Excessive Salt Intake Causing Swollen Ankles and Feet?

This is a pretty amazing site, so much information................

After having emergency surgery (August 2021), due to UC, I woke with a stoma. I had been so far out of it (I lost days where I recall nothing, remember going for scans, getting on the scanning table but nothing more and so on), waking with the stoma was a shock. However, I have come to terms with it reasonably quickly (so I am told). I was told by the dietician to include at least 2 teaspoons of salt in my diet daily. The stoma nurse (incredible people) told me to eat a lot of snacks, salty snacks. I struggle with this as I have never been a grazer. I now find I am dealing with swollen ankles and feet, though I walk a lot, nothing seems to be sorting this out. As soon as I get up in the morning, after showering, I need to put footwear on pretty quickly else I can't get them on. I can feel my feet swell when I take footwear off. Is it the salt causing this? Is so much salt really necessary? (I have never had it explained to me why so much salt, though I have asked).

Hi Jenny, the primary function of the large intestine is to absorb fluids into your system. When you have no colon, you need to replace the fluids you lose through your ostomy. A lot of salt, magnesium, and potassium are lost in your ostomy output. I find that drinking some sports drinks, Gatorade, etc., will put some of what you lose. Pedialite is very good. The love of my life, Kitty, had short bowel syndrome, and she used something called "Drip Drop". I use a bit more salt on meals than most people. I get a little dizzy or wobbly on hot days, but I find a bit of Gatorade works well. If you have a flu, etc., you will need Pedialite to get your levels up. With too little salts, you may have cramps in your arms and legs... too much will swell your ankles and feet.

Keep an eye on your blood pressure. I have a meter and check my BP regularly.

If you can see a dietician, you should do that. They are the pros.

Happy New Year. Eamon

I don't know much about losing a lot through an ileostomy since I have a colostomy. However, at least 2 teaspoons added intentionally to your diet in some way is a lot of salt to add to most foods that are already loaded with salt. Most sports drinks have a lot of salt for the average person. And if you're not a very active person, the added salt just stays in your system so much more. For me, the only thing I add salt to is French fries because, well, it just makes them better. I would think a call to your nurse or dietitian should be able to answer your question or maybe not adding so much for a few days and see if the swelling goes down.

Salt can cause swelling, but there are a lot of other reasons that cause swelling.

Hi Jenny, I have an ileostomy as well. I think that adding too much salt to your diet is a bit too much. I do salt my food generously and get along pretty well. Remember, fluid follows salt. I do drink the sports drinks on very hot days or if I think I need to boost my electrolytes. Try walking more and when you're sitting, elevate your feet and see if that helps. Best of luck

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

Hey Jenny. I've had issues with keeping my sodium from dropping too low. I do salt my food well, but that's not enough to keep my sodium level up. I've found that sipping on a cup or two of a good quality chicken bone broth daily helps to keep my sodium level within the required range. Hope that helps. Be aware though, you have to find a brand that tastes good to you, or you can make your own, which I do often.

Hi Jenny.

I have an ileostomy and was told to add salt to most things, although I have stopped for perhaps 6 months now as there is plenty of salt in most everything. Beware of the sports drinks as they are mostly sugar. There is a big difference between a sports drink and an electrolyte drink, so look for a cheap electrolyte in tablet form to add to your water now and then. Aldi has a good cheap one. And yes, salt can cause water retention in some, but the bad news is we are all different.

Maybe try Dioralyte to see if it delivers a better quantity of what your body needs

Hi Jenny, if you have an ileostomy, you definitely need to add salt to your diet, as you no longer have your large bowel that would absorb the salt your body needs. I agree to stay away from the sports drinks to avoid all the sugar. I add two teaspoons of salt to a large bottle of water, and sip on it throughout the day. You need to increase your fluid intake as your small bowel does not absorb enough to keep you healthy. If you are keeping well hydrated, two teaspoons of salt added to your diet should not be too much. This is if you have an ileostomy. If you have a colostomy, there should be no need to add extra fluid or salt to your diet. If you are retaining water, which it sounds like you are, you should get that checked out with your doctor, and have your sodium level checked. Something is out of whack. Talking to a dietician and an ostomy nurse would also be a really good idea.

