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Stones / iliostomy

Posted by Riva, on Sun Apr 26, 2020 6:48 pm

Wondering if anyone has had any situation/experience with passing of stones.  Staying hydrated but wondering if it is related to electrolytes, etc. .  just reaching out to the community .  Thks 

Reply by Anoniem18, on Sun Apr 26, 2020 7:07 pm

I ended up with a gall stone several years after my ileostomy operation, Surgeon removed gallstone then scheduled gall bladder removal, without any further complications 

Reply by w30bob, on Sun Apr 26, 2020 8:58 pm

Hi Riva,

  Yeah, it sure is.  Here's a 'cut and paste' that explains it well.  Link will follow on bottom.  

regards,

bob

 

How Ileostomy Promotes Stones


Water and Electrolyte Loss;


The colon reabsorbs large amounts of water, sodium, bicarbonate, calcium, and potassium. When colon is lost from surgery for cancer or inflammatory bowel disease, what it once reabsorbed is also lost into ileostomy drainage. Kidneys compensate as expected, by producing a scanty and acidic urine low in sodium, calcium and potassium. Kidney cells conserve filtered citrate and metabolize it to bicarbonate to help make up for ileostomy losses. Likewise, they produce copious ammonia, a way of removing acid from the body.

All these compensations supersaturate the urine with respect to calcium oxalate – low volume, and uric acid – low volume and pH. As a result, calcium oxalate and uric acid stones occur.

Does Not Increase Urine Oxalate Excretion;

Much the same pattern of water and electrolyte loss occur after loss of small bowel from surgery or other cause. Losses are less severe when the colon remains in place because it can reabsorb some of what escapes from the small bowel. But the colon is affected in such a way that it permits abnormal amounts of oxalate to pass through its linings into the blood. As a result urine is high in oxalate as well as scanty and acidic – so called enteric hyperoxaluria.

Dehydration vs. Oxalate;

This is a key point of distinction. Ileostomy causes stones and poses serious risk of kidney injury from dehydration. Small bowel resection poses less risk from dehydration but more from excess oxalate excretion that can cause both stones and severe kidney injury. Ileostomy plus small bowel resection, therefore, causes extreme risk of dehydration, but loss of colon removes the source of extra oxalate. In other words, with or without associated small bowel disease, patients with ileostomy form stones because of electrolyte and water loss, not excess oxalate.

Link to full article: https://kidneystones.uchicago.edu/chapter-11-ileostomy-kidney-stones/  



Last edited by w30bob on Mon Apr 27, 2020 12:16 am; edited 1 time in total
Reply by newyorktorque, on Sun Apr 26, 2020 9:23 pm

Hi Riva.  I have an ileo and gallstones.  My doctor put me on Bentyl and painmeds as I am not allowed to have anymore surgeries due to excess scar tissue.  I would say it's better tolerated now that I am on the meds.  I still have issues with hydration.  I need to drink more ORS - oral rehydration solution.  

Reply by Bellisima, on Sun Apr 26, 2020 11:31 pm

Hello Riva,

I believe Bob hit the nail on the head!  I have had an ileostomy since my early 20's and was plagued with total uric acid kidney stones for many years.  Thankfully, I was able to pass them, enduring much pain, and many times hospitalization for rehydration.  Then, several years ago, one formed which was too large to pass and I had to have a renal stent placed for many weeks.  It was extremely painful as I was suppose to lay around-which I could not do-and not walk around or do much of anything.  I was so thankful when the day came to have the evil, intrusive thing removed and get some relief.   I vowed to never have one of those stents put in ever again!  I was then referred to a nephrologist, who worked together with the urologist, and they put me on Allopurinol.  I can also take bicarbonate in water each morning but have not found the need to add that at this time.  Although I will always have to be very careful to stay hydrated, this medicine has seemed to do the trick (at least for now...knock on wood!)  I was always told that I would be prone to having kidney stones, after having the ileostomy surgery, for the very reasons Bob has listed above.  I am living proof it is from the ileostomy because I have been eating a completely plant-based diet for almost seven years, consuming no meat or dairy, and even without the purines usually found in meats, my body was still able to produce total uric acid kidney stones!  

Hopefully, working with your medical team, you, too, will be able to prevent any further formation of kidney stones in the future.  I wish you the very best...hang in there!

Reply by Bellisima, on Sun Apr 26, 2020 11:37 pm

Bob,

Your response to Riva on this topic was so on point.  I wanted to ask you a favor.  I was unable to open the link to view the entire article so I was hoping you could email me the info?  My email is proudsicilian69 at the gmail at com.  

