Managing Diarrhea with a Stoma

Most people will experience an episode of diarrhea in their lives, and that isn’t a fun time for anyone. For those with an ileostomy or colostomy, this is no exception. Loss of fluids and electrolytes is common for those with an ostomy, and having diarrhea can be dangerous since this leads to dehydration.

What is Diarrhea?

Diarrhea is characterized by sudden loose or watery bowel movements and can be accompanied by abdominal pain, cramps, nausea, and even a fever. If you have a colostomy or ileostomy, episodes of diarrhea are possible. Some people with an ileostomy have watery or loose stool most of the time.  There are many possible causes for diarrhea, but there are several ways to help manage diarrhea with an ostomy, so that’s the good news!

Diarrhea can pose some complications for those with an ileostomy or colostomy such as:

  • Diarrhea can clog ostomy pouch filters.
  • Diarrhea can cause more leaks, odors, embarrassing noises, and gases to release.
  • Diarrhea erodes the wafer, resulting in frequent wafer changes.
  • Diarrhea can cause you to empty or change your ostomy pouch more often, which can be unpleasant and messy.
  • Diarrhea could lead to dehydration since nutrients are not being properly absorbed.

Common Causes of Diarrhea

Diarrhea can be caused by several different factors. It is important to take note of your diet, medications, stress levels, and overall health to determine what the culprit could be. Then, with some simple adjustments, you can hopefully gain control of producing more regular bowel movements.

Here are a few of the more common causes of diarrhea with an ileostomy or colostomy:

Diet

The consistency of your stoma’s output can be drastically changed by the foods and beverages you consume. Usually, within an hour or two after consumption of certain foods, you will be able to identify what it was that set off your symptoms. Often, the foods and beverages that are identified as the cause of your diarrhea are not actually needed for a healthy diet and can be eliminated.  You might find other benefits from cutting out these unnecessary culprits. We’ll discuss diet in further detail later.

Medications and Supplements

Some medications or supplements can cause diarrhea for various reasons. Antibiotics are used to kill bacteria in the body, and some of that can be the healthy bacteria that help with digestion. Any over-the-counter medicine that contains magnesium or calcium can also cause diarrhea since these minerals work to relax the digestive tract and neutralize stomach acids. For those that may be undergoing cancer treatment, chemotherapy disrupts how the small intestine breaks down food, which may also cause diarrhea. 

Blockage

When you aren’t seeing much movement from your stoma or it appears larger than normal, you might be experiencing an obstruction or blockage. When the body attempts to flush out the blockage, sometimes a watery or liquid stool is experienced. As the intestines continuously try to push contents through the blockage, symptoms usually follow such as abdominal pain, nausea, and possibly vomiting. Note: If you are experiencing any of these symptoms, contact your doctor as soon as possible.

Dietary Impact on Diarrhea with a Stoma

Most of the time, by simply modifying your diet, you can start managing your diarrhea with a stoma. Drinking enough fluids throughout the day and paying attention to the meals you eat can help. Since diarrhea is watery, you’ll want to incorporate some foods that will thicken up your output from your ileostomy or colostomy.

The following foods are suggested to thicken ileostomy or colostomy output:

  • Starchy foods like noodles, white rice, potatoes, and white bread
  • Crackers and pretzels
  • Marshmallows
  • Applesauce
  • Under-ripe bananas
  • Nut butters (peanut, almond, etc)
  • Yogurt
  • Oatmeal

It is also important to remind yourself that fluid intake is critical. Replacing electrolytes that are lost when you have diarrhea is essential for proper hydration. Drinking beverages such as Pedialyte or Sqwincher products can be a great way to get ahead of potential dehydration.

If you suspect food poisoning or another bacterial cause of your diarrhea, you’ll want to contact a medical professional.

Foods to Avoid When Experiencing Diarrhea with a Stoma

If you consume certain foods and beverages and then notice a dramatic change in your output’s consistency, you’ll want to take note of them and avoid or cut them out of your diet altogether.

Some of the foods and beverages that are suggested to avoid to prevent diarrhea with a stoma are:

Foods to Avoid During Episodes

  • Coffee or tea
  • Alcohol
  • Spicy foods
  • Dairy
  • High-fiber foods
  • Artificial sweeteners
  • Soda
  • Fruit juices
  • Chocolate
  • Fried foods

Foods That May Cause Odor

  • Seafood
  • Garlic
  • Eggs
  • Alcohol
  • Asparagus
  • Spices such as curry, cumin, & chili

Foods That May Produce Gas

  • Dairy
  • Beans
  • Carbonated drinks (including beer)
  • Mushrooms
  • Onions
  • Broccoli
  • Cabbage
  • Cauliflower
  • Brussel sprouts

Sometimes a bit of trial and error is needed to find out what works for you. High fiber foods can cause blockage, and the skins of some fruits and vegetables can be difficult to digest. To get the nutrition needed from these types of foods and beverages, there are alternatives that are easier to digest offered by Thick-It, Nestle, and Abbott Nutrition.

Other Suggestions for Managing Diarrhea with a Stoma

Gelling Agents

Specifically designed to absorb ostomy pouch contents, these products are a popular choice for those with an ileostomy or colostomy. The Osto-Gel Ileostomy Pouch Gel is a packet of granules that is dropped into a new or clean ostomy pouch. As the pouch fills with output, the packet dissolves, and the granules form a thick gel that stays at the bottom of the pouch and away from the stoma. These gelling agents can come in granules, tablets, powder, or capsules, but they all work in the same fashion.

