Medication Absorption Tips for Ileostomy Patients

Most ileostomy patients know medication absorption is very different for us. Medication can end up in our bag long before it does us any good. I have had to do a lot of research with pharmacology, and in doing so, found the following. Please note, do not take my word for this. There is too much misinformation out there. This was tested at Johns Hopkins University and published in 2022. Once you Google it, you can read the study for yourself. They found that by lying on your right side for 10 to 15 minutes after taking your meds, it keeps it in the deepest part of your stomach and metabolizes it 2.3 times faster! Lying on your left side could take 100 minutes, and by then it is in your bag. Before knowing this, I tried taking NyQuil, and the entire amount ended up in my bag. By simply lying on my right side for 15 minutes, none of it appeared in the bag. For the average person, this may not be a big deal; for ileostomy patients, it can be a lifesaver. Again, always check any info that is posted here because even well-intentioned people can spread misinformation without knowing this. The study is there, other hospitals document it as well, and the reasoning behind it makes sense. I hope this can help someone else. Just be sure to lie on your right side fairly soon after taking the medication.

Thanks for the info. It sounds interesting. I am sure the study would be interesting to read. Can you provide a link?

Very interesting

Very interesting stuff! I am having trouble keeping my magnesium at a normal level. I take a supplement before bed, so I will try lying on my right side when I get into bed. I think my problem is more related to hydration leaching magnesium out of my system, but it doesn't hurt to see if this makes any difference. Thanks for posting.

Terry

I think, but I'm not positive, those of us with ileos also have to consider the type of coating, especially with capsules, and the size of the pill/capsule. I've taken small capsules that have the thin coating/jacket with no issues.

When I talked to an oncologist about whether I could take the chemo pill given my ileo, she said I could. But she did relay that she has a patient who once had a portion of the chemo pill pop out of her stoma. That thought freaked me out a bit.

For prescription drugs, I've also heard you should let your pharmacy know. (Something I haven't yet done but need to.) Hopefully, they can catch any prescribed pills/capsules that may not get fully digested because of an ileo and can make suggestions for alternatives.

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

You can Google John Hopkins' study on medication absorption. Let me know if you are still having problems.

You are right; there are several other factors as well, but I am posting this because my stoma nurse had no idea until I told her. And when I asked my pharmacist specific questions regarding ileostomy patients, her response was, "I'm sorry, I really haven't had much experience in that area." I was a paramedic for years, and at 74, I have literally gone back to studying pharmacology because there is so little knowledge in the medical community regarding how "our systems" work with medications. This is a no-brainer. There is literally no harm in trying, and if it works for you, it is a Godsend. Thanks.

Thank you for the info. Like others, I have had meds come through my stoma without being hardly absorbed at all. So I will give this a whirl and see if it helps!

Ileostomy here… fortunately I do not take meds, but on occasion when I need to (for pain), etc. I search for liquid, sublingual, or chewable… having a capsule pop into my bag early on this journey, I feared all meds would do this. I have also read that some capsules break down in the large intestines…? ….. If true… what good is this to an ileostomate?

Thanks for your post….

If you take liquids, the same will happen. They can end up in your bag before being absorbed, so again, it helps to lie on your right side.

Thanks, I will definitely do this next time I take any liquid medication. jb

Hi all, I've been an ostomate for 40 years, and I just learned something new. Thanks, Daystar.

Guess it is true…never too old or too ostracized to learn new things! jb

I have trouble with my magnesium too. I take a supplement at dinner time. Mine is 0.1 into normal. I too think it has to do with hydration and magnesium going out of my system through my bag. I think that is where it goes. I do think the supplement has helped minimally because it used to be below normal, and even 0.1 into normal is better than below. But I wish I had a good answer. I switched from magnesium citrate to magnesium glycinate because a nurse practitioner told me that it is absorbed better by the body. So now I take magnesium glycinate tablets. They don't come out in my bag, so I assume they are being absorbed.

