Hydration Challenges After Colon Removal

After ileostomy a couple of years ago, in April 2025, I had the rest of my colon removed; why is not important. I know hydration is a huge issue; however, it seems if I don't drink water or zero-sugar Gatorade constantly, all day, I will become lightheaded. If and when that happens, if I consume several glasses (16 oz) of water right away within a short period of time, I begin to feel better. For the record, there have been times I have been close to fainting. I have seen my primary care doc, PT who deals with vertigo, cardiologist, ENT, and I am waiting to see a neurologist. Does anyone have any similar issues or comments? At 81, I don't care to spend the rest of my life drinking water. Thanks, Terry

Drink milk; it hydrates better and at least has some taste to it.

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You should be drinking electrolyte beverages, not just plain water. Get something like Drip Drop or Pedialyte, something with substantial electrolytes in it. You can throw yourself out of balance if you just drink plain water.

Drinking water alone isn't hydration. You need a variety of fluids. Alex suggested milk. Yes. Orange juice. Apple juice. Chocolate milk. Of course, water is boring. You need just a little of that but concentrate on the electrolytes and less sugar in other drinks.

FYI - if you continue dehydrating, you will likely have kidney issues... serious issues. So do drink.

I suffered the same dizziness and lightheadedness when my colon was removed. Learned the hard way. There's also a loss of taste associated with colon removal.

This alone deters you from eating and drinking, but you must... until your body stabilizes.

81 years old? Bless you. Welcome to the front butt club. And the new norm.

My Ostomy Journey: Bruce | Hollister

Plain water in large amounts is the worst thing you can drink with an ileo. Four or five glasses throughout the day is fine, but all at once is a no-no. It's a tough balance finding out the right amount to drink, as we're all different. Standard advice is 2 liters a day. Until last year, I thought the only thing I was doing right was drinking enough fluids, but a blood test showed I'm not drinking enough. I'm trying to correct that mistake of mine, but another recent blood test still says I'm dehydrated. I have vertigo; mine is caused by having Meniere's disease.

As others have said, too much plain water is not a good thing. Even if you are drinking liquids with electrolytes, too much is not good. I have an ileostomy and have problems keeping my sodium and magnesium levels high enough. It's a fine balance between enough and too much, so it might take you time to find that balance. It's also better to spread out your liquid consumption throughout the day and evening, not a lot all at once. You should have your doctor check your micronutrient levels on a regular basis as well, to make sure you are not depleting yourself.

Terry

G-Day xxxltd,

Looks like you worked it out; by drinking some water, you felt better. Now just add some electrolytes to it, and you have got it fixed.

Drink like your life depends on it because it does.

Regards, IGGIE

Hello Terry.
I agree with the comments that others have made, so I won't repeat them here.
Just to say that I get similar symptoms when my blood pressure drops too low.
Drinking liquids will raise it sufficiently to alleviate the symptoms.
I find that keeping an eye on my blood pressure helps me to monitor when I should be drinking. I like water but recently I have found that drinking Aloe Vera (now available in shops) helps alleviate other unwanted gut symptoms as well helping with hydration.
For me, it's all about experimentation !
Best wishes
Bill  

Also, another good hydrator is coconut water.

IGGIE

I lost my colon many years ago. When I was in my 20s and 30s, I did not drink enough fluids and had many fainting or near-fainting spells. I now have kidney disease and am on dialysis. Dehydration is dangerous for us. Try lemon or lime in your water; it increases the absorption. Best wishes to you.

Thanks, Alex. Sorry, but I hate milk.

Thanks, Alex. Sorry, but I hate milk.

Going to give this a try; I drink a lot of zero Gatorade.

Hi, you could try this St Mark's ORS solution. This is a cheap mix that maintains vital electrolytes in the body. Water is hypotonic and can draw electrolytes out of the body and ironically increase stoma output. Hypertonic fluids contain high sodium concentrations (i.e. > 90 mmol/L), have been found to increase absorption of sodium and fluid and therefore help to reduce fluid and electrolyte losses. The idea is to prevent dehydration by enabling better absorption through what is left of the gut.

How to make St Mark's solution

glucose powder – 20 g or 6 level teaspoons
table salt – 3.5 g or 1 level teaspoon
baking soda – 2.5 g - heaped half teaspoon
cold water – 1 liter or 1 3/4 pints or 4 U.S. cups

I use this occasionally if I have a high output for some reason, and it helps to prevent dehydration. We need to look after our kidney health more than most folks, so hydration is really important.

The solution may taste salty. You can improve this by:

• storing the drink in the refrigerator and sipping it chilled

• freezing the solution and sipping it as a slush

• sipping it through a straw

• adding a splash of squash, fruit juice, or cordial. It's best to add these while making up the solution rather than adding them to each glass. This will keep the salt content at the right level

I am small and also prone to dehydration after ileostomy. My dietitian advised that both sugar and salt are necessary, as well as drinks to increase water absorption. I am wondering if zero sugar is working against you. And I am also wondering if drinking plain salty broth once or twice a day will help you hold onto the water you drink more effectively?

I order Fluid Tactical ORS powder from Amazon and mix it with water. I only use it when I have symptoms of dehydration or when I fly, since I have a colostomy and it isn't as often. My understanding is that rehydration products are for existing dehydration, not regular prevention.

@merecat.. this is a perfect example of textbook knowledge vs. street smarts.

