Ileostomy Dehydration

[22Sunpuperwolf22]

Hi,

I have had an ileostomy since 2007, and I drink a total of 20+ cups of water per day as told to me to do when I was a patient after having surgery. I have had a blockage, actually several, though in 2010, the blockage caused my small intestine to rupture and I was back in surgery to repair the intestine. I haven't had a major blockages since then, just partial blockages which I have worked out of the stoma with exercises at home.

What I have found since not having a colon, is that since the colon is the organ that absorbs fluid intake and fluids from foods back in to the body for the body to by hydrated, the fluids I drink and the food fluid content I take in runs right through my bag immediately! I have severe cramps all over my body even on cool winter days, even with all of the water I drink hourly! The cramps are in my rib cage, my intercostal muscles, my abdominal muscles, my legs, behind my knees, my neck, my hands, my ankles, all over my body on a continuous basis! I am wondering if there is a chance I may be drinking too much water and depleting the salts, potassium, and magnesium in my body by over hydrating? I feel like I am needing to drink water all of the time, in order to continuously hydrate my body. I don't ever salt my food, only on rare occasions do I salt my food. Although I do eat a lot of processed foods, which I am sure contain a lot of salt.. I have very liquidy fecal output.. It is never solid output. just on very rare occasions it is pasty, though mostly all the time It is fluid that I get in my ostomy bag.
Any suggestions on how to curb the dehydration and cramps that I have on a continuous basis, would be so helpful to hear!

[Mara]

I don't know how to stop your cramps but if I had continual discomfort that you describe I would certainly consult with a doctor. I have had my ileostomy for over 50 years and don't recall ever feeling like you do.
Best of luck to you!

[22Sunpuperwolf22]

Thank you, Mara.
I am seeing my Gastroenterologist in a couple of days and I will surely mention it to her.

[Mara]

You are welcome, 22Sunpuperwolf22.....I was thinking about how much water I drink and actually just measured how many ounces are in the glass I usually drink from. So my usual drink at one time is one cup or 8 ounces. I sort of think I drink maybe five or six of those daily. I also drink some juice and green tea and coffee so another couple of cups I would think. Twenty cups seems like an awful lot....

[22Sunpuperwolf22]

It is an extremely large amount, though I feel like my body requires the constant intake of water since we don't have a colon anymore which is the organ that absorbs the water that we drink and the fluid in the food that we eat and puts those fluids back into our bodies for our bodies to use to work well nutritionally. And yet with all of the water I drink, I continue to be dehydrated. Go figure! Every time I drink water it immediately runs into my bag, so I constantly drink.. I am definitely going to mention this to my Gastroenterologist on Monday when I see her!

[22Sunpuperwolf22]

HI Mara,

My Physician told me that my electrolyte blood work was in the very normal range, so she is not sure what is causing my severe body cramps. She suggested that peppermint oil can be added to tea to eliminate the severe cramps though cautioned me that it can cause heartburn as a side effect since it relaxes the esophageal sphincter. Since I suffer with heartburn already, I will just have to live with the severe cramps and continue to drink several cups of water as I have been doing since 2007, since my physician says I am not deleting the salts in my body according to the blood work.

[ron in mich.]

Hi 22 like Mara said that is a lot of just water which will flush electrolytes, minerals out of your body, in my 40 yrs. of having an ileo. the most water i,ve drank in a day is about 12oz. BUT i drink a variety of other liquids, coffee, milk, decaf pop, tea, gatorade that i mix from a powder, actually i should have said i sip on those, i also take one generic immodium after breakfast and one after supper in the evening.

[Mara]

Hi 22 (hope you're ok with ron's abbreviation)
Ok, your blood test was normal - but I would not be ok with her not doing something more about your severe body cramps. I am not sure if these are a recent occurrence or for a large amount of time. Whichever I would definitely - if it were me and you are not me - want some more followup to find out what the issue is....
And the continual liquid output - mainly my liquid output is mid-morning after my breakfast of a Vitamin drink EmergenC, green tea and a couple of cappuccinos. Otherwise it is not that liquidy....
Have you thought about decreasing the amount of water you drink....little by little...to see what happens?

[22Sunpuperwolf22]

HI Mara,
I could attempt to drink less water to see what happens. I hope I don't cramp even more.
According to my blood work my electrolyte panels were in the healthy range so I am not depleting my salts in my body at all.
I'll cut out 1/4 of my fluid intake and see what happens. Thank you both for your responses.

[Shamrock4806]

What seems to have occurred in your case is you had surgery but didn't get any follow up care about taking care of an illeostomy.

You were likely told you could "eat anything you want" but that's not exactly true. Because your colon was bypassed and a stoma placed on your skin that's not normal and the skin can't flex as much as an anus can.

So as a result there is a slight bottleneck effect going on there that people with one cannot pass larger objects and results in a clog or blockage that may require hospitalization like in your case.

Even though you may chew well and thoroughly sometimes something slips by an can cause a clog, a piece of corn or a bean will do it. I avoid nearly all veggies and fruits unless it's a juice or a soup or like it because nearly all plants are bad for the fibrous or hard skin factors. Tough parts of meats are also bad.

The stoma can try and prolapse to push it out and of course there is a wafer etc. trying to hold it back.

