Using Loperamide to Manage Stoma Output: Seeking Advice

Hi all.  I have started to take 2 Loperamide caplets to slow the output from my stoma before venturing outside the home for several hours.  I have a colostomy.  I do this around twice a week.  Just wondering if it is wise to do this, or better to fast for several hours before going out, or any other suggestions anyone has.  Thanks.

Why are you trying to fast or take something so you won't have output when you go out? 

As meds go, loperamide is a very safe med to take, non-addictive, and won't do you any harm if you take too much; it would have much the same effect as a blockage. I'm a believer in only taking something if you need to. Do you take it for high or loose output, or just as a preventive measure to try and stop having any output while you're out and needing to drain or change the bag?

I take it as a preventive measure or when my output is loose.  When I eat, my pouch often fills very rapidly.

I often have my output fill my pouch fast and it causes me concern when I am out.  When it happens, I am nervous about having a blow out or leaks.  I do carry emergency supplies, but dread that I may have to change my bag in a public bathroom.  Guess I need to suck it up and just go with it when  and if it happens.  I probably should be more careful about what I eat and the amount I eat at one time.

How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister

I have had an ileostomy for over 20 years; many people use this method. I have a friend on this site who is a flight attendant; he takes plenty before trips. Most of us with ileostomies have nothing but loose output. So don't feel awkward about taking something. On the other hand, you do have to start becoming more comfortable with going out.

I am currently taking 4 loperamide 4 times a day as my ileostomy is situated close to the stomach and my output is very liquid. Some days I wonder if it even makes a difference. I have been opening the capsules, dissolving them in water, and taking it that way, and I have just swallowed the capsules. I can't say which works better or whether I should actually be taking more. The doctors seem to be divided on this as well. Has anyone else struggled with this? I believe that depending on your output, you could take several loperamide before it causes issues. However, I am still trying to find my own way with the ileostomy.

I empty all the time in public restrooms with no problems. I take a bottle of water with me to wash out pouch etc.

Come on, who wants a bag of s*** filling up when you're on your main meal from the night before? Not to mention, when flying, it's better in than out for a day or two.

I use it all the time! Not only that, the delay thickens output!

Try and find out what makes your output thicker.

Actually, better out than in. Comes with having an ostomy, and you're asking for problems if you are purposely trying to stop going to the bathroom. And to thicken your output, find foods that make it thicker and have a slower transit time, but don't try and stop it until you want to go again.

I have a colostomy with short bowel syndrome so it’s more like an iliostomy - all liquid all the time.  I take 4 crushed loperamide in applesauce 4 times a day, morphine 1 to 2 times an day and an Octreotide IM injection once a month as ordered by my Mayo docs.  It does help slow it down.

I've been taking loperamide with every meal for years now with no ill effect. It makes my output manageable and keeps the food in me long enough for me to get some nutrition from it. 

UPDATE: Excellent result! I took two tabs at the table before our drinks were served and  had minimal output through the entire 90 min meal and 30 min drive home! I'm happy to have another tool for managing this osteo thing and will surely use this method again. 

Thank you! You have helped me a lot! I have a date for dinner with my husband this evening to celebrate our 50th Wedding Anniversary and I've been arguing with myself about taking a dose. At home, I often have to leave the table to burp the bag or empty it. I sure don't want to be waltzing through the dining room with a front butt bulge! 

Have you tried using a larger bag? It will give you peace of mind that it won't overfill and blow out. I use a maxi xl as the regular one just isn't big enough, especially at night! I also have very loose output at times and have been told by doc I can take as many as I need of loperamide.  It's very safe, I sometimes take up to 30 a day...... just don't take so many it stops everything moving as hard poop coming out can hurt! 

Hi, I have been using loperamide for over 10 years and find that it helps. I do have an ileostomy and take 2x 2 mg tablets before food. Elwick

I've known two people who have landed in the hospital from operative, and I took one pill once before my surgery when I had colitis, and almost landed in the hospital. It works by paralyzing your intestines. You're taking a very big risk of stopping your peristalsis and causing a blockage. Just look for a bathroom to empty your bag while you're out. Why worry about emptying your bag?

My phone changed loperamide. 

I often take Loperamide when I travel.

I've been using 2 Loperamides a day (one in AM and one at bedtime) to control the flow of my ileostomy.  When travelling I have some thickener pods (Amazon Par-Sorb) and put one in right before going through security, if I've had lots of fluids or going on a long plane ride. My Dr suggested UP TO 4 per day as you don't want it to get too thick.  Marshmallows can be eaten also to slow things down. 

