Four days ago (on Wednesday) my daughter had J-pouch diversion to loop ileostomy due to AV fistula and strictures in Jpouch.

She began a full low residue diet today. After eating half a plain (white flour) cinnamon bagal with maybe a tablespoon of sour cream, the output increased in volume and the bag filled rapidly (like every 1/2 hour for about 3 hours. Also, prior to eating this "new" diet (while on full liquids) the output was the dark, "bile" color. Now, after the bagel, it's thinner and lighter yellow in color. Is that "normal" and how long will it be before the stool firms up a bit? She also experienced abdominal pain that was relieved with vicodin. She's still in the hosptial and the nurses say this is all "normal." And, she felt/feels "full."

The ileostomy bag has to be emptied frequently and is thin as water. When will this change?

She's due to be discharged home Sunday, 5/27. The appliance was changed out once, Friday. When would it be changed again? We're hoping tomorrow, since she hasn't changed it herself, yet.

Hi Tyler,

The colour of her stool sounds normal for the stage she's at, but it sounds like your daughter could be having a partial blockage or that she may be experiencing an ileus.

The white bagel may have been just a little too stodgy for her new system. Did she drink plenty of water with it? Also it could just be that the sugar in the bagel hasn't agreed with her. A lot of people are sensitive to sugar especially in the early days after surgery.

I would just take things a little slower and maybe stick to liquids for today and then try rice or mash potatoes for a little while and see how she reacts that. Make sure she is drinking enough fluids as with her high volume output she could become easily dehydrated. There again she is in the right place to receive IV fluids should she need them.

As for changing her appliance, well as a rule of thumb about every 4 days but f she starts to experience stinging or itching around her stoma then change the appliance sooner rather than later to avoid skin issues.

Hope she feels better soon.

Shell

I agree with Shell...plus, with a loop, she may be prone to more liquidy output anyway. Even with my end ileo I have liquid output at times depending on what I eat (usually something high sugar). The difference is that since I've had it so long, my body has adapted and the volume of output is lower.

Talk to the dr about fiber - they may want your daughter to wait a while, but high fiber foods (oatmeal does wonders for me) and Metamucil and/or immodium might help, especially until her system adjusts.

Thanks, I'll print out your responses for her to read. What is an ileus?

Hi Tyler,

An Ileus is where the small bowel doesn't wake up properly after surgery and this can cause an obstruction. This will usually correct itself but can take a day or two. The symptoms to look out for are no output at all or very liquid output plus nausea or actually vomiting and abdominal pain.

Hope she feels better soon.

Shell

Hi Tyler,

My output was green right after my ileo surgery, and changed as I started eating. My output was also more water-like because I was eating very little fiber at the time. As your daughter recovers form surgery, she will be able to eat more foods that have some bulk to them, and that should help thicken things up. Bananas and rice are great for helping thicken output, and so is oatmeal. I don't recommend using fiber supplements to thicken output this early, but talk to her doctor about that.

The color and thickness of her output, how often she has to empty her pouch, and what her output smells like will vary a great deal, depending on what she's eating. Narcotics will also help slow her output.

I agree with Shell on changing. You might want to check on the internet on the company web sites for whatever system she is using. They usually little educational videos and use instructions have a recommended time limit for wafers. For example, the system I use recommends changing every three days. I change it every three and a half days with no problem (usually!). Some people get four to five days out of the same system. What my ostomy nurse suggested I do is to change at three days, and if there is no sign of stool on the underside of the wafer where it should not be, extend the change time by a half day until I get to the point that I can see my skin beginning to break down. I try to change on a regular schedule regardless of whether I think I'm starting to leak.

it isn't unusual to feel "full" at the stage your daughter is at. That will get better over time. I very strongly recommend that your daughter (or whoever will be changing her appliance) be able to change it before she goes home.

-Rae

just wanted to say thank you Rea, Shell and Jill. Everything is improving with time. Your responses are always helpful. It's so nice to have a place to go to ask questions from people that have experience with these things. Keep up the good work.

Hi there -

Just wanted to add a quick two cents regarding the "full" feeling; for probably the first month after my surgery, I felt full, no matter what I ate. It would get to the point where half a bannana would make me feel uncomfortably full. Needless to say, I lost a tremendous amount of weight (about 40 pounds, and I was NOT overweight) because I just couldn't force myself to eat.

I was tested for blockages and what not, and everything came back okay. In the end, it resolved itself and I think my body just reacted poorly to surgery.

So, while I agree with what Shell, Jill and Rae have said, the full feeling might hang around for a while, regardless of what is eaten. That was just my personal experience.

Tell your daughter to hang in there!

Compared to the end ileo, the output from my loop ileo is definitely more liquidy. Certain fibrous foods do thicken it up, but I wouldn't recommend that so soon after surgery. Once she is able to eat a more varied diet, it should thicken up a bit.

Hi Tyler - Can your daughter take immodium? I have a permanent ileostomy [failed j-pouch after 17yrs with chronic pouchitis] and I use closed-end pouches with liners. Its great!! To reduce the liquidity issue, I use immodium and there is a product out there called "ileosorb" which works like the the stuff you mix into dirt for planters. The granules soak up liquid and hold it. It amazing stuff. A tiny amount, about one teaspoon, can soak up a cup of liquid. I get the ileosorb from my ostomy supplier.

How old is your daughter? You should encourage her to access this website. It's so helpful. The folks on this site have gotten me through many rough times. Everyone here is so helpful and understanding.

Also, if she uses a closed end two-piece pouch with liner, she can just pull out the liner, dispose in toilet and then she isn't looking at the output in a clear bag. I personally just cannot deal with the clear bags and the drainable type. Just too messy for me.

Good luck to her and speedy recovery.

cmkbirdlady
aka Catherine

About the "ileosorb"...I guess you put this in the bag/pouch? Do you put it in everytime you empty? Where do you get it? Which company? I'll start researching, but any link to a web site?

Two piece bags with liners? Interesting. Who makes these? Do they fit in all the various manufacturers pouches/bags? How do they attach? Any web link to these liners?

My daughter is over 30 and accesses this web site very frequently. It's been a tremendous support for her over the years.