Another problem your having is drinking WAY too much water. This can be caused by many issues which electrolyte loss can be one of them. Stomach cramps are because of nutrients not being supplied enough.

Other BIG issue is DIET, eating or drinking certain liquids or foods can dramatically increase water loss as the body attempts to flush the system.

For instance fatty, salty, spicy or fried foods, artificial ingredients, caffeine, alcohol, chocolate and even too much normal food, can trigger a huge amount of watery output that is called runaway diarrhea..

You get very dehydrated from the huge water loss and try to drink more water but it just adds to the problem.

You may also be becoming diabetic and because of the low insulin the body flushes out more fast carbs and sugars, that's my problem.

Ileostomy diets need to be high on the protein, light on the carbs and very low on the fats. That's the winning formula. That and watching ones nutrition because meals have to be smaller (6 oz) and more frequent over 24 hours so they can digest slowly and uptake nutrients.

You really need to make sure your getting your USDA recommended amounts of nutrients per day consistently. So you just can't "eat anything you want"

What you need to see is an ostomy dietician and if you can't then at least obverse this list I got from mine about what foods and drinks may cause what with an illeostomy.

viewtopic.php?t=27735


You may want to try my sample diet to get started then experiment with small amounts of new things to see what happens. You'll see the results almost right away, the stoma goes crazy spewing stuff out. Especially alcohol and too much fatty anything for me.

viewtopic.php?t=27738

So your situation is a lot like mine, I had to get my diet under control to beat the bag, some like us are unlucky in that regard but others don't always have the same problems.

My current problem is getting my USDA of everything, I'm working on it. Because my mosquito bites were not healing, taking vitamins now and it's gotten better but not quite there yet.

Also besides an ostomy dietician, is to get a more thorough blood work done. They often just do the quickie and it misses stuff like B12 and other things.

Hope that helps!

[JerryNYC]

Instead of drinking so much water, I would recommend a rehydration solution containing a a balanced amount of electrolytes. I keep on hand a supply of "TRIORAL Rehydration Electrolyte" salts which are mixed with a measured amount of water. I buy these packets of Trioral from Amazon. When researchers were developing these rehydration mixtures in the '50s and 60's for treatment of severe dehydration from cholera, they found that a small amount of glucose was necessary for the salts to be fully absorbed into the bloodstream. Trioral and similar packets contain a balanced amount of electrolytes and glucose. If you are put off by the slightly salty taste of the mixture, you can add a little flavoring.

[Shamrock4806]

Homemade quick oral rehydrate solution

Cold water bottle

Drink one quarter of it

Fill back up with Orange Juice

Add a tiniest pinch of salt

Shake well

Sip slowly when needed

That's it. The orange juice provides the sugar and the flavoring. Just go very gingerly on the salt because too much will have the opposite erect of causing diarrhea and more water loss.

A diet high in protein, medium carbs and practically zero fat (just a sausage link per day say) will reduce a lot of diarrhea. As well as abstinence of alcohol, caffeine, spicy foods, salty or brined foods, deep fat fried foods, leafy greens, most vegetables, too much fruit juice, sugar or pasta or mashed potatoes and a nor more than a 4 oz serving of any lean meat. Certainly no artificial ingredients especially red dye #40.

Even too much of any food that's not in the list can cause diarrhea.

Try something in very small amounts and slowly increase until an unwanted reaction occurs is the best approach.

[22Sunpuperwolf22]

Thank you all for your advice! I am having a Sigmoidoscopy procedure tomorrow due to frequent mucous discharge to check my retained rectum for colitis or cancer. I met with my primary doctor today and she told me I am drinking the amount of water required for a person without an colon since I don't have that organ that absorbs the water back into my body really well, and my doctor told me to continue to drink 20 cups of water per day, eat healthier, and exercise 30 minutes 3 -4 x per week. I am having blood work done in a couple days to check my glucose level since I have been having some low blood sugar symptoms, and she is taking blood work for my muscles enzymes to check why the severe cramping is happening. My doctor tells me my electrolytes are normal and I am not over drinking water. Though I appreciate all of your suggestions and advice. Drinking fluids with Electrolytes is a very good suggestion, too! Thank you, Jerry and Shamrock!

I have been reading a textbook called "Nutrition" and I am learning all of the medical related data on nutrition! I have gained a lot of excellent knowledge from just reading 4 chapters so far... It is a textbook that was required for my Nutrition course when I was working on my Bachelor's Degree in Photography Fine Arts and I never ended up taking the course, though I had the book that I had purchased and decided to start reading it as of a few weeks ago! It is amazing!

As well, Shamrock, I was given a list at the hospital of what foods to eat after Ileostomy surgery and was told to chew my food extremely well. Though I have found that after a few years after the surgery was over, I have been able to incorporate a lot of foods back into my diet that I was told to be cautious with after the surgery, and I have not had a blockage since 2010.

[Shamrock4806]

True some can eat almost anything, but there's always a risk of missing something that can cause a clog or pancake their wafer off for others.

For me just a missed piece of corn could do it. Nut piece had me in the hospital with a painful clog.

All my foods have to be liquified before consumption or will do so in the stomach before entering the intestines.