What's going on with output?

Past couple months now my output is still fast,and having been losing weight again. . I haven't changed my diet, in fact have been drinking Ensure to get some extra nutrition. I did have a recent kidney stone episode where I had a stent in for almost a month before the doctor got the stone out, and had to increase the amount of Tylenol I was taking because of the pain . As I mentioned before, think back earlier this year,

I don't have the best medical care, my doctor is only a PA-C, and suspect illeostomy issues are beyond her experience. She did order some blood tests, results didn't show anything " wrong," Am also on Medicaid, which means lots of doctors/ hospitals won't take me as a patient,I had to get the kidney stone cared for via the Emergency department.

Have honestly lost trust in the medical profession, need to try something to improve my problem on my own. Does the digestive system change as I get older? Anyone else have this issue? Have had my stoma now for over 20 years, and up to recently my output, and my weight were pretty stable .

I'd love to empower you to solve this problem on your own but unexplained weight loss and change in bowel habits are major red flags. You need a complete work up. I don't know how you manage it with Medicaid but I wish you good luck.

Let us know how you do. I'm a little worried.

Hi Bob i hear ya on no doc. available i have,nt seen a doc. in years only a pa. When i needed to see a gastro. it was a 3hr. trip.

Hi Bob,

The answer to you question is yes, our digestive system changes as we get older. It gets less efficient and slows down. Peristalsis becomes weaker and slower and we experience a decrease in enzyme and acid production. Our bowel muscles tend to get weaker as well, and our gut biome changes by becoming less diverse in the number of good (and bad) bacteria that reside there. This can decrease our immune system function which can lead to a higher susceptibility to 'not good' things. Hey.......you asked!

Back to you. You're going about it the right way........by asking what's changed. Ensure is not an ostomate's friend. Whenever you see something with more grams of sugar than protein........it's essentially a candy bar, whether liquid or solid. When we consume sugary drinks it causes our body to secrete water into our bowels to try to dilute the sugary liquid into something the body can use. That water is then reabsorbed later by your colon........assuming you have one. If not it just tends to flush the body out more than help it. Liquids in general are a problem for most ostomates, unless their terminal ileum and full colon are still intact, so if the Ensure is the only change you've made to your diet then try getting more protein from solid forms of food and leave the sugar in the Ensure container. Interesting point that most don't know is that there's nowhere in the digestive tract where pure water can be absorbed. It has to be in combination with a co-transporter like sodium and glucose. Even the colon can’t absorb pure water. Just your fun fact for today.

Also, as you age your muscles naturally atrophy. The saying "if you don't use it you'll lost it" definitely applies to muscle mass as we get older. So with less muscle mass to provide for.......the appetite can decrease as well. You didn't say yours did, but just something to be mindful of for the future. Assuming you're eating the same and maintaining the same activity level and the only thing that's changed is the Ensure.......I'd start there. You also didn't mention how much weight you've lost.......are we talking 5 lbs, 10 lbs or more? Of course WHEN you eat and drink is as important as what you eat, and the order in which you eat your proteins, fats and carbs matters too......but I'm assuming that hasn't changed.

As an aside........the best doctor I've ever had was a PA-C. She was amazing, but had to move out of state for family reasons. I haven't found anyone yet that could touch her, no matter how many degrees they had hanging on the wall in their waiting room. Just saying.......you never know.

;O)

Don't lose trust. There are a lot of excellent doctors, PAs and supporting staff out there. Unfortunately, things do come down to money but there are likely some specialists within the network available to you. It's shameful to know that there are places that will refuse to help someone. I've been finding it sad that the first thing that's asked for is an insurance card and photo ID when you sign in (unless your info is already recorded) but I can also understand things from the hospital's perspective.

If you can get the nutrition you need from whole foods, that would be better than supplementation because of other components in food and the synergistic interactions. I eat more to balance my microbiome than what necessarily appeals to me. Luckily, what supports my gut bacteria I enjoy, too. Many whole foods are also anti-inflammatory which might help with any pain. A long time friend has terrible issues with kidney stones but as long as he's careful and stays away from foods that could cause a build up, he's ok. I've sent him links to lists over the years.

Sudden changes are worrisome but I always feel there's a root cause. If you can think back to any changes you've made diet wise in the last month, maybe the answer is there.

How to Get Back to Fitness After Ostomy Surgery with Ryan | Hollister

Your issue could be the Ensure. Not all nutrition drinks are the same. Some work for some ostomy patients while others work better for others. Try switching from Ensure to Boost. See what that does. Or try yet another brand. I know for me Boost worked for a while and then I started having large amounts of output all liquid. I switched to Glucerna and had the same issue. I switched to Ensure and it seems to be working better for me. But that too could change at any time. I also try to drink just half of it at a time. Then come back later for the other half. That seems to help too.