Thanking you in advance,

Susanna

 

 

 

30bob wrote:

Hi Riva,

  Yeah, it sure is.  Here's a 'cut and paste' that explains it well.  Link will follow on bottom.  

regards,

bob

 

How Ileostomy Promotes Stones


Water and Electrolyte Loss;


The colon reabsorbs large amounts of water, sodium, bicarbonate, calcium, and potassium. When colon is lost from surgery for cancer or inflammatory bowel disease, what it once reabsorbed is also lost into ileostomy drainage. Kidneys compensate as expected, by producing a scanty and acidic urine low in sodium, calcium and potassium. Kidney cells conserve filtered citrate and metabolize it to bicarbonate to help make up for ileostomy losses. Likewise, they produce copious ammonia, a way of removing acid from the body.

All these compensations supersaturate the urine with respect to calcium oxalate – low volume, and uric acid – low volume and pH. As a result, calcium oxalate and uric acid stones occur.

Does Not Increase Urine Oxalate Excretion;

Much the same pattern of water and electrolyte loss occur after loss of small bowel from surgery or other cause. Losses are less severe when the colon remains in place because it can reabsorb some of what escapes from the small bowel. But the colon is affected in such a way that it permits abnormal amounts of oxalate to pass through its linings into the blood. As a result urine is high in oxalate as well as scanty and acidic – so called enteric hyperoxaluria.

Dehydration vs. Oxalate;

This is a key point of distinction. Ileostomy causes stones and poses serious risk of kidney injury from dehydration. Small bowel resection poses less risk from dehydration but more from excess oxalate excretion that can cause both stones and severe kidney injury. Ileostomy plus small bowel resection, therefore, causes extreme risk of dehydration, but loss of colon removes the source of extra oxalate. In other words, with or without associated small bowel disease, patients with ileostomy form stones because of electrolyte and water loss, not excess oxalate.

Link to full article: https://kidneystones.uchicago.edu/chapter-11-ileostomy-kidney-stones/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Each one can produce a stone. A kidney stone is a solid mass made up of tiny crystals from the minerals calcium, oxalate and uric acid. Gallstones are hard, pebble-like cholesterol or pigment deposits that form inside the gallbladder. They can be as small as a grain of sand or as large as a golf ball.Sep 5, 2019



Reply by w30bob, on Mon Apr 27, 2020 12:30 am
Bellisima wrote:

Bob,

Your response to Riva on this topic was so on point.  I wanted to ask you a favor.  I was unable to open the link to view the entire article so I was hoping you could email me the info?  My email is proudsicilian69 at the gmail at com.  

Thanking you in advance,

Susanna

 

 

 

30bob wrote:

Hi Riva,

  Yeah, it sure is.  Here's a 'cut and paste' that explains it well.  Link will follow on bottom.  

regards,

bob

 

How Ileostomy Promotes Stones


Water and Electrolyte Loss;


The colon reabsorbs large amounts of water, sodium, bicarbonate, calcium, and potassium. When colon is lost from surgery for cancer or inflammatory bowel disease, what it once reabsorbed is also lost into ileostomy drainage. Kidneys compensate as expected, by producing a scanty and acidic urine low in sodium, calcium and potassium. Kidney cells conserve filtered citrate and metabolize it to bicarbonate to help make up for ileostomy losses. Likewise, they produce copious ammonia, a way of removing acid from the body.

All these compensations supersaturate the urine with respect to calcium oxalate – low volume, and uric acid – low volume and pH. As a result, calcium oxalate and uric acid stones occur.

Does Not Increase Urine Oxalate Excretion;

Much the same pattern of water and electrolyte loss occur after loss of small bowel from surgery or other cause. Losses are less severe when the colon remains in place because it can reabsorb some of what escapes from the small bowel. But the colon is affected in such a way that it permits abnormal amounts of oxalate to pass through its linings into the blood. As a result urine is high in oxalate as well as scanty and acidic – so called enteric hyperoxaluria.

Dehydration vs. Oxalate;

This is a key point of distinction. Ileostomy causes stones and poses serious risk of kidney injury from dehydration. Small bowel resection poses less risk from dehydration but more from excess oxalate excretion that can cause both stones and severe kidney injury. Ileostomy plus small bowel resection, therefore, causes extreme risk of dehydration, but loss of colon removes the source of extra oxalate. In other words, with or without associated small bowel disease, patients with ileostomy form stones because of electrolyte and water loss, not excess oxalate.

Link to full article: https://kidneystones.uchicago.edu/chapter-11-ileostomy-kidney-stones/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Each one can produce a stone. A kidney stone is a solid mass made up of tiny crystals from the minerals calcium, oxalate and uric acid. Gallstones are hard, pebble-like cholesterol or pigment deposits that form inside the gallbladder. They can be as small as a grain of sand or as large as a golf ball.Sep 5, 2019



Hi Susanna,

  Check your inbox......it should be there!  If not just let me know.

Regards,

Bob

Reply by ron in mich, on Mon Apr 27, 2020 9:20 am

Hi Riva i,ve had my ileo. for 30 some years and have been plagued by kidney stones ever since, i had one stone the size of a thumb nail that caused infection and had to be lasered out, after that my doc. said to drink a glass of lemon juice every day and i havent had any problems since.  good luck

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