Question: Concerns About High Watery Output in Ileostomy

I’ve been living with an ileostomy for over 15 years and recently experiencing very high watery output several times a day. I’m worried about dehydration and have been taking electrolyte drinks, along with magnesium, potassium, vitamin D, B12 supplements, and daily Imodium. I’m considering Rifaximin and probiotics as the BRAT Diet isn’t effective. Without a family doctor, I want to avoid prednisone. What are your recommendations?

Response: Guidance on Managing High Output and Maintaining Electrolyte Balance

Your situation is complex and requires careful consideration of various factors that could be influencing your high ileostomy output:

  1. Stress as a Contributing Factor: Stress can significantly impact gut function. Consider stress-reduction techniques and assess if recent life changes are affecting your gut health.
  2. Rule Out Infection: Before considering antibiotics like Rifaximin, it’s essential to test for a possible bowel infection. Only a stool test can confirm this and suggest the right antibiotic.
  3. Approach to Probiotics: Recent studies suggest that probiotics can sometimes disrupt gut bacteria balance. Consult a dietitian for personalized advice on probiotics. Read more at Bad Gut on Probiotics.
  4. Monitoring Dehydration: Given your history with dehydration, regular blood tests to monitor electrolyte levels are advisable, especially with changes in your ileostomy output.
  5. Imodium Dosage: You’re currently under the maximum Imodium dosage. Consult a pharmacist about possibly increasing the dosage for better control. More information is available at Imodium Website.
  6. Dietary Adjustments: Seek guidance from a dietitian who can provide specific dietary recommendations. Find a dietitian in your area through Dietitians of Canada. Rory Hornstein (Rory RD) specializes in bowel issues and diet.

By addressing these areas, you should gain better control over your ileostomy output and maintain a balanced state of health.

Wishing you well in managing your health effectively and safely,

Andrea Manson
Retired Nurse and Health Advisor