Dehydration with Ostomy

JanJan63

My issue isn't a dramatic one but it is an issue for me and I don't know what to do about it. I'm not good at googling things and can never seem to get the information I'm looking for.

So I have the illeostomy and have dehydration because of it. I drink all day and drink so much that I end up going to the bathroom over and over including three to five times during the night. What seems to be happeneing is that I drink lots but my body just dosn't absorb it. I've been doing this all along so its not a matter of my body getting used to it, it just won't absorb very much. My mouth is always dry unless I'm drinking but it just goes through me and into my pouch seemingly without bothering to stop and be absorbed. Or at least very little is.

They have drugs that make the body get rid of excess fluid, is there one that encorages it to absorb it? I see my doctor in a couple of days so I'm wondering if I should ask for something in particular or if there's something I can just do at home. I've noticed that my output as always like water unless I eat something like meat or potatoes, then it gets a bit thicker. I was told a trick a few years ago that you eat marshmallows shortly before changing your appliance so it doesn't leak out while you're changing it. So something I eat can change how things go through. Any suggestions on eating certain things?

Thanks you guys!

Jan 

John23

Desert or dessert?

Re:
"I drink all day and drink so much that I end up going to the bathroom over and over including three to five times during the night. What seems to be happeneing is that I drink lots but my body just dosn't absorb it."

Actually, what is happening is perfectly normal. You are flushing out your digestive system. You are not only flushing out the contents of food products, you are tossing out all the liquid your body requires for proper hydration. If you do what you are doing long enough, you not only will be clinically dehydrated, you will suffer of malnutrition as well.

You have an Ileostomy. You never said if it's a "loop" Ileostomy or not. That doesn't matter until you have a revision that reconnects the small and large intestine. When they provide an Ileostomy, they remove the Ileocecal valve (it's part of the large intestine). A "loop" Ileostomy may (or may not) put the valve back; an end Ileostomy usually loses that valve forever.

The Ileocecal valve does two things: 1. Prevents the backflow of product from moving from the large intestine back into the small intestine (helps prevent bacteria contamination into the Ileum); 2. Helps slow the product from flowing too rapidly into the large intestine. I.E. - The body senses a need for more "food and water" and shuts the valve down to help the small intestine absorb what's needed.

Ileostomy=absence of the Ileocecal valve.

Usually the WOCN (wound care/ostomy) nurse explains to the new Ostomate that a dietary change is required for survival. Unfortunately, most of us (me included) never had a WOCN assigned and left the hospital without any proper instructions or information. I hope those reading garner a clear understanding that this is not a "USA" health care failure, but one that is universal across the world. There is a gross lack of communication between physicians, nurses, and patients.

With an Ileostomy, you should not, ever, ingest more liquid than is necessary for survival. The small intestine absorbs the majority of liquid needed for survival, and the colon removes the balance. That well cleansed and pure hydration is added to your system as needed. Surplus is ejected as waste via your kidneys or diarrhea. Indication? You're urinating continuously and (if you have an Ileostomy) emptying the pouch continuously.

Sound familiar?

Too much intake of liquid and you have a "'flush" situation, where the body is dumping the excess as fast as it arrives.

Drugs to "slow things down"...? They have two. One is not "controlled" and can be bought over the counter. It rarely works. The other is an opiate derivative. They add a chemical that will make the user very sick if too much is taken. Most of us find that the maximum dose is needed to have any serious effect; just below the sick reaction point. Sometimes. The bad effect is the loss of "motor control". The drug slows down all motor responses (involuntary and voluntary). Your intestinal operation slows, but so does your ability to lift your feet while walking. Nice. You may end up laying on the floor, but at least it's not in a puddle you've ejected while laying there. Sometimes.

The bottom line? Adjust your diet and intake to accommodate the revision to your digestive tract. You should have a dietician to turn to, or at least a gastroenterologist that has ostomates as patients.

Stop what you are doing and think about what you are doing before you do it.

You mentioned problems with blockages on another thread....... And then you mentioned that it may have been from eating celery. No #$%^, really? What a revelation! Fiber will do that? Holy #$%^&.

Most Ostomates know at least some facts for survival. What they don't tell you, you can learn from web sites like the UOAA website, that is dedicated to and for Ostomates.

If you plan to survive, you have to take some time to allow yourself to be educated. It's part of "self survival".

Hoping for your better health,

John

 

JanJan63

Thanks John, I was hoping you

Thanks John, I was hoping you'd reply to my post. I think mine is a loop. That's the one where both ends are there at the stoma, right? If so, that's what I have. The only information I got when I first had it was that I probably wouldn't be able to eat fruits or vegetables. Which is unacceptable. Beyond that, a brochure and that was it. It was supposd to be temporary so maybe they didn't feel the need to concern themselves with long term usage. If I ant to talk to the ostomy nurse I have to make an appointment at the hospital in the city. And I'm not sure they're useful for long term ostomates, just for after the surgery.

I see so many doctors it's ridiculous. No I'm lined up with a urologist for the kidney issue. So I'm adding another specialist. I already have four that I have to see and I'm not sure I want to add more. My boss is great but if this keeps up I don't know how long that will continue.

