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Nov 13, 2023

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This topic is about managing high output and staying hydrated after getting a new ileostomy. The person sharing their experience is six weeks post-surgery and is dealing with a high stoma output and low sodium levels, which sometimes require IV drips. They are seeking advice and support to help manage these challenges. Here are some helpful tips and insights:

1. Work with healthcare professionals:
- Consult with stoma or IBD nurses and your surgeon about combining medications. For example, using loperamide with codeine or octreotide injections can help manage high-output stomas, though they can be costly.

2. Hydration and electrolyte replacement:
- Avoid drinking large amounts of plain water; instead, sip fluids throughout the day.
- Enhance your drinks with flavorings like orange squash, electrolyte tablets, or solutions like Dioralyte. Other options include Gatorade Fit, Liquid IV, and homemade solutions like St Mark’s E-mix.
- Aim for about four 16 oz/500 ml bottles of fluid daily, or have a glass each time you empty your pouch.
- Foods like watermelon, V-8 tomato juice, and lightly salted snacks can help maintain sodium levels.

3. Diet to thicken output and reduce volume:
- In the early stages, try "binder" foods such as white bread, bananas, applesauce, peanut butter on toast, and marshmallows.
- Other foods that may help include flapjacks, fiber-rich vegetables, and meats like bacon. Be mindful of potential pancaking.
- Season your food with salt if your sodium levels tend to drop.
- Consider having dinner by 6:30 PM to reduce nighttime emptying, with some people finding it helpful to empty their pouch at 11 PM and then sleep until early morning.

4. Practical fluid tips:
- You can mix your own oral rehydration solutions using recipes like St Mark’s E-mix.
- Sports-drink powders are a cost-effective option, and keeping sachets or tablets handy for outings can be convenient.

5. General encouragement:
- It's normal to experience high liquid output in the initial weeks, as the gut will gradually adapt over time.
- Protect the skin around your stoma, as leaks and moisture can cause damage.
- Healing and finding the right products take time and practice, so don't hesitate to reach out to stoma nurse lines for support.
- Many people have faced dehydration or kidney issues early on, but consistent electrolyte intake can help prevent these problems.
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