That is true at least of extended-release tablets. I have been told never to take an extended-release tablet for that reason. It is no good for someone with an ileostomy.

I take the glycinate too, for the same reason. It does seem to be staying with me a little better, but I'm still getting infused when I go below 0.70. I have reduced my hydration a little too, as I think I was overhydrating. I'm getting infused tomorrow, and I can really tell when I'm low. Not only does it affect my sleep, but when it's really bad, I get muscle cramps. I was having bad ones in my thighs in bed last night.

Terry

Methylated vitamins get absorbed faster than regular vitamins, so maybe they'd work better?

https://www.victorymenshealth.com/methylated-multivitamins/#:~:text=Methylated%20multivitamins%20give%20you%20the,folate%20and%20methylcobalamin%20for%20B12.

I try to use liquids when possible and capsules when not - some hard-pressed tabs go through unscathed lol today I threw up an 800 mg tab I took yesterday afternoon. I have been on Gattex for several months for absorption issues, aka short bowel syndrome, but I haven't noticed a significant difference even after all those daily injections (good that my insurance covers it as it is about $10,000 a month, similar to the weight loss med. It is GLP-2 not 1, I did lose about 20# in the first 3 months! but still sometimes see pills in my bag if they are hard tabs. I am taking a break from it as I am having massive hot sweats especially at night, not sure why)










































$10,000

I have short bowel syndrome due to complications and a failed J-pouch, and I need IV infusions at least once a month at the Infusion Center in the next town. I used to go to the local ER, but they frown on me going just for infusions. I have been using Gattex for several months, but I am having side effects now, so I am taking a break. Good thing I don't have to pay for it because it is about "$10,000/month," similar to the weight loss drug GLP-1; it is GLP-2, so I did lose about 20 pounds, which was good! I have night sweats and leg cramps, and when my gut is working too hard, I wet myself, and the medication I take for that doesn't seem to work with any stress. I refuse to wear Depends (depends on if I cough or sneeze) lol. The Myrbetriq I take is a hard tablet (also extended release); maybe a different medication would be better. I do get dehydrated chronically, even drinking an electrolyte drink like Pedialyte often. Now I am having cardiac problems along with my gut issues. So good luck with your journey!

Dang, the whole song and dance I wrote disappeared. I am on Gattex for short bowel syndrome, get IV fluids once a month, and still get dehydrated and have cramps mostly at night when I am not drinking Pedialyte in most glasses of water. Gattex is
GLP-2, not GLP-1, but I did lose almost 20 pounds. I have had many surgeries after my ileostomy for dead bowel and a failed J-pouch. I also had my bladder rebuilt twice due to scarring that affected the bladder (also hepatitis C from blood transfusions), so I am complicated for sure and not a typical ileostomy for sure. Good luck on your journey.

Hi! I have low magnesium too! I've had to get infusions, so I'll try anything! I'm supposed to hydrate, but everything goes immediately through me even when I sip! Good luck to you.

Ileostomate here, thank you for this. I get bad leg cramps sometimes at night and did not know what could cause this. I do take magnesium, but it's highly likely that not enough is staying in my system. I am going to see what my doctor and pharmacist think and get my levels checked more often. The cramps are so bad they have me in screaming agony sometimes.

The Johns Hopkins study is very interesting. However, I think that we may be a little premature in evaluating its significance.

The key concern is that the results are obtained from a computer model of stomach function, rather than from an actual functioning human stomach. Constructing a computer model is difficult, and the researchers have to make a number of simplifying assumptions. Did they omit something important? The description of the study on the JH website says that “The findings are based on what's thought to be the first model to simulate the mechanics of drug dissolution in a human stomach.” So there is no other computer model to test against the JH model and identify possible errors.

The idea that posture could have such a strong effect on the mechanics of drug dissolution is potentially very valuable. The JH computer study is useful in bringing that possible effect to our attention. Whether or not we accept it will depend on a follow-up study involving large numbers of human subjects with human stomachs. The JH study was published in 2022. Apparently, no study with human beings has been done since that time—or we would know about it.