Managing Swollen Ileostomy Pouches at Night

Topic: When the Pouch Swells Up Like a Balloon

I've had a radical ileostomy with complete removal of the large intestine and rectum. It was non-reversible surgery. I've been

living with it since October 1992. The topic I want to discuss now is when your ileostomy pouch swells up like a balloon. The most

inconvenient time this usually happens is in the middle of the night when you're sleeping. There are some appliances which have

a kind of gas release valve at the top. But I've never had much luck with those appliances.

A month or two after surgery, I attended a class at Bethesda North Hospital where a nurse talked about living with a permanent

ostomy with an appliance. Everyone in the classroom was an ostomate. One bald-headed middle-aged man kept complaining to the

nurse about how his pouch swelled up like a balloon at night, so tight it could easily burst. The nurse didn't have too much advice

on how to handle such a problem.

In my case, I've learned to live with it. A number of times during the night when I come out of a deep sleep and am in that

hypnagogic state when I'm half-sleep and half-awake, I look down and see the pouch swelled up like a balloon ready to burst.

Sometimes I force myself to get up, go to the bathroom, and release it. Other times I'm just too tired to get up and go

through all this bs and just lie lightly on my side until the alarm clock rings.

As I mentioned in a comment elsewhere, the best way to stop this is by not eating any full meal after 7 p.m. and not doing any

heavy snacking after that time either. I've had about four accidents over the many years, and there's not a whole lot I can

do about this damn situation except what I previously mentioned.

I guess I am lucky in that respect. I have a colostomy and I am retired. Mostly mine happens in the daytime so I am free to check and release it. I have to get up several times a night because of kidney problems. So if it balloons, I can catch it. Like you said, it mostly depends on what you eat.

CK,
You can always try Gas-X or the generic brand. Also, Beano works well too.

Pouches with the gas filter suck with ileostomies. They are geared more toward colostomies. With ileostomies, they get saturated too easily with fecal matter and just as messy as a leak. Just my 2 cents.

Bain

Thanks for the feedback. I really appreciate it.

Thanks, Lovely.

Hi Cin kid.
I have a permanent ileostomy and use a 2-piece Convatec system. Honestly, through the night, if my bag fills with air, I stay in bed, undo the clip, and burp the bag. It can be stinky at times, but it is what it is. Take care.

Ange

Hi Ckid,

So are you saying your bag only contains gas when this happens... or is there liquid/solid waste in the bag as well? If it's just gas, you have a few options... such as not fully closing the outlet of the bag or installing a pressure relief valve at the high point of the bag. You can simply remove your daytime bag before you go to bed and replace it with the bag with the pressure relief valve installed. Then in the morning, you just remove and re-install your regular bag. I assume you use a two-piece barrier. Now, if you use a non-removable bag, you need to be a little more creative. What I would do is find a way to modify the outlet of the bag. I'd find a way to insert and seal a long (3 or 4-foot) piece of thin clear plastic tubing into the bag outlet and then clamp the other open end of the tubing to the top of my bed's headboard or to something significantly higher than your bag when you are lying in your bed. The open tubing will allow any gas to escape but be high enough that any liquid you generate during the night can't escape. Bill is the master of DIY ostomy gadgetry... so you might want to pick his brain as well. Let us know how you make out.

Regards,
Bob

Thanks w30bob. I can use all the help I can get. :)
I'm never too old to learn some new tips.

Hello Ckid.
I see you have a lot of good advice so far, so I will not repeat that, I like to experiment with stuff, so when I had the problem of gas pressure in the bag overnight, I tried using an irrigation tube overnight, folded up to make a huge bag. I am still using this method years later and I can say that I have not had any of those problems that you describe. I do use my own base-plates, so the sleeves last a month or so before needing replacement.
Best wishes
Bill

Thanks, Bob. No matter how old I get, I will always be learning.
Sometimes you never know how best to deal with something until you hear someone with a better way. I've experimented with different types of pouches before. I expect I'll be learning till I die. And hopefully, that will be a very, very long time from now, lol.

Hi CK, I have heard that if your stomach is empty, it creates gas. So, I always eat some yogurt about an hour before bedtime and rarely have to get up during the night.

Thanks for the tip, but it's never just gas. It usually has a third of the bag full of stool from the food. I have a high volume pouch, so if I eat three meals a day, I have to empty the pouch ten times or more during the day, and usually have to get up several hours before my normal waking time to empty the pouch.