Question:

I have had an ileostomy for one year. I recently read about certain drugs and vitamins that are best taken in liquid form. How can I find out more? For example – which vitamins that I am currently taking actually dissolve properly in just my small intestine, and also drugs in pill form, such as Cortef – hydrocortisone – which I am currently taking for adrenal insufficiency. And Tylenol – should I take it in liquid form? Thank you so much for your attention.  

Response:

Great set of questions! It is advisable that you consult with your pharmacist. Your pharmacist will know what drugs and medications come in liquid form. An established relationship with your pharmacist is important to your care. Being your own advocate is very important.  

Useful Information:

Because portions of the intestinal tract have been removed or bypassed, people with a fecal stoma (ileostomy or colostomy) may experience difficulty in absorbing and, therefore, gaining maximum benefit from oral medications. The shorter the length of the remaining bowel, the greater the problem of absorption, particularly in the ileum. Generally, people with descending or sigmoid colostomies absorb medications as well as people who do not have an ostomy. However, some medications (eg, enteric-coated tablets, time-release products, or large tablets) are designed for gradual absorption along the full length of the intestine (the ileum and the colon). If transit time is reduced/increased and/or portions of the bowel have been removed, these medications can be incompletely and erratically absorbed, especially in persons with an ileostomy. It is also suggested that ostomates be cautious when crushing tablets without first checking with the pharmacist, because the practice may expose the medication to gastric fluids, which could cause gastric upset or inactivate the drug. During your consultation with the pharmacist, ask them to explain how the absorption of the medication will or not be affected by having an ileostomy or colostomy. Before taking any new over-the-counter medication, it is advisable that you check with your physician, an NSWOC – Nurses Specialized In Wound, Ostomy And Continence Canada (formerly called The Canadian Association for Enterostomal Therapy (CAET), and/or pharmacist to determine and potential side effects and/or interaction with other currently prescribed medications. To locate an NSWOC nurse in or near your location – go to the OstomyCanada.ca website. You will see the “Support” menu on the top banner, click on the drop-down menu “Support Listing”. In this drop-down menu, you will see “Find a NSWOC,” click and follow the instructions.