Low ileostomy output ALWAYS

[Richie]

Does anyone else have low output that regularly registers under 500 ML? My providers indicated this as the worrisome threshold but I simply never even reach that. I'm not dehydrated and am eating 4-6 mini meals/day. I am still in the recovery phase of surgery on a low-residue diet but I'm not eating a low amount quantity wise.

If this is ok to have happen, then does anyone else have this or know the cause? There is some concern my ileum may be damaged (i.e., it wasn't just my colon) but I'm not sure the two are associated. My transit time is also extremely long (~12 hours from ingestion to output). Hoping for all of this to improve with time but I am constantly in a state of worry I have a blockage because of how low and slow it is.

[Shamrock4806]

You shouldn't have blockage unless you consume food that actually can cause blockage, like nuts, nearly all solid veggies, tough parts of meat and anything you can't chew into mush. Veggies as thick as pea soup or less like juices are fine.

Do see a referred dietitian or nutritionist that specializes in otosmy care for this guide:

Ileostomy Nutrition Therapy from the Academy of Nutrition and Dietetics

It will list foods and drinks that may cause certain issues with those with a Ileostomy. Like diarrhea, thickening, thinning, gas and of course clogging.

I can give you this though, caffeine or chocolate anything causes diarrhea and coffee is especially bad as it just flushes acid out of the stoma which makes leak burns far more severe. Drink tea on a good bag so you can wait out the diarrhea effect. I just learned to do without caffeine really.

If you try to replace the bag on a diarrhea stoma, it's about impossible. If you drink anything but water and an occasional electrolyte drink routinely, a small glass of vegetable or fruit juice daily, it's like drinking salt water. You need fresh water to flush it out the flavored water (like sodas), then fresh water to originally replace what you were trying to satisfy your thirst when you had the flavored drink in the first place. Then you need electrolytes to replace what you flushed out drinking so much plain water. So you can get actually get dehydrated and screwed up even though you were drinking something, it's just the wrong things.

You know they might be intentionally getting you used to eating small nutritious meals more frequently (during the day is best, nearly nothing but snacks at night) to get you into a new eating habit. Eating too much food at once just gets wasted and comes out in the bag, makes for a dirrarea situation as well. The body just flushes what it doesn't need. Also less at night means less bag dumps during the night, so I usually stop eating bigger portions after 3 pm.

So I think that's what's going on here and that's actually a good thing for you. Took me the better part of the year to learn that unfortunately.

And the bag application process is:

1: Wash area with nothing but water and use a wet wash cloth. Dry off. Blow dry area preferably. Apply nothing else to adhesive areas! The temptation is there to apply ointments and so forth but adhesive needs clean, dry, oily and dust free surface to adhere to. Otherwise it will fail and you spring a leak.

2: Apply stoma powder to leak wounds if any, one grain level high.

3: Apply spray skin protectant as to lock stoma powder in place. Allow 30+ seconds to dry. Repeat over the entire area where adhesive is going to stick.

4: Apply your no-sting paste or rings (two loops of paste is best to cover where wafer meets the skin) to the skin first as to check that it covers all the skin up next to the stoma and that it sticks. Adjustments may be necessary or else you leak and waste a wafer and everything else putting it on wrong.

5: Prepare your wafer hole in advance by cutting to fit, but a hair bigger. Test fit and make reference marks on the wafer edge and the skin, a little paste or a magic marker works good. This way you can line things up perfectly and press the wafer on.