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.

Caring for Peristomal Skin

Are you or someone you care for living with an ostomy and experiencing problems with the skin around the stoma? For those with an ostomy, peristomal skin damage is fairly common. However, it doesn’t have to become normal for you. First, you may want to identify the potential cause of the issue, which is an important part of figuring out how to treat your skin irritation. Next, consider taking several measures to avoid future damage to this sensitive area.

Causes Related to Peristomal Skin Damage

Incorrect Size or Shape of Skin Barrier

Getting the right skin barrier for your unique body may help reduce the risk of leakage and skin damage from stomal output. For example, skin folds or creases can make it difficult for the ostomy skin barrier to securely stick to the abdomen. An improper skin barrier fit can result in leakage, which may cause the skin to become irritated and begin breaking down. If your stoma is retracted or flush with your skin, you may want to consider a convex skin barrier.

ConvaTec’s SUR-FIT Natura Moldable Skin Barrier provides a personalized, custom fit around the stoma to help protect the peristomal skin. They are available in both flat and convex options.

In addition to skin folds and stoma protection, the size of the stoma is an important factor in getting the right fit for your ostomy skin barrier. Ensuring that the barrier is the proper size may help prevent leakage. 1-2mm larger than the stoma is suggested for a close fit. The ConvaTec Natura Durahesive Accordion Trim-to-Fit Skin Barrier with Convexity features an easy cut-to-fit option for those needing a skin barrier with convexity and for use for those with a retracted stoma.

Frequent Applications and Removals

Continuous application and removal of skin barriers can really irritate the peristomal skin causing it to become extra-sensitive. The top layers of the skin can be stripped away, which can result in weepy, sore skin around your stoma. In order to address issues like this, ConvaTec created the Sensi-Care line of peristomal skin care products. These products work to protect skin from damage caused by adhesives and are great for using every day with no residue build-up or bonding to skin folds.

Too Much Pressure Around the Stoma

When there is constant pressure at the stoma site, the skin may react unfavorably. Certain types of clothing or an ostomy belt that is too tight can irritate the peristomal skin by putting too much pressure on the site. Choosing the right ostomy appliance belt can provide an added sense of security when stabilizing an ostomy pouch. You want it to fit securely, of course, but make sure it is soft and comfortably adjusted as to not put too much pressure at the site.

Questions to Ask Yourself

Peristomal skin should look similar to the rest of the skin on the body. Slight redness in this area is normal due to the adhesive used on the barrier. However, any type of discomfort experienced could be a sign that the peristomal skin may be unhealthy. Asking yourself a few questions may help determine if there is more than meets the eye.

  1. Is the skin around your stoma itchy?
  2. Is the skin around your stoma blistered or inflamed?
  3. Does the skin around your stoma feel or appear as though it is wet?

Ask yourself these questions and then consult with your doctor or a WOCN (Wound, Ostomy, & Incontinence Nurse) about steps you can take to manage your peristomal skin issue.

Preventive Steps to Take

By maintaining a good skin care routine, you can help prevent peristomal skin irritations from forming. These are some simple steps you can take:

  • Routinely change your pouch.
  • Use an adhesive remover to gently remove your skin barrier and any additional adhesive residues left behind.
  • Use oil-free and alcohol-free products to reduce irritation when cleaning the skin around the stoma.
  • Make sure your skin is completely dry before applying the next ostomy bag.
  • Look closely at your peristomal skin each time you change out the barrier.
  • Use a barrier foam or spray to protect the skin.
  • Make sure the hole cut in the barrier is the correct size for your stoma.
  • Ensure the barrier is secure with no gaps or folds to prevent leakage.

Peristomal skin should be healthy skin. Even the mildest irritation should be taken seriously and is worth getting advice from your doctor. Most of the time, solving the skin issue can be as simple as changing to a different product, altering your routine, or taking additional steps to rectify the problem.

For any questions about the products we carry or if you need help choosing the right barrier, belt, or bag, we are just a phone call away. Our Personally Delivered Product Experts will be happy to help you find exactly what you need.