Terry

Thank you all so very much for your replies. All of the answers you gave me have been very much appreciated.

I have added sports drinks to my shopping list, but hopefully be able to get the sugar-free ones. My stoma nurse told me

a while back to avoid them. When I asked why, she told me they were not good for you. But having read what you folks have written, I think

I would be wise to take on the advice of the people who live with the actual experience of stomas, etc. That's all of you.

I walk about 5 km a day, though the last two days I have been absolutely wiped out so haven't walked at all. The need for sleep being overwhelming.

I am due next month, when everything gets back to normal, for more blood tests. My bloods have been all over the place. There's an infection there somewhere but they can't pinpoint it. I will ask my doctor about having the tests include sodium levels.

I have other questions, one's a bit gross, sorry, so I will be back!!!!

Thank you all once again.

Don't worry Jenny, ask anything. We have all been through the nasty blood and guts periods, shit all over the bed, running down your leg in public, etc. As I have said many times, we have experienced worse than you would see in a horror movie, so most are not the least bit squeamish.

As regards salt, I agree that most foods have lots of salt in them. If you are going to be drinking lots of liquids, you have to find one that tastes good. Not sure why, but plain water gives me terrible heartburn!? I drink Gatorade, but I will do half water and half Gatorade, it is very sweet. Just pay attention to how you feel and you'll find how much extra hydration you need. Listen to your body!! It knows best. Eamon.

Hi Jenny, just one other thing I'd like to add; when I first got my ileostomy, I was told how important it was to drink lots of water and I was also advised to add salt and sugar to my water, quite a lot actually, much more sugar than salt. It turns out they advised adding the sugar just to improve the taste as many people really don't like drinking salted water. I started feeling terrible, headachy, tired all the time, not sleeping well. I had my doctor run blood tests and my sodium levels were normal but my glucose levels were very high and my liver enzymes were quite elevated. He advised to quit the sugar and that if I kept it up I could become pre-diabetic and also develop non-alcoholic fatty liver, this just from too much sugar! That scared the crap out of me! Since then, I've just added salt to my water and had my blood work re-done recently. My sodium and glucose are normal and my liver enzymes are back to normal too. I haven't eliminated sugar from my diet at all, just not adding all that extra to my water. So, something to keep in mind.

Terry

I drink lots of SmartWater. It has added electrolytes and none of the aftertaste of a lot of the mainstream water bottles that add minerals and other things to add "flavor". If I feel like having it flavored, I add a couple packs of sugar-free drink mixes to it. The ones with orange flavoring also usually have potassium citrate and citric acid to help prevent the buildup of kidney stones... That will eventually be something you will encounter in the future. I just passed one today actually! What a fun day it was. LOL

BTW, I buy the 15-pack of 1L SmartWater bottles from BJ's Wholesale Club for around $16. Great deal since I bring 2 of them to work every day.

Have had my colostomy, now ileostomy, for over 28 years.

Hi there. About your Smart Water, a safety tip, seriously. If you ever put Smart Water in your microwave oven (anyone who might do this... beware). This Smart Water is simply distilled water, produced by the evaporation process. Distilled water, without impurities, has a much higher boiling point than regular water. If you get it too close to boiling, for tea, etc., and take it out when boiled, you risk the water exploding in your face if you drop a tea bag or sugar. You risk 100 degrees Celsius water exploding in your face. 212 degrees Fahrenheit.

This pearl of wisdom was tested and proven by The Mythbusters, and further reading confirmed this.

Be careful.

I had a look at how "Smart Water" is made and how it's enhanced...

Distilling water requires an enormous amount of electricity. It's basically the same as leaving a pot of water on your electric stove all day and containing the steam, then condensing the steam back into water!! Keeping the boiling pot of water filled all the time. The distillation process removes every good ingredient that naturally occurs in water as well as possible contaminants. Most contaminants can be easily removed with a water filter.