Nutritional Supplements

There are several nutritional supplements on the market today that are formulated to deliver the vitamins and minerals needed without the dairy and sugar. Novasource Renal Nutritional Support Formula contains optimized electrolyte content and is an excellent nutritionally complete product that is also lactose- and gluten-free. The Hormel FiberBasics line of beverages contain 3 grams of fiber to promote bowel regularity and are another great option to help manage diarrhea with a stoma. Just be careful with the amount of fiber intake as you do not want to end up with a blockage.

Consider a High Output Ostomy Pouch

High output ostomy pouches are designed to better manage liquid output and are able to hold larger capacities of stoma output. The SUR-FIT Natura Two-Piece Ostomy System by ConvaTec is a perfect example of a simple design that features a removable filter to reduce pouch ballooning while neutralizing odor and an anti-reflux valve that decreases liquid output backflow. This high output ostomy pouch easily drains high liquid output and users can change the pouch quickly without the need to remove the skin barrier.

Managing diarrhea with a stoma is possible and there are options. Although we offer suggestions, it is always a good idea to speak to your physician to determine what is the best treatment plan for you.

For any questions related to the products we have mentioned or any other home delivery medical supplies we carry, give us a call. One of our Personally Delivered Product Experts will be happy to speak to you.

Cystic Fibrosis and Urinary Incontinence

Cystic fibrosis is a rare, progressive, and hereditary disorder that affects the lungs, digestive system, and other important organs. The cells in the body that are responsible for producing sweat, digestive juices, and mucus become very thick and clog up necessary pathways in the body. A person with cystic fibrosis often experiences lung infections, weight loss, gastrointestinal disorders that affect bowel movements, and chronic coughing that often leads to urinary incontinence.

Urinary Incontinence and Cystic Fibrosis

When urine unintentionally leaks from the bladder, it is called urinary incontinence. Urinary incontinence is a condition that anyone can get, not just those with cystic fibrosis. However, studies have shown that it is common for those with cystic fibrosis to develop incontinence, especially young adult women. It is important to note that just because a person has cystic fibrosis does not mean they are sure to have urinary incontinence. Awareness is key and having the information to be prepared is beneficial.

Chronic Coughing and the Pelvic Floor

Because those with cystic fibrosis experience frequent coughing episodes, the muscles that control the bladder may become weak, causing the inability to control urination. This type of urinary incontinence is referred to as stress incontinence due to repeated coughing putting stress on the bladder. Under normal conditions, the bladder muscles work to hold urine until you are ready to use the restroom. When a person has a chronic cough, pressure is put on the bladder, causing the pelvic floor muscles to suddenly relax. This relaxation results in unexpected leakage of urine. The pelvic floor muscles need to contract when a person coughs in order to prevent leakage, and with the persistent and prolonged coughing a person with cystic fibrosis experiences, these muscles sometimes are just unable to keep up.

Controlled coughing may help control the pelvic floor muscles and help minimize or even prevent leakage. The following short video shows the technique of clearing your cough to protect the pelvic floor.

What Can Make Urinary Incontinence Worse?

There are some conditions that can contribute to worsening urinary incontinence in those that are affected by Cystic fibrosis.

Gastrointestinal Problems

Constipation or hard, bulky stools can make urinary incontinence worse by putting pressure on the bladder. Many nerves in this area are shared and become overactive when a person is constantly straining. This can lead to stress incontinence and result in leakage. Medications are usually recommended to treat these problems and can improve the symptoms of urinary incontinence.

Urinary Tract Infections

When bacteria enters the bladder,  a urinary tract infection occurs. This can be a very painful experience, especially when you have strong urges to urinate and only release a little bit each time.  A urinary tract infection can contribute to urinary incontinence and is also usually treated with medication your doctor can prescribe.

Cystic Fibrosis-Related Diabetes

The excessive mucus buildup in those with cystic fibrosis results in scarring of the pancreas and the normal production of insulin stops. This scarring blocks enzymes that play an important role in the digestion of food and the proper breakdown of nutrients. One of the common symptoms of cystic fibrosis-related diabetes is urinary incontinence. If left untreated, this disorder can make urinary incontinence worse because of the frequent need to urinate. Speak with your doctor if you’re experiencing urinary incontinence and whether you should be screened for this condition.

What Help is Available?

Speaking to others about urinary incontinence is not something most people want to do and can be embarrassing. The fact is, when symptoms related to cystic fibrosis are left untreated, they can only get worse and lead to even bigger problems. It is important to make your doctor aware of any problems you are experiencing right away

Your doctor may suggest the use of appropriate incontinence pads that can help with your leakage. There are various types of incontinence pads and different levels of absorbencies available to manage your leakage and protect your clothing and bed. It is also a wise idea to be prepared for a larger leak just in case.

If you have been screened for Cystic fibrosis-related diabetes, your doctor may suggest you maintain a high-protein, high-calorie diet to make sure you stay at a healthy body weight. There are many nutritional options available that deliver the fat, protein, and calories required and manage glucose levels for a complete and balanced diet.

Your doctor may refer you to a physical therapist or urologist that specializes in the treatment of urinary incontinence related to Cystic fibrosis. They may order some specific tests that can help guide treatment and can also help show you how to properly exercise and strengthen your pelvic floor muscles to reduce the symptoms.

Urinary incontinence, specifically stress incontinence, is a very common symptom in those that have Cystic fibrosis. Always remember to speak to your doctor immediately about the symptoms you are experiencing. If you have any questions about the products we carry, our Personally Delivered Product Experts are just a phone call away and ready to help.