

I will keep you updated on this never ending saga!!

My stoma nurse told me to forget about veg. You need vitamins but you can get liquid supplements. Your colon loves veg. Your ileum? Doesn't need it.

My op was 13th October.

My diet?

Egg on white toast.

Bacon and sausage. Ketchup.

Cream cakes.

Crumpets and cheese ( strongly recommended by stoma nurse ).

Cornflakes.

Smoked salmon.

Yoghurts and fools.

Roast chicken dinner but don't max out on veg!

Chips if you like them. Fish and chips.

Tinned peaches and apricots and ice cream.

Then flat isotonic drinks. No bubbles.

But for your mum? Starch. Starchy. Stodgy. 

Good advice.....it seems starchy stodgy is the best. Unfortunately though.....mums now on 80 mgs of loperamide a day....dry as a bone from meds.....and it still keeps going day and night. Fybogel does seem to be slowing it down a bit but it dosnt last. She can barely talk from the dryness......they are going for reversal in week 8. I honestly don't know how you manage a high output stoma without getting very ill.

So sorry for your mum, Sounds as if it's not diet-related then and not therefore subject to improvement by alterations in eating patterns. There's more going on. Hope somebody cracks this for her.

in the meantime she needs to hydrate as much as she can. Isotonic drinks, electrolyte tablets you dissolve in water, fluids and more fluids, Dioralyte.

Hi cricketnut......mum is still in hospital.....week 4 now.She is on a fluid restriction of 1 litre at marks and 500 MLS other fluid like squash milk and tea. They are very strict about fluids....even counting jelly as 80 MLS of fluid! She is on constant 8 hour drips as more fluid is coming out than going in! I can't see her coming home anytime soon....there are about 8 others on her ward in the same position. I can't believe this can happen to anyone!!

Hi cricketnut......mum is still in hospital.....week 4 now.She is on a fluid restriction of 1 litre at marks and 500 MLS other fluid like squash milk and tea. They are very strict about fluids....even counting jelly as 80 MLS of fluid! She is on constant 8 hour drips as more fluid is coming out than going in! I can't see her coming home anytime soon....there are about 8 others on her ward in the same position. I can't believe this can happen to anyone!!