Diarrhea.

Jul 12, 2021

Diarrhea obviously means watery or loose stool – much more than usual in the case of ileostomates, whose output is already pretty liquid. Colostomates can recognize diarrhea pretty easily, but ileostomates have to judge it by quantity. For most ileostomates, normal daily output is about 3-4 cups or 900 ml. That means about 6 half-filled, medium-sized pouches a day. If it’s suddenly a lot more than that, and this is more than their normal volume, it’s probably diarrhea.   

Symptoms 

  • Sudden onset of loose/liquid stool (more than typical for ileostomates) 

  • May have cramps 

  • If severe, may show dehydration symptoms – like dry mouth, dark urine, nausea, and feeling weak 

Causes 

  • Certain foods (like foods that are natural laxatives, or foods that aren’t well tolerated by the individual) 

  • Contaminated food or water 

  • Digestive disorders (like IBD and celiac disease) 

  • Intestinal flu or bug 

  • Chemo or radiation therapy 

  • Side effect of some prescription medications 

  • Emotional stress, sometimes 

What to do about it 

The main risks of diarrhea are dehydration and an imbalance of electrolytes.  

Even if it seems counter-intuitive, drink lots of liquids. 

Drink a combination of water and drinks that replenish electrolytes, like sports drinks.  

You can make your own electrolyte drink - one that includes sugar and salt … so something like a half-and-half mixture of orange juice and water, with a little salt.   

Or drink a cup of sweetened liquid, like clear sweet tea, and an hour later drink something salty, like a clear salty broth. Keep this up, switching between sweet & salty drinks every hour.  

Avoid foods that worsen diarrhea. Eat those that thicken output and are high in potassium, to replace what you’re losing. See the Food Tables (Appendix A) for examples.  

An easy reminder of some good foods to eat while you have diarrhea is the BRAT acronym:  

       Bananas, Rice (white), Applesauce & Toast (white) 

Text Box
If diarrhea continues despite these tips, or if you develop dehydration or other symptoms like blood in your stool, stomach pain, fever, or nausea, call your doctor or go to the ER.  

Courtesy Joan Scott, author of The Ostomy Raft