Smart Water adds in (after these are removed by distillation) calcium, magnesium, and potassium bicarbonate, no vitamins or other minerals. By the way... you can buy a gallon jug of distilled water and add calcium, magnesium, and potassium yourself, saving a bunch of money.

The thing is they take everything out of the water and put some back in again, seems like a total waste of energy. The high price of the Smart Water may reflect all the electricity it takes to vaporize it!!

I use V8 Vegetable juice. One or two glasses a day will give you antioxidants Vit A, C, and E. There is no sugar added and no artificial colors or flavors, and you get a daily required vegetable intake. I could get a juicer and I just might, but the V8 makes more sense for one person. ... Not trying to tell people what to do, but the benefits really don't seem to add up to much.

Just one more point from the company literature. (They invent a new word!!)

If I got anything wrong, please let me know, Eamon/AKAMagoo.

Happy New Year to all.

...

"Pure, crisp and electrolyte-afied FOR TASTE". Added for taste, not function.

I love my V8 juice too, drink a glass every day!

Hi Jenny, I had my stoma formed (ileostomy) in 2014. I was advised, at the hospital, to take drinks that have electrolytes in and sip throughout the day. If I do strenuous exercise or it's hot, I need more than if it's not. Now and again, I crave salty snacks and sugar but not excessively so, and I feel I've found a balance. Hope this helps. Happy New Year. Sue

Hi,

You folks are invaluable, writing of your experiences and giving advice!! Thank you. I have stopped swelling up so much having cut down a little

on my salt intake.

I have also been sipping on sugar-free electrolyte drinks. Even though they say they are sugar-free, they are incredibly sweet to me.

Huge test coming up this month (well, it seems huge to me), a full day of watching cricket live at one of our local grounds. I know any drinks

are banned from being taken into the grounds, so it should be interesting. They have water stations all around, but yeah, it will be interesting.

Oooh, I used to put that juice on the shelves when I used to work in a supermarket!!
Recall a colleague and I having quite a conversation about them one evening, neither of us that brave

to try them, hahaha. Might give them a go.

Hi again Jenny, I have started buying dissolvable tablets with electrolytes in them and you drop one in a 500ml bottle of water and there you have it. They are great for me, and convenient. Hydro tablets, I get mine on a well-known/used site online. Good luck.

Hum, this is interesting. I have to omit as much salt... no more than 1500 mg. But after I too woke from surgery, not realizing a stoma in place... and lost 7 months of memory.... I now have CKD! I'm guessing from my chemo. So my whole diet has changed!!! Is there another way to get the proper nutrients you need without all that salt?

Best wishes and hang in there.

Hi Mikia, your past posts stated that you have a urostomy, right? If this is the case, there should be no need for you to add extra salt to your diet. Loss of electrolytes, mainly salt, is what happens to people with ileostomies. The small bowel does not absorb water efficiently, so many of the nutrients we consume are flushed out and need to be replaced. As long as you have a healthy diet, you should be fine. If you are absorbing nutrients normally, too much salt can be a bad thing. Maybe speak to your doctor if you are in doubt?

Terry

Oh, no need... I do have a urostomy, seems like I'm the only one! But my mom had a colostomy. So I have seen both worlds. I also hold a degree as a food chemist, with a nutrition degree... but no degree in ostomies!

People with Meniere's Disease and ostomies face a conflicting challenge: one mandates a very low sodium intake and the other apparently requires more sodium to prevent fluid losses and dehydration. A Hobson's Choice for certain.

Remember, there are different ostomies, so sodium intake requirements may differ depending on what a person has.

Very true, I was referring to ileostomies.

Hi Jenny,

I've got an ileostomy. Depending on activity level, I'll just salt my food or add in some olives and pickles as needed/desired. The key is to let your body tell you what it wants and monitor any changes you may notice (like leg cramps mean more sodium is needed or swelling means less is required). If you've got a craving for salty olives, vinegar, mustard, pickles, or whatever, go for it. One issue you may have is a potassium deficiency (cramps- heart beat anomalies at the doctor's office). The two minerals are responsible for bringing water into and out of the cell. I've found ways to supplement potassium with electrolyte powders like Dr. Berg's or Keto 1000. All the best to you and God bless!