Alternatives to Imodium? Also Not Absorbing Fats

[Diane C]

Hi all,

My ileostomy has been quite active from the time that I received it in 2018. I'd sure like to slow down the output. I don't really think there's an affordable alternative to Imodium but am posting anyway. At first, I tried the liquid but that sometimes flowed right out of my stoma though did seem to help initially. So I switched to the gel caps or tablets -- usually taking 2 a couple of times/day with water. They worked better on and off. I finally switched to a generic and that seemed as effective -- or not as effective -- as Imodium which is rarely on sale at drugstores.

I spoke to my GI doctor and he prescribed Motofen. When the pharmacy called, I found out these tablets cost around $600! I don't recall the quantity but decided NOT. Actually, I now think that with a co-pay, Motofen tablets are "only" $400 -- unsure. My doctor had samples so I picked them up. Glad I didn't pay as they don't seem to be doing very much. About as effective as Imodium or the generic.

Due to gas and digestive issues, I don't do well with a high fiber diet -- but sometimes splurge on well-cooked string beans or other vegetables and pay the consequences soon after. I'd never eat a high fiber meal if I were out with friends or at an event (which isn't happening these days). I usually stick to applesauce when it comes to fruit but occasionally have strawberries or even an apple. (I was going to start the FODMAP diet that helps reduce gas but admit I haven't gotten there yet... it's quite challenging.) Bananas don't seem to slow the flow for me much -- ripe or not. I heard that eating marshmallows is a rumor and they're filled with sugar. Almond butter on sourdough bread seems to help. AND add on the pounds.

Wondering if anyone has found anything helpful to slow output? My doctor did tell me to avoid Kaopectate.

My GI doctor also tested some stool samples. I recently learned that my pancreas does not seem to digest fats -- most of which are found in almond butter but some in fish and chicken. I'm unsure of the consequences of this and we're holding off on figuring more out until the mystery with fluid around my lungs (see other post) is solved. I knew that my output was overly "greasy" and think the lack of fat absorption is why. Stains have ruined clothes and I've still many laundries to do... My GI doctor gave me samples of Zenpep. Before eating a meal or drinking much, one should take 1-2 capsules. Zenpep contains enzymes to digest the fat -- especially lipase but also protease and amylase. Years ago, pre-ostomy days, I used to take enzymatic supplements due to poor digestion, slow transit, and distention. I just read that taking lipase with omega 3 fish oil helps with nutrition absorption.

Wondering if anyone has these issues or has found any solutions.

Many thanks!

[To Dream a Dream]

Good to see you posting, Diane. I, too, would like to find an Imodium substitute because with this pandemic, we find it difficult to obtain at the local stores. Finally found a couple of boxes of the plain scored tablets (no added Simethicone). (I still question if the hydrogenated castor oil (supposedly inert ingredient) in the gel caps was a factor in the episode I endured a few weeks ago.) My overall situation seems to be improving, but still have weakness & lightheadedness upon standing for any length of time. I did lose inches around my abdomen (possible fluid?) But still find I have some edema in my lower legs & feet at bedtime. Fortunately my outputs seem to have stabilized.
Will probably contact someone at the Clinic, but again with the ongoing pandemic, I try to avoid bothering the staff.
On a brighter note, had a visitor to my garden today. A PA Eastern Garter snake. No doubt looking for chipmunks.
Be safe, my Board friends & may all of our dreams improve soon.

[Diane C]

Hi To Dream,

Thanks for your reply -- and you reminded me that the Imodium gel caps contain fats. I imagine most gel caps do -- and I try to avoid soybean oil. Since my pancreas isn't absorbing fats, gel caps would definitely not be wise for me to take. I'm not finding that the prescription meds are helping much. I do need to eat more often and LESS -- not have a large meal, esp at night. I'll stick to capsules and tablets. Need to contact my GI doctor now that the fluid around my lungs has (temporarily?!) abated.

Have you lost weight or water? I need to do the first. I lose poundage but gain it back... Def must exercise!

Sorry to hear you feel light-headed on standing. Hydrated? Get enough sleep? My bp is pretty low. It could be due to the amount of output so I need to hydrate more.

Those snakes can be useful but please keep them at your house. I love how you appreciate Nature. It really helps during this time.