Why Do Some People Have Odor Problems with an Ileostomy?

I've had an ileostomy since the first of the year (2023). My entire colon was removed, but I still have the rectum and am hoping for a reversal this fall. But, my question is not related to that. While reading posts on this site, one subject keeps coming up again and again and it is something I do not understand. That is ostomy bag odors and what to do about them. I really do not understand this. Maybe I am nose blind and I understand that my 75-year-old olfactory senses are not what they used to be. But, I do not see a problem with strong odors from my ileostomy. The odors from my bowel movements in the years prior to my colectomy were so much worse. Every year, I visit a friend of mine in Missouri. She has always made sure there were plenty of candles available and the fan was in working order. Largely because the guest bathroom is also the laundry room. I was perfectly aware of the stench and did what I could to mitigate it. I haven't visited since my surgery, but I do not see that as a problem any longer.

My question is, why do so many people have odor problems with an ileostomy? I can understand maybe problems with colostomy, as the colon is still somewhat in play. But, the only time I have any problem with odor is when I change the appliance and not when I empty the bag. Could this be because I do two flushes of the bag with 120 ml of water each time? I eat a lot of things that are supposed to produce odor. Baked beans, eggs, fish, garlic, onions, peanut butter, and cheese are all part of my diet.

I am not saying that my shit don't stink. But, it doesn't stink near what it did before I was gutted. :-) Am I just nose blind or somehow different from other people?

--Daniel

Daniel:  I too find ileostomy odor rare.  I use baking soda which I dip into the bag each time I empty as a hedge against any smell.  HenryM  

Do you not use anything at all? I use M9 and for me with my colostomy it works fine. I rarely smell anything with the bag on, if I do I know I have a leak. It is when I am in the bath and making bubbles that there is a smell like never before.

When out of M9, I used peppermint Life Savers. It seemed to work but did not test it further. Lots of people use Tic Tacs. If it does not bother you, it should not bother anyone else.

Been using Hollister one-piece since surgery 8 months ago. When I empty, I spray air freshener in and around the toilet, immediately empty, and immediately flush. Very little smell after. Also, when I'm on the outside and have to use an outside bathroom, I always carry a small can of air freshener and spray after done. Never had a problem on the outside with any type of odor, but then again, I've never had a leak on the outside to have to contend with the problem.

Hi Mose, I don't know what all the odor fuss is about either. I have an ileostomy and the only time I have ever smelled it is when I had sprung a leak. It's an early warning signal for me that there is a problem. When I empty, of course there is some smell, but I flush as soon as the output hits the water, and then again after cleaning the tail of the pouch. My output does smell, and I know it's due to my diet which consists of lots of garlic, onions, cruciferous vegetables, beans, etc., all the bad stuff that tastes so good. I know it's my diet because I remember commenting to the ostomy nurse while I was still in the hospital post-surgery that my output didn't seem to have any smell, which was not the case when I had a colostomy previously. I realize now it was because all I was eating was the totally bland hospital food. As soon as I got home and started eating normally, that all changed.

Terry

My Ostomy Journey: Bruce | Hollister

No. I don't use anything other than the double water rinse. The only time I notice any smell is when I empty or change the bag. With the former, it is not enough to stink up the room. Nowhere near what it was when I had a colon. Even the two times I have had leaks, they were in bed and the smell was sickly sweet and not so overpowering as it used to be pre-Clostridioides difficile. I've talked about this with my wife and she agrees that there is little issue with odors except during bag/appliance changes. And then only when she helps.

Thanks! --Daniel

Thanks, Terry. I eat a fair amount of odor-producing foods and I can tell when I have. However, it is not that big of a difference and nothing that lingers. My wife also has not noticed anything outside of when she helps with appliance changes or accidents. But, we do have separate bathrooms and I do frequently clean mine with a bleach cleaner. Bleach is about the only cleaner that will kill the Clostridioides difficile bacteria. Even without a colon, the C-diff bacteria is there, as it is in every other human, and I want nothing more to do with it. I am paranoid enough about it that it has taken me a while to feel comfortable emptying my bag without gloves. :-)

--Daniel

Thanks, Henry!

--Daniel

Thanks. I don't use any sort of spray. But then again, my wife and I have separate bathrooms. One of the luxuries of an empty nest!

I also have not yet emptied my bag anywhere but home. That will change eventually, so carrying an air freshener may be a good idea just in case. :-)

--Daniel

I think people are combining 2 different scenarios here. 1) If you can smell anything when you are just wearing your bag, obviously there is some sort of leak starting. 2) The smell when you empty your bag and the worry that you're gonna smell the room up so much that others are gonna look at you like "WTF?" For me, I normally add water to my bag, squish it around, and then empty as I flush the toilet, thus taking nearly all the smell with it. Obviously in the house, I have an exhaust fan on too. I don't have much odor. If I do sometimes, I just keep some air freshener to spray. I think a lot of people make the mistake of waiting to flush until they are all done wiping the bag entrance, allowing the smell to build longer than it needs. Flush the toilet, empty as the water is going down, taking almost all of the smell with it, then flush again when you need to.

Alex has the right idea. When I took his advice and began emptying as the toilet water was swirling to the drain, it was a revelation. Less odor, quicker, and if handled right, there is almost no splashing. Saved a ton of dough on cleaning products! I also add water and do a washout using enema bottles. If you squeeze the bottle, it's a bit like a pressure wash and super easy to refill. Much less wiping this way, although I do still wear gloves. By the way, I'm a colostomate, 16 months in, and still learning.

I normally wait to flush the toilet when I am finished and have closed the toilet seat. I have always done this ostomy or no ostomy. I do so because leaving the toilet seat uncovered generates a bacterial mist when flushed. Since my life-changing encounter with C. difficile, I have been even more diligent about this. And since I empty my bag sitting down, flushing also can be a damp experience since I do not have a low-water toilet. :-)

Also, I live in Colorado and hammered water conservation into my children when they were growing up. It would be disingenuous for me to lose the hammer now. :-)

--Daniel

I do have the odor issue. I try to be careful what I eat, and if I eat pizza, it stinks up the whole house. I'd been using safe and simple odor drops for a while, but they suddenly stopped working so I had to go back to M9. It seems my odor has gotten worse in the last 4 months or so, and I don't know why. They checked for C. diff, but that was negative. I'm pretty clean about things, though. I bought a Swiffer for the floor for any back splash, and I put Clorox toilet bowl cleaner in after and scrub. I might have to try that dropping the output in while the water is swirling trick. I'm all about saving money.

Silly question here but since you mentioned M9 in your post - I bought M9 at the suggestion of my visiting nurse, but I find the instructions on the bottle to be vague... Am I supposed to spray it into my bag after emptying for odor control or is it a bathroom spray for the air? - KC

There are two types, a spray and drops. The spray is for the room and drops are for the bag. One squirt is enough.