Hydration Concerns with Ileostomy: Seeking Advice

Hi all, I have a 6-month-old ileostomy and this is just a question regarding hydration with an ileostomy. I am drinking lots of fluid, including at least 1 litre of ORS daily. I have noticed that my urine output is nowhere near as much as it was before my ileostomy despite all the fluids. I tend to have pale to straw-colored urine and don't feel dehydrated. I did read that ileostomates do have decreased urine output even when not dehydrated. Anyone got any advice? Thanks all.

I use Buoy drops in a drink 3 times a day to make sure I'm getting needed electrolytes. I don't like any of the sweet hydration drinks so these work out really well for me and there is a medical discount-you just send them an email, really easy process. I also started drinking club soda with fresh limes- I didn't like club soda before I was colonless now I do. It really changed my sense of taste and I crave salt. Sometimes I put pink Himalayan salt in my ice water with lemon too-the lemon helps cut some of the salt flavor but any salt flavor tastes good to me.

The exact amount to drink will vary greatly for each individual. Activity level, age, other health issues, climate, etc. all play a role in how much fluid to take in. Personally, I have a colostomy so I'm a bit different. I don't drink a lot of plain water. Just water makes me pee a lot, plus it's boring. I'll drink milk, juices, hydration drinks, smoothies, soda, etc. In my opinion, drinking just plain water will keep you hydrated but I think it also flushes out many nutrients that, especially for ileostomies, have a harder time retaining if you have normal watery output. Of course, that's just my opinion.

Thanks for your reply. Just wondering whether ileostomy causes reduced urine output. It's certainly not the amount it was prior to ileostomy. Any thoughts appreciated.

Hi Doreen, I've never heard of reduced urine output for ileostomies. I can't imagine why that would be, unless the person is just not drinking enough fluids. I drink a big jug, 1.89 litres, of lightly salted water daily, along with lots of plain water, tea, coffee, milk, and I also mix up a big glass with a small, like less than a quarter cup, of cranberry juice mixed with club soda. I'll sip on a couple big glasses of that in the evening. I pee a lot and have not noticed my urine output to be less at all. If your urine is a very pale yellow, or clear, it doesn't sound like you are dehydrated.

Terry

I'm two years into my ileostomy and I've noticed less urine production during the day. For some reason, overnight my bladder seems to empty completely at 3am LOL. As was mentioned, I'm learning to hydrate smart. I use various electrolyte drops, vitamin water, sea salt.

My one GI doctor told me the intestines aren't active when you're sleeping. No digestion is happening, so I wonder, in my non-expert medical opinion, if more liquid goes to your bladder then rather than out of the stoma opening.

Hi, thanks for your reply. Interesting that you have noticed less urine during the day too. Do you think it's because the fluid is being excreted via the stoma? I do worry about it, but my urine is pale or clear when I pass it.

I am curious as to why your GI told you the intestines aren't active when sleeping?? You don't have to empty your bag during the night?

Yeah, that makes me wonder too. Mine are very active at night, and I need to empty at least twice.

Terry

Mine definitely slows down during the night but took a few years to do so.

Mine can vary from day to day, don't know exactly why. Some things go straight through to the bag, others don't. Lemon seems to go straight through, for example. I put half a teaspoon of salt in every liter of water I drink. The usual sports drinks are loaded with sugar, which I rarely use. These can go straight through me too.

Right, the intestines don't stop moving unless that's when your quiet time is, and some only have like 5-10 minutes of quiet time, and others have longer. But with an ileo, that bad boy is on the move, lol.

Lucky duck! Lol, I have to go a couple of times in the night, and I stop eating anything by 7 or 8, and that's usually just crackers, like 5 crackers, lol.

Hi Beth

I do get up once in the night but it's more of a habit/precaution. I eat a full meal by 7pm, but it wasn't always this way. I'm ready for bed by 11 - 11.30.

Axl, like I said before, lucky duck. Lol, I have to watch what I eat that close to bedtime. If not, I won't be sleeping. Lol.

I think you might be on to something. When I'm awake and super thirsty, if I drink a bunch, which I used to do before, within 15 minutes my bag is full. My nutritionist and I have been monitoring and she said something very similar.

No doubt!

I regulate my hydration by the frequency and concentration (color) of my urine. Plus how thick the ileostomy output is. I try not to drink or eat anything after 6-7pm in the evening so my sleep is not disturbed. Hydration is important because of our risk of kidney stones too.

Recently, I ended up in the ER getting IV fluids overnight because of a GI virus.

Have you ever eaten too much before going to bed (before or after an ostomy doesn't matter) and then gotten sick because it didn't have a chance to fully digest? I don't know if the peristalsis wave of the small intestine stops when the brain is sleeping or not (I'm just referencing the small intestine since I don't have a large intestine anymore but I know everyone's situation here is different). I usually did a bag empty around 12-1am and then learned my lesson about not sleeping in too late. I set alarms at first but got used to doing another early morning empty and going back to sleep.

Gentlejohn, I hadn't heard about the increased risk of kidney stones. Is that with any type of ostomy?

I don't have a large intestine either. The small intestines are constantly moving, unless it's your downtime/quiet time. Now everyone has different quiet times and the length of a quiet time, and some of us have little to no quiet time.

Oh, I know there is no controlling when that stoma will be active. If I had that doctor here to explain what he meant, I'd ask him. I don't see him anymore. He didn't listen to me when I told him symptoms I was having, thankfully his boss did listen to me.

Did you intentionally leave off beer and liquor?

Ileostomy here (+ileal conduit) and I drink enough water to get exactly what you mentioned pale wheat color for output. Depending on the season (humidity and temperature) it usually takes me until about mid-morning to feel hydrated - and I always carry water (with electrolytes). I usually eat salty foods (and sometimes add Mediterranean or sea salt to my food). I'm often eating food high in potassium - cut tomatoes, avocados, bananas, and add electrolytes to my throughout water. But for me, it's all about monitoring my output (color and clarity) since input is relative considering how much I sweat, elevation, humidity. All the best in staying hydrated.

I have to empty my bag at least once, if not twice during the night so I think that there is definitely digestion/movement happening when you are sleeping.

I think if your urine is an OK color, you are OK. You will definitely be peeing less because more liquid is in your ostomy output. A big part of what happens in your colon is absorption of water - which then can either go back into your body or come out as pee. If there's more water in your poop, there is less in other places. But I feel like if your pee is still a reasonably light color you are in ok shape.

My Dr. told me everyone's digestive system is usually active at night and not as active when the body is active. Unfortunately, mine is active every night, making it hard to sleep, but I'm coping. When I was young and had a healthy colon, I would have to use the restroom every morning like clockwork. I miss the good old days.