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Whole pills ending up in the stoma bag!


Hi everyone,

I've just been restarted on Mesalazine for my IBD since having an ileostomy. I have been prescribed two 800mg modified release tablets which I take in the morning with food. I've noticed on two occasions that around 4 hours later these tablet appear completely intact in  my stoma bag. They obviously aren't serving any pharmacological purpose  at all!  Has anyone else experienced  pills just passing straight through and if so did a doctor find a solution. I'm aware that Mesalazine is available in a granular form but I don't know if this would be better. Any insights would be most welcome.


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Hi there

In the early days when any medication would pass straight through me the Doc suggested crushing the tablets in a mortar and pestle, tipping it into a little water and drinking, tasted like crap but worked for me, but check with the Doc that this is suitable for you.


Howdy mister that's why.... they are time release and our stomies know no time we process to quickly for any time release meds to slowly work....Hope it helps have a great Sunday 

ps if you take vitamins try getting the chew type 



Maybe Try one in the morning and one in the evening

 Flomax is the same. Dr. Doubled my dose and i take it twice a day and works like a charm.


Hi Tino. First make sure the pills are not coated and if capsules get gel capsules. You should be having the pills with your meals. If you are not getting the proper pills, then just cut them in half. It doesn't take take much time to disappear after that. Mike


I take the standard non slow release ones and also Loperamide (Imodium) to slow everything down and my tablets absorb before they get to my bag. Tell your doctor straight away.

Good luck!

Reply to Axl

Hi. I was recently prescribed Metformin Extended Release. This is usually prescribed for diabetes but it was prescribed to be for too high testosterone. In addition, I was also diagnosed with macular degeneration and recommended to take AREDS 2. Shortly thereafter, I also found what looked like a whole tablet in my output. I asked my doctor who said that it was the Metformin because it is extended release that it is just the shell of the tablet and that I was still benefiting from the medicine. I researched the internet and found that it said exactly the same as my doctor told me. Extended release tablets are digested in the small intestine and this happens with people who don't have an ostomy, too.  When I first thought it was the eye supplement capsule, I opened the capsule into some apple sauce to be sure that I was getting all of the nutrients.

Hope this helps.



Yes….Diabetics taking Metformin need to make sure they get the normal Metformin, NOT the slow release ones!  Doctors should be aware of this issue.  Sometimes it only takes 3 hours for me…..and the tablet is out….almost whole!


Maybe find out if it could be made available in a chewable form. 

Posts:7 immediate, liquid, granules, uncoated are better in terms of absorption. 

what modified mesalamine are you taking? where is it released? where is your colitis?  Modified released dosage forms (in contrast to immediate-release dosage) delivers a drug with a delay after its administration (delayed-release dosage) or for a prolonged period of time (extended-release [ER, XR, XL] dosage) or to a specific target in the body (targeted-release dosage). It probably is developed to release too late for someone with an ileostomy, thus the pills are comping out whole.  

Lastly, if you have an ileostomy didn't they get rid of your colitis? 


Hi.....   I've had the same thing happen with many different medications ( over t he nearly 60 years, that I've had my ileostomy)..I've had mixed answers from doctors and  pharmacists alike..  Some say, the body  sucks what it needs out of the   pills,   even if it seems to come out " whole".    I didn't fully believe that.   Another doctore suggested not using time release medications...   I always r emind my prescribing dr....of my ostomy,  and if I have more  questions about other forms of the drug ( liquid, powder etc)  I speak to the pharmacist...    Sometimes we substitute another brand......of I 'm  advised to cut the pill in half...   I hope this helps...  Marsha...

Reply to rdt4

Hi, I'm on Octasa MR. Unfortunately even though I have had a lot of my colon removed (50%) a recent CT scan showed I still have inflammation. I've spoken to my excellent stoma nurse yesterday who said it's pointless me talking  those meds and is going to follow it up 


Thanks to all of you for the advice and suggestions. I have a brilliant stoma care team who have a direct line to the doctors. I spoke to stoma care yesterday who said those meds are wrong for me and there's no point in me taking them. They also said they'd follow it up with my doctors so hopefully I'll be prescribed something that I can actually absorb. What I think is that I should be on biologics 


Hi there,

Anything I take is in liquid form ... Or the the old school tablets... Ya know how Tylenol used to be the white chalky like pill.. no coating, no time release ,no capsules.. I would ask your doctor if he could give it in liquid form ..


I had my blood pressure pill show up in my pouch many times, I asked our pharmacist about it, he said it is not uncommon, that most of the time it is just the shell, the medication gets out through the small indent in the center of the pill. Sure enough I managed to squash the pill and as the pharmacist said, it was just a shell and my Blood Pressure is stable.


Well, finally someone else has had this issue - and I thought it was only me.  Thanks for your post- made me feel I am not alone.    I have commented on this before so I won't go into detail about my feelings regarding the “practice of medicine”.  I am confused why any doctor would recommend meds in tablet/pill form if they are aware the persons sports a stoma.  Also, have read some meds are broken down in the colon - what good would that be to a person with an ileostomy?  I don't take meds except for B12 in sublingual form so I have no answers for you - maybe the best source is your local pharmacist.


Yes. When I first had my ileostomy my pain medication was going into my bag whole. Several times found up to 5 pills in my bag. I spoke to my dr and he started giving my pain meds in liquid form.  Although the price doubled or more. 

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