Loperamide query

Hi AlbaH 

Thats a very good point to pose to the group, and I hope someone who’s living with, or has had,  an ileostomy might come along a pitch in with some helpful advice. 

As I’ve got a permanent colostomy I have no relevant experience to share-I actually haven’t needed to take a single loperamide in more than 4 years! 

Did the new nurse indicate to you the reason for taking it daily, twice a day? As it seems you have managed to handle things with diet and on an “as required” basis, I think I would want to understand her thinking on this.

Sarah xx

I have a permanent ileostomy(nearly 5yrs now) and have never been advised to take loperamide .my diet sorts it.I would try and have another chat with the nurse as sarah suggests to find out her reasoning.

All the best

Kath

My output has always been loose from when I had the ileostomy and even now with my newish colostomy.  I have had mixed results with loperamide. Sometimes it doesn't take effect until the next day, but if I  take it every day my output goes solid and I get pancaking. It's trial and error really, but when I had my ileostomy reversal in 2008 and had galloping diarrhoea for weeks, the consultant said take as many as 8 loperamide a day if necessary. The stoma nurses say to take it 30 minutes before meals, but the colorectal consultant said 4 hours before meals.

Diet is my best way to thicken consistency, but I don't really want to eat pasta, mashed potato or stewed apple at every meal. My consultant advised me last week to try psyllium powder in water/juice as a bulking agent, but I haven't dared try it yet and don't know how often would be optimum. She also said to try half a loperamide to see whether that works better. In reply to my post last week about psyllium, i think it was Dulac who said he swears by peanut butter (which I'm not keen on).

We  all react differently and have to muddle our way through until we get it right.

Thanks for your reply Sarah. The new stoma nurse said the daily Loperamide would help my body to absorb more nutrients. But Ive always said when asked that I only take a tablet if needed and nobody else has ever corrected me on that… including other stoma nurses, oncologist or surgeon! The pharmacy label also says ‘take as required’ so I think I’ll stick with that! 

AlbaH

Thanks for your reply, Kath. I feel the same and would prefer to manage through diet! I’m reluctant to use Loperamide unless needed. 

AlbaH

Thanks for your reply Catgirl2… I’ve decided to hold off taking any unless needed. When I had radiotherapy I was also told I could take up to 8 per day but thankfully I only needed the occasional ones to settle the output. And yes, I was advised 30mins before food too. Agree with you that it’s trial and error with finding the foods that work the best.

Hope you find a good solution that works well for you!

AlbaH

Hi there 

I am reversed so have a little experience with using it.

When I had my Ileostomy my stoma nurses prescribed Lopermide however I wanted to try a dietary balance. It really worked although if I told anyone that I ate wotsits in my previous life they would not believe me. 
Dry cracker every night at ten o’clock. Sort self the a good sleep until seven   

Now after reversal I fell for taking one 2mg at ten p.m. It did not help 

Its helps if I have had too many treats and I have the knowledge to control what’s happening down there 

Best wishes 

It might seem weird, eating smooth natural peanut butter straight from the tub. However, it occurred to me that with an ileostomy my daily medication (tablets - not cancer related) might pass through before the active ingredients get a chance to work. I took the view that a fairly dry plug of peanut butter before the tablets might just slow things down a bit. And it does! Not having a sweet tooth it is also very tasty.

Dulac

Also  with an Ileostomy your diet lacks serotonin  and nuts are a great source 

I ate it coz I liked it anyway then found out it helps with mood 

Great tip Dulac 

Hi AlbaH.

Just a note about Loperamide and stomas. When I went to the hospital to collect my first cycle of chemotherapy tablets, my prescription meds were all ready for me to collect. Chatting to the nurse, she asked me what operation I had. When I told her I had an APR, she took the bag back from me saying that as I have a stoma, this means I cannot have anything in capsule form, which had been put up for me. She got them replaced with tablets. I also had this issue with Gabapentin. It can pass straight through undigested. I have now got liquid form of Gabapentin. Nobody else seems to have picked up on this in my experience of the medical profession.

Hope this helps 

Kim

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