Kidney Issues Post-Ileostomy: Seeking Advice

Hi folks. I had my ileostomy about 8 months ago. My surgeon is pleased with my progress, but I have an ongoing problem with kidney function. I take 8 loperamide daily to help thicken stoma contents. If I drink too much liquid, the stoma contents are too loose, but if I cut back on what I drink, then my kidneys show signs of dehydration. I've been referred to a renal specialist, but I just wondered if anyone else has had similar problems or has tips on how to improve the situation? Thanks.

When I had my ileostomy surgery years ago, no one ever mentioned the need to increase my hydration.  As a result, I've now got chronic kidney disease and constant dehydration issues for which I get regular infusions.  It's crucial that you keep drinking during the day.  Figuring out how much is very individualistic.  Consult a nephrologist.  It may depend on the current state of your kidney function which can be determined readily via blood work.  The blood work will also determine such things as sodium level, an important reading as too much liquid intake may wash out sodium and present a different danger.  My own liquid intake has varied between 96 oz per day (a few years ago) to 60+ today.  A lot of this determination re liquid intake is certainly guesswork, but better to let the kidney doc do it than you alone.  

Hi Janko, I have found that if I drink different fluids and not just water or coffee, my output isn't as loose or runny. I also eat foods that help thicken the output, like peanut butter on toast or bananas.

It's as much how much you drink as it is what you drink. Do you drink electrolyte drinks? You need to keep drinking even if you have loose output. I have stage 3 chronic kidney disease from dehydration issues after my ileostomy. I even had acute kidney injury from dehydration. Don't just drink water, though; drink Pedialyte, G Fit, Drip Drop, or another electrolyte drink product.

Agree with everyone's advice above.

The sad part is we as ileos never got the complete story behind having the ileostomy.

Which is dehydration causing kidney disease.

A variety of drinks are needed to keep your taste buds happy and kidneys operational.

Never cut back on drinking fluids. Use Imodium to bulk up or proper foods as advised by the above members.

You have to find an M.O.

A method of operating daily to keep yourself hydrated and keep yourself bulked up to retain nutrients from your diet.

Trial and error will get you to a new norm. This will be your daily routine, and it will become second nature to you.

The trick is finding what works for you and keeping at it. We can only suggest things that work for us. Individually.

Good luck.

How to Stay Hydrated with an Ostomy with Collin | Hollister

Hi Janko,

Dehydration among ileostomates is extremely serious. The colon's function removes water, electrolytes, and some nutrients from the food sent to it from the small intestine. For ileostomates, that function performed by the colon is eliminated because our colon has been removed. Our stoma is actually the small intestine. I have had my ileostomy for 51 years. Dehydration and the replacement of electrolytes have always been a continuous focus. Then, I moved from Wisconsin to the sunny 100+ degree days of Louisiana. There was a period of 18 months during which I entered the hospital 6 times with severe dehydration. My kidneys shut down and I blacked out. The ER doctors immediately wanted to put me on dialysis. Fortunately, my wife (who works at a hospital) emphatically refused. Wanelle, 😇 (bless her), knowing what was going on, instructed them to get IVs started with fluids and electrolytes. Within several hours, my kidneys were functioning normally. Now, I carry water and/or Pedialyte religiously. It's in my hand or a holster on my belt. However, I do have an appointment with a renal specialist every 4 months as a precaution.

Thank you for your replies. Nobody tells us what the aftereffects of having an ileostomy really are and what happens to the kidneys. I appreciate you sharing your experiences and realize that it is all an ongoing battle. I attended the renal specialist today and am waiting for the results of various blood tests, so I will need to wait and see what happens next! Take care!

Hi Janko,

I thought that this might also be helpful since you just had some blood work done. For the 51 years of having my ileostomy, I have continued to battle with deficiencies in magnesium and potassium levels. Two very important and necessary electrolytes: potassium for muscle and nerve function, and cramping; magnesium for muscle and nerve function, regulating blood sugar, blood pressure, and bone health. When you review the report of your blood work, take notice of those two electrolytes. Note that every item on that report is important. But do take notice of those two. I don't know if it's just me or if this battle is also experienced by other ileostomates. You may, like me, need to take a supplement. Caution: if you do need to take a supplement, take it in gummy or powder form. Capsules work too. Ileostomates have problems with hard pills not dissolving or digesting in the stomach and passing straight through your short digestive system, ending entirely whole in the bottom of your pouch. Again, just a precaution. Hope, in your case, that this is not an issue. 🙏

Agree, 8 loperamide seems like a lot. At most, I use 3.