over active ileostomy during the night.


Hi All.

I've had a loop ileostomy due to cancer for nearly 6 years. Due to problems following surgery, I developed an Anastomotic leak, which caused Sepsis, after being discharged from hospital. I was readmitted and recovered with drainage operation, and lot's of intravenous antibiotics. 

Because of the damage done during/after operation, I can't have my dearest wish of a reversal.

My problem now is that my stoma becomes very active during the night, much more than day time, even though I only have a small sandwich to eat, with a small cup of tea, around 7pm.

It is virtually active when going to bed about 10.30pm. and continues throughout the night, disturbing my sleep on having to listen to it, then getting up to empty my bag.

I take 2 loperimide capsules just before bed time, but they don't stop this activity. 

I must admit, this is getting me down, and affecting my health with depression. I am a male.

If anyone else has, or had this problem, and could give me any advice on how to ease the situation, I would be eternally grateful. My local doctor or Stoma nurse don't have any suggestions.

Many thanks, Ron.

Mysterious Mose

What does your daytime diet look like? Are you eating foods that will increase the bulk? Such as potatoes, rice, etc. Have you tried taking the loperamide with your morning and evening meals and not before you got to bed? When I do that, the output from my ileostomy gets quite thick and I have to back off the evening dose. But, I suppose that is yet another example of how we are all different. And mine is not a loop ileostomy.

I should also ask if this is a new occurrence, or has it been this way for all 6 years.


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Ask your GP to refer you back to hospital to see a Consultant and dietician if needed as diet can play a big part towards it .

If you have  a high output stoma tea & coffee are the worse things you can drink they will make your output higher.

Taking loperamide just before you go to bed is a waste of time you should take it before you eat so it can do it's job, 2 loperamide is a low dose you can take much more but only with your Dr's advice that's why I would advise speaking to a Consultant.

Reply to Mysterious Mose

Thanks for responding. It's been like this for about 6 moths. Yes, have an early lunch, about 12.30-1pm. Always have either boiled/mashed potatoes, or chips, with battered fish, green beans, bit of broccoli/cauliflower. Chicken breast/thighs in a mild spicy sauce, together with mostly same vegetables. 1 coffee (caffeine) morning, and 1 about 4pm. Nothing else until 2 thin slices of white bread, as 2 sandwiches, containing ham or cheese about 6.30 pm.  Have 2 white toastie slices with small amount of butter and marmalade. Small cup of tea (no sugar) for breakfast, and same cup of tea with evening sandwich. I take a 2mg loperimide before breakfast, and 1 after lunch. Take 1 or 2 before bed to try and reduce activity of loop ileostomy, but it's not solving the problem.

Cheers, Ron.

Reply to Ben38

Hi Ben 38,

Saw GP this morning and she has referred me to speak/see a dietician.

Cheers, Ron

Living with Your Ostomy | Hollister
Mysterious Mose
Reply to ronjay2808

Here in the U.S., that would be called a punt. :-)



Can you try to add a spoonful of creamy peanut butter or two? Also, try some short grain white rice. I’ve also been struggling, but those have helped me.

Reply to Mysterious Mose

Hi Dan,

What do you mean by a ''Punt''?


Reply to JVM261

When would you suggest I take the peanut butter?

Thanks, Ron.


You may want to experiment with psyllium husk powder , sprinkle it on food or even put it in water and drink it. It absorbs many times it's weight of liquid. I took it for a different reason and it works very well.

Reply to Mysterious Mose

What is a Punt  Daniel. Does it mean have a Bet?   Regards IGGIE

Mysterious Mose



Mysterious Mose
Reply to ronjay2808



Reply to Axl

Hi Axl,

is it safe to take it before bedtime, having an overactive loop ileostomy?

Thanks, Ron.


Hi Ron

You can take it any time as it simply absorbs many times it's weight in liquid and slows down the process. Most take it for other purposes but it also works great slowing down the system in our circumstances. You can add it to water, stir and drink it quickly as it start to gel quickly. Just start with a teaspoon and evaluate where you go from there. You will find Metamucils main ingredient is also psyllium husk. The plain husk powder tastes a little dreary but it is dirt cheap and can be flavoured or give the Metamucil a shot, the latter has other ingredients. Take it when you want, just start slowly. Google "Metamucil and ileostomy" Feedback for others would be great too.


Do you monitor how active your pouch gets after your other meals? Since I don’t have a colon, I am incontinent. I won’t eat past 6:00 pm so that my food passes and my pouch is less active. Of course, if I eat something fatty then I will be up several times emptying. Sometimes it helps for me to eat a banana or applesauce to harden my loose stool and slow things down. 


I find that the best way to avoid frequent night bag emptying is to eat early and limit fluid intake, I have to take 6 loperamide 4 times a day and 2 omeprozole a day. It does help but do empty at least twice a night. It’s really affected my energy levels and sleep patterns but I guess the less you put in the less active it should be.


all very good comments.

very accurate..

my quess  is a bit off the wall.

i empty once or twice a night.

eating light by six does help..

bananas marsh mellows as a snack.

but i have though why is the stoma more active at night? does being prone several hours influence the stoma out put? laying down? 

wondering with all great advice given, if a recliner chair might solve issue too? 

anyone try it? or gave that a chance?