With a colostomy you can use liners, and just pull the liner, place in a zip bag and toss. 

I can understand the hesitancy to go out and use public washrooms.  However, you have to learn to do it otherwise you will never live a normal life!  Travel usually is the first step in curing this.  I have a small inventory in my purse:  Nitril gloves, several squares of "Charmin Ultra Strong" TP, an elastic, a travel size of "Just a drop" deodorant, a lubricating deodorant, and a 4 oz squirty water bottle.  Also, a couple of the black ziplock bags in case I can't get to a restroom.  I use one glove on my dominant hand, so nothing slips and I don't have to touch anything.  In the washroom I fill the water bottle. In the stall I use an elastic to tie up my shirt.  Using the supplied TP I lift the seat and add some of the deodorant and place the paper in the bowl to cut down splashes.  If theres an "autoflush" place some over the eye (if possible). After opening and dumping the pouch into the bowl I use the squares to clean around the opening, rinse a few times with the water, then dry it and drop some lubricating deodorant inside.  All done! Using the gloved hand drop the seat and flush (or remove the paper from the eye).  Sure, it takes 10-15 minutes sometimes but so what?  

We have a disability and have to work around some things.  

Thanks, Heather.  I found your suggestions most helpful.  And you are right;  I need to put myself out there and get on with life.

Hi. I can understand your anxiety. I like to sort the bag in the morning and if I am working or going out I don't like to be aware of the various sensations or discomfort going on later. I was told when I was in hosp that loperamide could be taken every day if wished. I just take it when there is a malfunction usually caused by eating too much or too much variety. I eat more biscuits than before this happened. I think sometimes there is discomfort because you haven't eaten so little and often is supposed to help . I feel morbid and anxious some days but if it's quiet I almost forget it.

Nothing wrong with taking Loperamide to slow output when going out. I often take 1/2 pill about an hour before golfing and don't worry about my bag at all. But don't count on it helping your game. I know from experience. 

Thanks.  I often do eat too much at one time and don’t eat often enough.  Have to work on it.

LOL! Thanks.

I wear pouches that are emptyable, but when I go out, it's easier for me just to put on a new pouch. Plus, in California, we have a "Restroom Access Act" that gives me a bit of ease when I go out knowing

that this Act requires a place of business open to the public for the sale of goods that has a toilet facility for its employees to allow any individual who has an eligible medical condition or uses an ostomy device, is lawfully on the premises of that place of business, and requires immediate access to a toilet facility to use the employee toilet facility, even if the place of business does not normally make the employee toilet facility available to the general public.

I do not wish to force any business to give me special treatment or cause any trouble, but if I need to push because I am in great distress, I do have that option.

https://www.cdph.ca.gov/Programs/CCDPHP/DCDIC/CDCB/Pages/RestroomAccessAct.aspx

I've had a colostomy for several years with liquid output and have also been anxious when I had to go outside the house for any length of time. Fear of leaking and always having to empty my pouch, even though I use the largest pouch available. I was taking loperamide before leaving the house but had to take more and more pills, then they finally quit working. The doctor wouldn't up my dosage or try something different that I had taken in the past; for some reason, she didn't believe anyone could pass that much liquid stool. I switched doctors and informed him of what I had used for continuous output during my cancer treatment. He immediately started me on it, Opium Tincture 10ml, take 0.6 ml every 4 hours as needed. I only use it when I'm going to be out for 2-3 hours. It really does the job! No output at all; by the time I get home, it has started to wear off and my flow is getting back to normal. We usually have our supper around 4:00; if any later than that, I usually will take a small dosage before bedtime so I don't have to keep getting up in the middle of the night to empty. Sorry, so lengthy, but hey, I'm a retired 70-year-old, what else do I have to do?

Heather, I have two questions. What are thickener pods and how do they work? Also, what are liners, and how do they work?

Thank you. 

Peggy

I have liquid stools and tried those thickener pods, the gel capsules; they never did anything for me. They always came out whole, never dissolved, came out the same way they went in. Haha!

We have this in CT as well! It's illegal to refuse the bathroom to us. I was also able to get a card for free from the CCFA (Crohn's and Colitis foundation of America) that states you can't wait. I'm so grateful for this because when my Crohn's started I was in Boston and finding a toilet was awful. Diapers daily and massive anxiety. Grateful they make laws to help us!