A colostomy is a surgical procedure that creates an opening, known as a stoma, from the colon through the abdominal wall. This new pathway allows stool to exit the body into an external pouch, bypassing the rectum and anus. While a colostomy helps manage various bowel conditions, individuals with a colostomy may sometimes experience diarrhea, which can be challenging to manage.
Understanding Diarrhea with a Colostomy
Diarrhea with a colostomy is characterized by frequent, watery, or unusually loose stool output from the stoma. This differs from the normal, often semi-formed or pasty consistency of colostomy output that many individuals experience. The colon’s primary role is to absorb water, so when a portion of it is bypassed or removed, the remaining digestive tract may have less capacity to reabsorb fluids, leading to looser stool.
Several factors can contribute to diarrhea. Dietary choices, certain medications like antibiotics, and gastrointestinal infections are common causes. Underlying bowel conditions such as inflammatory bowel disease, stress, or the body’s adjustment after colostomy surgery can also lead to increased, watery output.
Immediate Steps for Relief
Prioritizing hydration is important when experiencing diarrhea. Replacing lost fluids and electrolytes is key to preventing dehydration. Oral rehydration solutions (ORS), which contain a balanced mix of salts and sugars, are often recommended, alongside water and clear broths. Sports drinks can also help replace essential salts and glucose.
Temporarily adjusting the diet to include binding foods can help thicken stool consistency. Foods such as bananas, applesauce, white rice, pasta, and plain toast are commonly suggested. Cheese, especially hard cheeses, and smooth peanut butter can also contribute to firmer output. Monitoring the volume and frequency of output from the stoma is also important to track the severity and progression of diarrhea.
Dietary and Lifestyle Modifications
For sustained management and prevention of diarrhea, specific dietary and lifestyle adjustments are beneficial. Limit or avoid foods that commonly loosen stool or increase gas. These include high-fiber foods such as raw fruits with skins and seeds, raw vegetables, whole grains, and legumes, which can be difficult to process. Greasy or fried foods, spicy dishes, artificial sweeteners, caffeine, and alcohol can irritate the bowel and increase output.
Incorporating foods that promote firmer stool consistency is helpful. This includes refined grains like white bread, white rice, and plain pasta, as well as well-cooked, peeled vegetables such as carrots and potatoes. Lean proteins, like eggs and poultry, are generally well-tolerated.
Establishing regular meal times and eating smaller, more frequent meals throughout the day can help regulate bowel function. Thoroughly chewing food before swallowing aids digestion and can prevent issues with output. Adequate fluid intake, ideally between meals rather than with them, helps maintain overall hydration without excessively flushing the digestive system.
When to Seek Professional Medical Advice
Certain symptoms indicate the need for professional medical attention. Signs of severe dehydration, such as increased thirst, a dry mouth, significantly decreased urine output, lightheadedness, or persistent fatigue, warrant immediate contact with a healthcare provider. Persistent high-volume, watery output lasting more than five to six hours, or if diarrhea does not improve despite home management efforts, should also prompt medical consultation.
Additional warning signs include the presence of a fever, severe abdominal pain or cramping, or any visible blood in the stool or colostomy pouch. Indications of infection around the stoma, such as increased pain, swelling, warmth, redness, pus draining, or red streaks, also require prompt medical evaluation. While over-the-counter anti-diarrheal medications like loperamide (Imodium) can slow bowel movements and thicken output, they should only be used under the specific guidance of a doctor or ostomy nurse to ensure appropriate dosage and avoid complications like constipation or blockages.