Medication Absorption Issues with Ileostomy

Hi, I'm still new here. I'm 9 years post-permanent ileostomy. I'm on several medications, and I was noticing white pills in my pouch. Now I have to crush them and mix them with yogurt.

Is this a common problem for others?

When I was taking some medications, I was doing this as some just passed straight through, but I just crushed them and mixed them with water. It tastes like crap, but it works. You should run it past the docs first. For example, some drugs are not meant to be released into your system all at once and can cause harm. Check first to be safe.

Ileostomy here…. I rarely take any medication, but if need be, I always look for liquid or chewable meds. Early on, I had a rather large pill pop right on through, and I was thankful it did not cause a blockage…

Also, it is my understanding that some meds are designed to head to the large intestine for processing; they would pretty much be useless for us ileos - so Axl's info to seek a doc's input is excellent advice. Note: I have found that not all docs are even aware of this special need (liquid/chewable) for an ileostomy as opposed to someone with a colostomy….. jb

I couldn't get my horse pill potassium to dissolve in time; I was passing it. My doctor switched me to gel-coated capsules. The dosage is different; I have to take two at a time, but my level is stable now. Yes, ask the doctor about alternative options!

I agree with everyone else... sometimes they stop dissolving. My potassium pills did after a while, and I was changed to the gel ones like Heidi. The good thing about those is you can either open them or take them whole. Since then, I haven't had a problem, other than once in a blue moon one of my small pills will pass... but let the doctors know.

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

I had this issue when I was on fish oil and took it in gel caps. They'd just come out in my bag. I also had this with extended-release medications. They absorb in the large intestine mostly, and I don't have a large intestine as I have an ileostomy that is permanent. Crushing what pills you can is a good idea. If you can't crush something, ask your doctor if there is an alternative. Explain the situation and help them understand the problem. If you can crush your pills, that is a good solution.

Ileostomy 37 years, never noticed any pills in my bag, and the older I get, the more I need! I know it happens to some people.

Good advice. I have a colostomy and was told by my WOC not to take extended-release meds if at all possible. When I take Imodium, I crush the tablets and mix them with applesauce.

37 years and no trespassers…wow! Just curious…is your bag clear (as in a shadeless window) for all viewing? My guess is those who have a bag with a “cover-up” to avoid viewing may not even notice a pill that has failed in its duties…I know some bags have the peek-a-boo view ability, and my guess would be not everyone would peek at each empty (and understandably so) because, as “they say,” whoever “they” are…you peek and you'll boo!!! If this is the case, mayhaps they would miss spotting that little escapee….jb

Yes, it's clear.

Hi, I don't take any medication, but I do take vitamin supplements. Occasionally, they end up whole in the stoma bag. What I do is eat first, like bread for breakfast. Then I take the vitamins. Eating slows down digestion, which helps absorb the supplements. If my digestion is too fast, I take Imodium, but that doesn't happen often. I've tried fish oil, but it really flies through my intestines. Eating doesn't help then. So, no fish oil for me.

I notice the same with tablets, especially the slow-releasing ones.

I don't have an ileostomy, but I know a little bit about medications. It is critical to discuss this with your doctor or a pharmacist. Not all pills can be safely crushed, and some may interact with certain foods. So you'll want to be sure that what you're doing will maintain safety and effectiveness.

The information needed to make this determination is usually readily available in the prescribing information, but most people will need a professional to interpret it for them.

Susan nailed it. Most medications can be compounded to release at different times, i.e., in different places in your digestive tract. And most docs are clueless about ostomies or just don't give it much thought. If you've had multiple bowel resections or poor documentation after surgery, it means no one knows what parts of your bowel have been thrown in the dumpster. It might be a trial-and-error process to get the medications to release where they are supposed to in order to be absorbed properly. Also, consider that for some, the part of their bowels needed to properly absorb that medication might not even be there anymore. Many meds are coated or encased in a shell to protect them from your stomach acid, which would render them ineffective. So it's a complicated issue, and there is no one right answer for all of us. If it's a 'serious' medication, the most effective and foolproof way is to have it administered via IV. Regardless, whenever any doc gives you a prescription to take, make sure you let them know you're an ostomate and tell them to compensate. Because if you don't say something, they won't be diligent enough to figure it out. And a lot of times, pharmacists are smarter than docs in this situation. So check with both!

;O)

I have seen "do not crush, take whole" on many med bottles. Definitely speak to the doctor before he fills the script. Explaining to the pharmacist about this would delay the medication. It's gotta come from the doctor, the order-script.

You are totally right about the script. But pharmacists are in a better position to give you this kind of detailed information. And if it's okay to crush and put in yogurt as OP described, the pharmacist is faster. The pharmacist will also be better positioned to advise the doctor on a replacement. Not all pharmacists will do that second part, but they are literally trained to do this. The average drugstore pharmacist is using less than 10% of their training.

I might have come within an inch of going to pharmacy school... shhh it's not widely known.

You are correct about asking a pharmacist about alternative meds. Most doctors are clueless.

Two of my sisters were pharmacists, and interactions with customers oftentimes centered around this exact topic.