We are street smart on hydration. The cancer association on this subject needs an update.

Water helps, but a much smaller quantity is needed with proper fluids as mentioned above.

Fact vs. fiction here.

It is a balancing act. Unfortunately, low sodium can also make you dizzy. My husband is 82 and has to take sodium tablets twice a day and extra salted pretzels to help keep his levels up. He knows he needs to drink more water if his urine is starting to look concentrated.

I've heard that drinking only milk for hydration could actually lead to dehydration. According to Harvard, the studies on milk being better than water are weak and inconclusive. They still recommend water over milk.

It sounds like you may have what we call a high-output ostomy. It's a delicate balance to get your hydration right. This type of ostomy robs the liquid from the rest of your body. You're constantly balancing electrolytes with plain water. Too much plain water can wash too much sodium from your body, causing a serious condition called hyponatremia. This condition causes all large muscle groups to fail upon activation. Hence, you're on the floor calling for emergency services. Please be careful with plain water. It can be your enemy. Best wishes to you.

My experience and suggestion are similar to others - supplement your water intake with something else. How much/often is something I have had to experiment with during my previous ileostomy and now colostomy.

Longer version:

Back in the day, I did a lot of triathlons and used only water for hydration. I found myself having to make a lot of pit stops to urinate and figured that was just part of the sport. After reading some research on the topic, I learned that the reason people use sports drinks is that plain water does not absorb as effectively, and our bodies pass it through more quickly. Once I started using sports drinks, I found my hydration stabilized and way fewer pit stops (and faster race times!).

I am not a huge fan of all the chemicals I cannot pronounce in the various sports drinks, so in more recent years, I use an old trail running formula (my poor man's Gatorade):

- Large cup (12 ounces) of water

- 1 tablespoon sugar

- 1 tablespoon lemon juice

- 1 tablespoon lime juice

- 1/2 teaspoon salt

I like that I can get those ingredients nearly anywhere I go, and they are cheap.

As to how much...after I have my morning coffee, I sip a cup of the formula above to kick start my day and then monitor my urine color and output and adjust pure water vs. my formula during the day based on activity. Hot day with garden work? More of my formula than water. Relaxing day reading with the granddaughter? Less frequent amount of my formula.

Hope all these suggestions help you find what works for you.

This is what I do, so it might not work for you. I take Imodium and fiber every day and drink 64 oz of water throughout the day, mixed with electrolyte beverages. You don't have to drink only water or Gatorade forever as well 😊; you can have other stuff; you just need to maintain your hydration and electrolyte intake. You lose more than you realize with an ostomy bag. Also, Imodium is OTC, so you don't need a prescription; it's helped a lot since I have a high output.

Those studies are b.s.

It's not "just drinking milk" alone.

Everyone has to do a trial-and-error experience.

All the comments so far are a balance of this and that.

ALEX suggested milk as one of the many varieties of fluids we must drink. Just the idea of drinking milk only makes me... wait for it... have a cow.

I respectfully disagree with any and most studies. They are biased or outdated. They can't possibly know what works for me better than this or that.

Everyone is different.

Recommendations are suggestions made by experience and individuality. Disclaimers should be understood.

I do okay during the day but have ended up in the ER as I get in trouble around 3 AM. Currently using Gattex for short bowel syndrome, and I wake up incontinent of urine and soaked with sweat. Not sure if it is the injection; I am taking a break now. Or some sort of vaso-vagal syncope, but it is quite frightening. BP is up and I am also very shaky with PVCs several times a minute. I do drink various sports or Pedialyte drinks.

Dear Terry

Sorry to hear about your symptoms when not hydrated enough. I've had my ileostomy since 1996, and I have had the same problem with feeling lightheaded. I have also found that if I don't stay hydrated, it triggers a headache and output becomes sluggish.

Apart from water, I eat melon and dilute fruit juice (not orange - this upsets me and makes me 🤢!!!).

I hope this helps. Good luck.

Panda85

I have short bowel syndrome and have found lately that adding more salt to my food helps retain water.

Hydration is a must! I had a total proctocolectomy in 2008 and since then an ileostomy. What is working for me, and at the advice of my nephrologist, I also have CKD, is the World Health Hydration recommendation. I dilute one teaspoon of table salt in a gallon of water and add two pitcher packets of Crystal Light Orange flavor drink mix and manage to drink, including some sports drinks, nearly two gallons of fluids in twenty-four hours. My kidney function is checked periodically and monitored by my nephrologist. As I've previously indicated, this works for me. The orange flavoring helps. Has your kidney function been checked?

@watsonvito- I think you sent this to me in error.

Just wanted to point that out; you hit the reply button after reading my message. That's fine, but it should go to the general public by scrolling to the end and hitting reply... once.

Often, many hit that reply button several times, and you basically send your answer seven times.

I have no issues with kidneys. I drink a variety of fluids daily, including Liquid I.V. powder mix, plus fruits. Thanks for sharing. Sorry about your CKD. That's a given when you don't hydrate enough or properly. Good luck.

Re: Prescription for Imodium? Insurance company won't pay for it. At least mine won't. I sent it in and they dismissed it because over-the-counter Imodium is quite expensive daily, and over time. Time suck 🤦 requesting it from the doctor. But I tried to save money 💰.

Looks like a medical write-off - tax-wise - now at the end of the year. 🤷‍♂️