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How Do You Gain Weight After An Ileostomy?

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Posted by whatnow2012, on Thu Sep 19, 2013 1:37 pm
Thanks MMM - What kind of vitamins do you take and how in the heck do they stay in your system? Don't they just come right out of your ileostomy? My husband was taking a lot of vitamins once we found out he had bladder cancer but he had to stop during chemo. I believe the vitamins had a lot to do with him rebounding in the past as quickly as he did. However, he hasn't been able to take anything and I don't even give him a multivitamin because they're so big I don't know if they'll have enough time to break down before getting washed into his stoma and then get stuck there! The only prescribed med is a blood thinner. Did your surgeon prescribe specific vitamins at your follow-up? We have an appointment tomorrow and he has chemo on Monday and I'm starting to panic at how this is going.

Thanks much and prayers,
Reply by ron in mich, on Thu Sep 19, 2013 10:25 pm
hi anna as for vitamins i use chewable type or the gummie type, or the more expensive liquid which work great in the begining when you need all the nutrition you can get.
Reply by MissMeganM, on Fri Sep 20, 2013 12:53 pm
Anna, I have to get vitamin B12 injections - I just can't absorb it through the small intestine anymore.  I take a chewable multi and a regular iron supplement, and vitamin D supplement that is a gelcap.  The only medications you have to be careful with when it comes to an ileostomy is enteric coated meds (they come out whole, it's happened to me LOL) and time released meds.  Otherwise he should be fine
Reply by ron in mich, on Sat Sep 21, 2013 12:20 am
hi megan yeah didnt you hate to see those vitamins come out whole, for me it was quite a while ago but i thought what the hell am i taking these for, but now there,s chewables and gummies and such.
Reply by gutenberg, on Sat Sep 21, 2013 4:40 am
Hi folks, I had my surgeries in 2003 and it wasn't until about 18 months ago I started to put on a few pounds, went from 120 to 157  in a very short time, of course I had to be buying new pants every few months or so but it was worth it, now just to hang onto it. I never took any kind of supplements but still dont know the reason for the weight gain, so good luck to all, Ed
Reply by MissMeganM, on Mon Sep 23, 2013 8:45 am
LOL Ron, the doc wanted me to take an aspirin a day and I told him the enteric coated aspirin he had ordered for me wasn't doing a damn thing.  He asked me how I knew, lol.  I said, because it's in my pouch every morning!!!!  HAHA!
Reply by gutenberg, on Tue Sep 24, 2013 12:42 pm
Hi MMM, I know what you mean, I was given a slow acting pain pill and used to see it in my pouch, it finally made sense to my doctor and no more of that crap. But to get back to the aspirin if it is really necessary for you, as it is for me, if you crush it up you will find the benefit, although you may not feel it but nevertheless it is normally good for you, ED

PS: warning, I just read you should NOT crush the enteric coated asprin

Last edited by gutenberg on Tue Sep 24, 2013 7:15 pm; edited 1 time in total
Reply by MissMeganM, on Tue Sep 24, 2013 2:37 pm
Thanks Ed Smile  I just started taking a chewable aspirin instead and no more pouch pills LOL
Reply by jenepooh, on Tue Sep 24, 2013 9:39 pm


: Wed Sep 18, 2013 2:12 pm

   Post subject:

Hi Jen - How long was it before you started eating regular food? Did you have to wait for approval from your doctor or did you just gradually move from liquids to semi-solid and then up from there?


They told me originally to start and the liquid stage... that was in the hospital... and then I went to soft foods by the time I got to go home. Because of all the surgeries that I've had, I am only working with some small intestine and my ileostomy, so I'm supposed to be really careful all the time. I've gotten used to drinking a lot of water, especially when I eat. I love salads, but have to drink a lot of water with those, too...etc etc. Same with spaghetti... etc. It's really going to depend on him and his body..mainly his body which WILL let him know if he's overdone it. As far as eating slow... lol... that took practice. I've gotten to where I will sing something like Old MacDonald or count to 20, etc in order to know that I've chewed my food like I should.

Now, there are times where I will eat too fast still. I'll admit it. We all do it. I usually lay down after something like that so things can move better.. Again it depends. I try hard to not do that these days...especially since I fought my way through a blockage here at home instead of going back to the hospital because I can't stand the NG tube....again. (sighs)

At any rate.. it will depend on how his body can tolerate things. Take it slow. There is no rush, no hurry, nada. If he ever wants to talk, let us know. We're always here... Sorry for the delay in response btw... I didn't get the notice this time. Go figure lol.

