1. Changes in your ileostomy output

Whilst in hospital, the output from my ileostomy was very watery and frequent. It wasn't unusual for me to have empty the bag 10 times a day. What came out looked like gravy with bits of partially digested food in it!

Don't worry though- things do calm down a lot. Depending on how much food and what kinds of food you eat, you'll empty your bag on average about 5 or 6 times a day. I find it most helpful to empty out when I use the bathroom normally. The output does tend to thicken up a bit, although it will never be solid.

To thicken up your output eat jelly sweets (eg. haribo gums, jelly babies) or marshmallows. The geletin helps.

The body needs lots of salt as it can't expel pure water. So, when the body expels water- when you pee or sweat, salt comes out too. Salt is essential for other things in the body too- formation of new tissue etc.

The first sign that your body is low on salt is a feeling of being dehydrated- needing a drink, feeling headachy, tired and run down. Our first instinct is to drink, which is actually the worst thing to do. By adding more water to the system, it lowers the salt-water ratio. The result is increased output from the ileostomy.

So, to reduce your ileostomy output, simply eat a whole tonne of salt. Add it to your dinner, cook your veggies in it- eat as much of it as you can handle. Having no colon, we simply don't absorb enough salt to pose a threat to our heart.

2. Watch what you eat

Your diet will play a part in how your ileostomy puts out.

There are some foods you should avoid: foods that swell in the bowel , foods that don't digest very well and stringy foods.

Foods that swell:
These may cause a bowel bloackage

~Mushrooms (a mushroom had me hospitalised with a blocked bowel. It's extremely painful and required a shot of morphine to relieve the pain)
~dried fruit (currants, sultanas, dried apricots etc)
~dessicated coconut

Foods that aren't easily digestible:
These can be a bit awkward to expel
~nuts
~sweetcorn
~pickled onions

Stringy food:
Can catch in the bowel tract and cause a bloackage
~celery
~pithy fruit eg. oranges, grapefruit (remove the pith well)
~coleslaw

In addition some foods cause wind which will inflate your bag and could cause a bit of embarrassment. These include:
~beans
~fizzy drinks
~brassicas (eg, cabbage, sprouts etc)

Make sure you cut up your food in little pieces and chew very well to aid digestion. Avoid gulping food and drink as this will cause wind that will inflate your bag.

3. Extras needed with an ileostomy

Because you are bypassing the colon which absorbs most water, you'll need to drink a bit extra than you used to to avoid dehydration.

You will also need to consume more salts than non-ostomists. I add quite a bit of salt to my dinner and eat a packet of ready salted crisps now & again.

4. Ileostomy bags

You'll initially start off with a maxi sixe bag, usually a one-piece. (Backing wafer and bag are all in one). If you're like me, I was desperate to try a smaller sized bag for more discretion. My advice is to stick with the maxi until you've found your stoma has calmed down- this could be about a month.

Trust me on this one- the smaller size bags are a pain as they fill up quicker,bulge quicker and require more trips to the loo.

Once your stoma has calmed down, you should find a midi size bag sufficient.

There are mini bags available, and I was certain that these would be the most discrete. However, I've found that the mini size are a real pain in the neck as they fill up and bulge too quickly. Save this size for swimming or sports where you'll only require them for a short time.

I started off with a one-piece bag where the backing flange and bag was all-in-one. The bag had to be peeled off and changed every two to three days.

I have since changed to a two-piece bag. With these, the backing flange (sticky bit) is separate from the bag itself. You change the backing plate every two or three days, but the bag clips on and off as often as you like. I have found many benefits in this system:

~It allows you to change your bag as often as you like.

I put on a maxi at night to save me from getting up too often in the night, I can change my bag for a dry, clean one after a bath, and I can pop on a mini bag to go swimming without having to keep peeling off the backing plate and making my skin sore.

~It allows you and your partner to come to terms with your stoma. By unclipping the bag, I can see my stoma through the hole I have cut in my backing plate. I change my bag twice a day, so me and my husband are quite used to looking at it. It used to be a bit of a shock, but now it's no worse than cutting my nails!

~I feel cleaner being able to change my bag more often. I didn't like the idea of three day old waste hanging around my abdomen!

~It makes cleaning your stoma easier. Even though I emptied my one piece bag before removing it, I still found it quite a messy affair when it came to changing the bag as there would be some leftovers. The two piece allows the bag and leftovers to be discarded, and the backing flange can be wiped round before peeling it off. Not a dribble in sight!

on September 21 2002 01:00:32 ·