Ileostomy Transit Time - What's Normal?

Hi gang, particularly my fellow ileostomates. I haven't yet been able to get an answer from the medical community, so I thought I'd go to the source. I am trying to gauge what is "normal" in my new world as an ileostomate. I feel like my transit time, that is the time it takes for what I eat to exit my body, is longer than it should be. So what is normal? I have read many posts from those with ileostomies who say they can see what they eat come out in their stool, as it doesn't change much in the digestion process. I am staying away from all the "dangerous" foods that might cause a blockage, so most of what I am eating is very easily digestible. The only thing I can identify is the canned peaches I have for breakfast. Based on this, I have concluded that my transit time is at least 24 hours from when they went into my body. What do others experience? Does this seem like a longer than normal time? I do feel uncomfortable for periods of time during the day. I have had to increase my intake of fruit juice (on the ostomy nurse's recommendation) and that has helped.

Thanks!

Terry

I have seen my food come out. And I chew, chew. It depends on what I eat.

Hi Terry,

"Normal" will be different for everyone and is a function of the amount of bowel left, what underlying conditions are prevalent, and how much and how quickly you eat.....not to mention what you eat. Also, the bowel needs time to adapt to the missing colon, which takes years. I don't have enough bowel left for my experience to be relative to your situation, but as an example my transit time has grown from literally seconds to about 30 minutes now. And where in the beginning everything I ate would transit at the same time.....I now (6 years later) see some things come out hours later. I would kill for a 24-hour transit time......but the "uncomfortable for periods of time" is a bit concerning. Do you still have active disease in portions of your small bowel?

Regards,

Bob

There is no normal, just what's normal for you. Fruit juice has helped, why not increase the amount or other fluid intake? Sounds like you weren't drinking enough. Maybe still not, it's just working out the right balance for you.

Hi Bob, Thanks for your thoughtful answer. I wouldn't be worrying about my transit time if I was feeling comfortable all the time. I don't have any active disease in my colon, never did, just a colon that never functioned properly to push the stool out. It seems that even with just my small bowel hooked up, it is moving very slowly.

Regards,

Terry

How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister

Hi Terry,

Have you asked your doctor if they have motility increasers?  I'm always looking to slow stuff down, but I'd think they'd have something to increase motility, which should help.  The other aspect to ask about is how to increase bile production.  That would also help  speed up transit time.  Have you had an MRI of your abdomen recently?  Adhesions can cause what you describe, but without any active disease there would be no reason for the scan. You might want to mention that to your gastroenterologist as well.  I'd think a little exploratory scoping could also provide an answer, and with the scope now being inserted directly into the small bowel they can image a much larger portion of it than if they had to start at your butt and snake through the colon.   

Regards,

Bob

Hi Bob, I think motility increasers are just called laxatives! I was completely dependent on them with my colostomy, huge amounts required to get things to work. This is now almost six weeks without laxatives, since getting the ileo, which is a good thing. However, I am having to drink lots of sugary juice (no sugar added, but it's still a big sugar hit) which isn't good either. I don't want to end up a diabetic! I will ask about the bile production increasers. I have had so many X-rays and CT scans in the last year, I probably glow in the dark. I will ask about the scope though. Thanks again,

Regards,

Terry

Hi Terry,

Sure, some stimulant class laxatives are "motility modifiers", but they work by causing violent cramping, which means increasing the magnitude of the contraction, not by increasing the frequency of the contractions. The other types of laxatives are either osmotic in nature or stool softeners/bulkers. The osmotic laxatives do exactly what the bowels of us short-gutters do when we eat too much sugar.......they cause the bowels to dump water from the body into the bowel to dilute and lubricate the contents.   What I'd like to see developed are laxatives that simply increase the contraction rate of the bowel, not cause the contractions to become more severe.   Bile is produced in the liver and stored in the gallbladder, so I'm not sure which, or if both, need to be stimulated to get more bile to be secreted by the bowels.......should be an interesting discussion!

Regards,

Bob

Hi Terry ... I have had my ileostomy for 5 years now and Sheldon has changed his output habits over the years. I now joke and say he thinks he is a colostomy instead of an ileostomy. When I first had my surgery, anything I ate would pass through almost immediately, or at least very shortly for sure! Now I can go like you, 24 hours before I can recognize something. I do not normally recognize the food. I know if I am hydrating enough by the consistency of the output ... and if I feel uncomfortable (I am guessing we are talking about the same feeling), a cup of hot tea does the trick for me. I have no idea why, but hot tea ... not coffee or anything else. I make sure I drink things like Power Ade Zero to hydrate more than just plain water. That seems to help keep the consistency of the output less firm. I have gone from having to empty my bag multiple times a day to 2 to 3 times a day. I am fortunate in that I do not experience leaks and have been able to find just the right combination of supplies to ensure a good fit for my ostomy.

I hope this helps a little ... Depending on how well I chew things pretty much dictates if I can tell what it is when it comes through the output. But as others have said, we are all different.

Paula

Hi Bob,   Over the years I have had to educate myself on the various types of laxatives, i.e., stimulant versus osmotic and stool softeners, etc.   There are a couple on the market that are supposed to just increase the number of muscle contractions in the bowel to make it move more effectively.   One is called Constella (linaclotide).   I tried them all at one time or another, and often I would find something that would work really well, for a while.   Then my bowel would develop a tolerance for it and that would be the end of it.   The fact that my bowel is moving without the aid of laxatives may seem like progress, but really is it when I am using high concentrations of sugar to make it move instead?   It's still something that has a laxative effect.   Oh well, we'll see what the Doc says.

Regards,

Terry

Hi

I have had my ileostomy about 16 years now.

I find if I eat anything that can't be fully chewed, like lettuce or tomato, you can tell when this has gone through, usually in about 6 - 12 hours.

But otherwise, you really don't know!

Drink as much as you can as this also helps keep things moving.

When I forget to drink (it happens, I get busy) my output gets very thick and causes issues. Not to mention becoming dehydrated. I don't recommend it at all!!

One thing I notice is foods that you used to go straight through before the surgery, continue to do so now - e.g. for me it's apple or spicy foods.

Good luck, certainly see your doctor if you start to feel too uncomfortable :)

Hi Donz,   Some very helpful suggestions, thanks a lot!

Regards,

Terry

Thanks Paula,   Lots of good advice. I still have a lot to learn and lots of experimenting to do.

Regards,

Terry