Good luck!! xx Oh and very nice to meet you, Anna!
Reply by Past Member, on Tue Sep 24, 2013 10:36 pm
It didn't take me too long. I personally don't care for Ensure but one day I decided to freeze it and in no time flat I put all my weight back on and then some. Why freezing it changed the way it tastes I'm not sure, but I just sit there with a spoon and enjoy every moment of it. Try it. Hopefully it might work !
Reply by livinnandlearnin, on Tue Sep 24, 2013 11:01 pm
I hate all of those supplement drinks too!  Yuck!  I had a complete colectomy with ileostomy in 2010 and then my Crohn's got into my esophagus (which is very rare) and I had to have my esophagus removed in 2012.  I had to wait a year before having reconstructive surgery this past Spring so I was on a feeding tube that entire year--18 hours a day.  Even with the feeding tube all those hours, I was only about 97 lbs.  I looked awful so once I had reconstruction and could start eating again, I was anxious to gain weight but they stressed to me how important it was to make every bite count as far as nutrition was concerned.  So I know where you're coming from!  Since then I have managed to put on weight and I am now about 115, the most I have weighed in years.  There's no real secret to it.  I eat small meals every couple of hours.  It's much easier to digest small amounts.  I try to focus on protein and nutrient-rich foods but sometimes I just eat high calorie foods like brownies and ice cream.  One note though, dairy foods can be very hard to digest and it sounds like you are using a lot of milk-based products.  Ensure is the only supplement I am aware of that is not milk-based and by making milkshakes out of them, you are adding even more dairy.  It's high in calories and has lots of protein but personally my gut would be in knots if I drank that with an regularity.  You don't have to be lactose I tolerant to have trouble digesting dairy.  It is difficult to digest all on its own.  Your husband just needs to always be eating.  And as far as vitamins with the ileostomy, it's also better to dose them multiple times a day.  Not all of it will get digested but dosing 3 or 4 times a day will I improve the amount that gets absorbed.  If he has a real issue with malabsorption, he may have to go to injectables, but that would be his doctor's call.  Hope this helps!
Reply by duzluvxist, on Tue Sep 24, 2013 11:54 pm
Hi Anna , I have had my ileostomy for 31 yrs now. I had my surgery when I was 16 hrs old.  I realize that age does affect a persons ability to recover quicker but I wanted to share some knowledge I've acquired.  I read earlier you were curious if a surgery some people were talking about to relieve blockages would help your husband. I had the procedure done 10 yrs ago.  The surgeon actually takes the small intestine and removes any scar tissue that may be causing strictures (tightening) in the bowel.  That is what causes a blockage to occur..when fibrous food is not chewed well it can catch on that stricture and it becomes like a dam keeping most everything from passing this usually causes the bowel to start dumping large amounts of fluid through the ostomy in an attempt to push it through.  I found this surgery worked for me for a few years but be causes of the way my body heals and scars I'm back with the same issue. Everyone heals differently so it may work for most people.  Also, I found if I ate things that had cheese in it really helped me with gaining weight..also, I know ensure taste like a big vitamin but if you get it real cold and add some ice and put it in a blender it tastes a lot better. Try to stay away from caffeine since this stimulates the peristalsis (waves) in the bowel which can cause diarrhea and shorten the amt. of time nutrients can be absorbed and I have found diarrhea is hard to get under control with an ileostomy.  Sounds like he is getting enough fluids from what you stated. 2000 cc total of saline and 1600 of TPN.  I'm also wondering if maybe you are doing too much for him..sometimes when we help others too much they tend to not have a reason to not help themselves due to depression etc.  I work in the medical field and I see this a lot.  You have the greatest intention but it can actually hinder him.  He should be able to empty his own bags and this may build some self confidence.  I know when I first had my surgery I didn't want anything to do with was so foreign and didn't feel like it was really a part of me but my family had me do it myself and it gave me some pride that I could take care of myself.  I hope I haven't insulted you but just one persons view and I may be way off.  He may need to talk to a doctor about antidepressants because who wouldn't be depressed with everything he had been through and some of those medications actually stimulate appetite as a side affect.  I did stay in the house and lived from chair to bed for about three months then slowly took small trips out of the house and it was really hard at first because of the just wasn't enjoyable but I kept pushing myself a little further each time.  I think you are a great motivation for him.  I think you are incredible and he is fortunate to have such a caring and loving wife.  Take care ,  Tim
Reply by dcrazy, on Wed Sep 25, 2013 2:00 am
Hi Anna, sorry to hear. Your situation is kind of unique, being there is multiple parts. Really duz did a good job with his answer. Really I would say liquid vitamins would probably be easier to absorb. Sometimes it's not how much is consumed as per absorbed, if that makes sense. Ensure- I am not a fan of, except for it's non-lactose component. This is why I was wanting to write a blog on fitness, then injured my shoulder now it's getting better. Ensure IMO can help, but it's a small part. I have heard of people getting sick by drinking too much of it, myself was included in this. Fish is by nature a natural anti-inflammatory. It's high protein. Putting olive oil on fish can add calories and flavor. Yogurt? Yes. However, too much can cause some liquid. So i'd say a cup a day. Applesauce yes. Bananas yes. These will help with absorbing. Realistically there can be so much played into this so let me hit this from angles okay. From an absorbing stand point the foods I mentioned are good. They are healthy foods as well. Other safe foods( being most do ok with ) is chicken, rice, and potatoes.
   Let's hit this from another angle. The human body has a homeostasis( where it likes to stay ). When it gets use to losing/ thrives off it. Take for example a healthy, yet over weight women. She exercises, but is discontent. So then she crash diets....when she eats normal again, her body gains weight. Then you hear her say," I just gain the weight back."..or..." I can't lose weight ." Well see in that example, her homeostasis is use to being her weight, so her body wants to be that weight. Follow? So when I use to train ppl I pay attention to homeostasis and metabolism. So really if the body is swinging around, the homeostasis is raffled. So it's great to start maintaining, then gaining. So the body has a platform to build from.
     Anxiety/depression? What is really going on....well adrenaline is the hormone that speeds up heart rate by definition, clinically. So when someone has anxiety( smaller ppl usually lose weight, while heavier bigger bone tend to gain ) their heart rate speeds up. Well, so does their breathing, maybe oxygen slightly deprives from brain causing " dizziness." Lets take this up a notch. Well, if the heart is faster and breathing....well so will the G.I system as duz was referring to. Actually it can speed up 3-5x faster. See why anxiety and these type of surgeries don't get along? So, by lowering any anxiety( don't focus on it, or it may cause more ) can help with absorbing as well? Also, anti-depression pills, yes as duz referred to can have a weight gain like effect. I took some off label for zzzz while bulking for weight lifting. I went to the docs a few months later and he couldn't recognize me. He kept looking for me, and I was not far lol. I packed on muscle and weight. All through the practices I believe. Recovery, diet, and micro tearing and stimulating the CNS( central nervous system ) but not overloading the CNS.- Many lifters over stimulate the nervous system by lifting to long or to much work load. I don't expect him to be lifting, so I will stay away from that.