John23

Loopy ostomies

If there's two "tubes" that you can see, then it's a loop ostomy. They yank a section of intestine out through the skin's surface, cut the intestine to allow the waste to be diverted into the ostomy pouch, while the disconnected part sits empty awaiting reconnection. Doing that allows that unused section to heal (surgery repair, infection, etc) without being contaminated by stuff flowing through it. It also makes reconnection somewhat easier, since both sections are right there.

And...... more often than not, the Ileocecal valve has not been discarded and left connected as part of the large intestine (colon). "Your mileage will vary". A lot depends on the surgeon and situation. It's a question you should demand answered: "do I still have the Ileocecal valve and will I have it after a reversal". Without it, a reversal can be a problem. Think: uncontrolled fluid, bacterial infections, diarrhea..... All the things that may make you wish you had an ostomy while you sit on that toilet 18 hours out of the 24 you're awake....  Just sayin'....

If it's a "loop", then they had a future reconnection in mind initially.

A "Loop" ostomy is more difficult to maintain than an end ostomy. There's two sections of intestine sticking out, making it difficult to seal the waste from discharging from around the stoma. Very difficult actually, and a reason why so many with a temporary ostomy insist on getting a "reversal" rather than spend their life suffering with ostomy leakages, etc. A well formed and well placed "end ostomy" does not cause a fraction the problems a "loop ostomy" is responsible for.

Any ostomy should be planned. The location of the stoma should be measured and placed according to how you wear your clothing (whenever possible). A good WOCN (wound care/ostomy nurse) should be available to work with you to do the measuring for the surgeon. Usually we're rushed into the ER and operating room and little if any planning is made; the importance is in clearing the obstruction. Changing the location after the fact isn't a great idea. It requires more surgery and makes the generation of adhesions and hernias more likely. Get it right the first time whenever possible. Difficult to argue when you're doubled over in pain and screaming at the surgeon's ankles, but remember that you are closer to the surgeon's vulnerable areas as well. Try to insist that time is taken to place the stoma in the best place for you before they operate.

Aside from that...... have a great day!

(haha)

Be well Janjan.... You'll be fine!

John

 

Bellen

Ostomy question

Hello Group - Does anyone know whether a person, who has an ostomy - either in the small or large intestine, should be following a low residue diet - foods that are easily digested, not necessarily the healthiest, but break down and pass through more easily.  I have followed a low residue diet for about 5 yrs now, due to an area of stricture in my small intestine (from previous cancer radiation).  It was suggested to help reduce partial blockages (severe spasms that last for hrs), although I have still had partial blockages over the years - it may have helped to reduce them though - to follow this type of diet - no nuts, seeds, grains, skins, fresh vegetables and fruits, etc.  Right now, I have been diagnosed with CRC (new cancer) with mets to my liver, and I may in the future, have to have an ostomy, so I wonder about this.  

JanJan63

Bellen said:

Ostomy question

Hello Group - Does anyone know whether a person, who has an ostomy - either in the small or large intestine, should be following a low residue diet - foods that are easily digested, not necessarily the healthiest, but break down and pass through more easily.  I have followed a low residue diet for about 5 yrs now, due to an area of stricture in my small intestine (from previous cancer radiation).  It was suggested to help reduce partial blockages (severe spasms that last for hrs), although I have still had partial blockages over the years - it may have helped to reduce them though - to follow this type of diet - no nuts, seeds, grains, skins, fresh vegetables and fruits, etc.  Right now, I have been diagnosed with CRC (new cancer) with mets to my liver, and I may in the future, have to have an ostomy, so I wonder about this.  

I just saw my surgeon the

I just saw my surgeon the other day and he sid it was mostly about proper chewing but to be aware of things that won't even break down well from chewing. He mentioned canned mushrooms, it's something that people tend to just swallow rather than chew, but he had to perform an emergency surgery on a guy who had a full blockage from them. Oranges were mentioned. Not the pulpy part but the tougher membrane that surrounds each segment. I had a prtial blockage in the past from celerey strings. The mass of the celery broke down but the strings didn't and hadn't been chewed properly and went into a little clump. I wouldn't try nuts but I've eaten popcorn plenty of times while being very careful. Because my partial blockages seeming to happen more often in the last few months I'm scared to try it again. My latest blockage I believe was from a piece of meat, I've been sick all week from it.

I do eat fresh veggies and fruit but I chew very, very thoroughly. Best of luck!

Jan

Trubrit

JanJan63 said:

I just saw my surgeon the

I just saw my surgeon the other day and he sid it was mostly about proper chewing but to be aware of things that won't even break down well from chewing. He mentioned canned mushrooms, it's something that people tend to just swallow rather than chew, but he had to perform an emergency surgery on a guy who had a full blockage from them. Oranges were mentioned. Not the pulpy part but the tougher membrane that surrounds each segment. I had a prtial blockage in the past from celerey strings. The mass of the celery broke down but the strings didn't and hadn't been chewed properly and went into a little clump. I wouldn't try nuts but I've eaten popcorn plenty of times while being very careful. Because my partial blockages seeming to happen more often in the last few months I'm scared to try it again. My latest blockage I believe was from a piece of meat, I've been sick all week from it.

I do eat fresh veggies and fruit but I chew very, very thoroughly. Best of luck!

Jan

Thank you

JanJan, thanks for this post. I know I've read it all before, but for some reason, you post resonates with me today. Maybe because my bowels have been playing silly devils with me this week, and I'm wondering 'Why the heck?'

Now your post basically is telling me why, and I thank you for that. 

SUE