Now pure diet: Understanding.....Take the opposite of the heavy girl with homeostasis I gave earlier. Turn it around, a guy who is trying to gain weight, but having trouble. You need to add 500 calories a day, so 3500 a week 500x7=3,500 to gain 1lb a week by traditional dieting guidelines. However, higher the absorbing rate, slow the metabolism with reduced anxiety or correct depression and it can be less. However, they add in what's called injury factor. So another 200-300 calories. Now this is just for your pure understanding( this is a healthy person ). However, lets up it a notch. So you want the person to maintain, then gain. However,the body might not feel hungry or be able to eat because of the new found raffled homeostasis and the stomach not use to eating as much, and yes anxiety can play a factor. So slow and steady. Like I said a simple adding olive oil to fish can increase 100 calories and get some extra fat in. Adding yogurt to a small lunch can add 100 calories and small protein. I can give you a mock diet and you can take it for what you want, no caffiene. No milk, no pork, no ham. Again a moq:

Toast two slices- yes with the burnt part( it can help with enzymes ).
Anything else tolerated( fruit ), oatmeal, etc

Sandwhich, all natural peanut butter and jelly or turkey( close to the bone )..closer to the bone less preservatves.
All natural potato chips
One cup yogurt
1/2 Banana- cutting off those ends lol.
Something snackish, little debbie
String Cheese(all natural, organic )

2fish fillets, with garlic and olive oil( eliminate garlic if it's not tolerated )
2.5 servings of rice, all natural
3 potatoes

Snack 4: Ensure

Snack 5: Pretzels, etc, etc- stay within 200-500 calories, don't overload at night.

Protein sources I like.
- Whey protein acts quick in the body, but also shoots out the body. Egg white protein powder, is more slowly digesting, it's probably all natural....I like Egg white protein!!!!!! Maybe see if adding half the serving size of egg white powder, stir it in an ensure, vanilla is probably better b/c of the egg white flavor. Now you got yourself a High octane drink. Filled with vitamins and amino acids.

Last thoughts: What I wrote is from an opinion I could be off via the conditions.Also, you can scale down anything like instead of two fillets fish 1. Instead of fish, chicken? Etc. The diet was a mock diet to help gain. Also, I'd say liquid multi vitamin over pill, for absorbing- ask the doc( or show him this ). Also, a the egg white protein might help so you can reduce ensures and get a better drink by mixing it wit an ensure. I hope this helps or anyone else. You can always feel free to keep in contact on is Rick Bitty...if you have anymore questions if you find this helps. Feel free to contact me here to. Gl you seem like a good person standing next to him through everything. Oh I forgot...G2 seemed to sit well with me. Also propel. However, flavors like strawberry, peach...didn't. Also I see some have the same problems with those fruits strawberry and peach. Also, for blockage problems, maybe some fiber. I hope this helps.
Reply by itchy22, on Wed Sep 25, 2013 3:11 am
Hi there. After my stint in the hospital, I lost 35lbs. I'm now back to my usual 225. All I did was spend some quality time at McDs or A&W or Burger King and Kentucky Fried Chicken. It works every time.
Reply by jjj0922, on Wed Sep 25, 2013 7:22 am
I sure wish I had that problem. Of course I dropped an immediate 25 lbs. from the surgery and recovery. However, after about 6 months I started gaining weight and now I weigh 40 lbs. more than I did BEFORE the surgery. In the reading I've done and from the Ostomy Club meetings I attend monthly it has been said that an ileostomy is cause for weight gain so I'm confused? I wish I did have the problem of trying to gain weight. Sad

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