DIY Ileostomy Deodorant Alternatives and Safety Tips

I have been just informed that Medicare has reduced the allotment of ostomy deodorant to one 8 0z bottle of ostomy lubricant/ deodorant per month. I have been using Hollister M9 with good results but 8 oz/month will not suffice. On line a bottle sells for ~$27.00.

I am looking to make a substitute deodorant. Has anybody had experience using mouthwash and dilute hydrogen peroxide (an effective bactericidal agent)? I am looking for approximate proportions; I am aware that hydrogen peroxide if too concentrated  can cause irritation of the stoma. I would appreciate any suggestions...

How much M9 do you use per month now?

I have used baking soda for years, as it absorbs odor.  It's also inexpensive and a large box lasts forever.  I just scoop a little bit in after emptying.  

I have been using slightly less than 2 8oz bottles per month for a relatively active ileostomy.

How to Manage Emotions with LeeAnne Hayden | Hollister

So you get 1 for free like normal. Then, figure out how much whatever concoction you’re gonna use costs along with your time/effort to make/store it, and then see how much the 2nd bottle really costs you. And also figure in whether your new “brew” works as well as the M9 does and that you have confidence in. 

Fortunately, I can afford the second bottle of M-9 deodorant if necessary, but it frosts me that some government bureaucrat who knows nothing of ostomies or ileostomies decides that I don't need more than one bottle per month.

My medicaid only pays for 4 bottles of 1oz bottles a month. It isn't enough by far. They used to give me an 8oz bottle a month but now are going down to 1oz bottles and I can get 4 in a month. So that is not a lot. If I want more I have to buy it out of pocket. Just like if I want adhesive remover spray instead of wipes I have to buy them out of pocket. The wipes do nothing. I hate them. And if I want no sting barrier wands instead of wipes I have to buy them out of pocket for $64 for 25 in a box. That is a lot of money for me to be spending out of pocket. Some of it is the distribution company and some is medicaid. Mostly it's Byram. What they carry.

I'm with you! My supplier kept telling me that Medicare had a 4-bottle limit per quarter on my Brava lube/deodorant. I go through one 8 oz bottle in 2 weeks. I had a Medicare rep do a conference call with me and them, and the message was clear: Medicare sets no such limit. It was all about the way my doc wrote the script. The supplier found it easier to lay it on Medicare than deal with the issue.

My husband isn't on Medicaid, but he uses Safe n Simple ostomy deodorant. Is that offered under Medicaid? We buy it off Amazon; one 8-ounce bottle is half the price of M9 drops. Never has an issue with odor. He gets about 3 weeks out of the 8-ounce bottle, but it could probably stretch to a month.

You can use a mixture of pre-dissolved antacids in a small water bottle to flush out the bag with while on the toilet or use a few drops of antibacterial dish soap and fresh water to wash and flush.

What's nice about the antacid water mix is the top liquid in the bottle can be used to flush and the more concentrated mix at the bottom used to leave a little bit inside the bag (after flushing) to act as a future output neutralizer and odor eliminator as it will mix and kill the digestive enzymes responsible for the horrific odor. In fact I leave a bottle of premix in the car for bathroom breaks which occur a lot with my high output otosmy. It also doubles as a burn reducer in case of a small leak while driving or at home with a active stoma, sure beats standing in the shower for hours on end.

Bad side effect of the antacid water is it can tend to leave deposits on the bag after 3-4 days of your a one piece type, but can be mitigated by using the antibacterial dish soap more often,. Both methods do the same thing, kills the bacterial enzymes.

The antacid water does so by raising the pH level past what the enzymes can handle. Don't use baking soda or anything more caustic or acidic, antacids are just perfect enough and don't cause any other damage or effects.

The extra left in the bag can mix to get the output to slide out and down better. However to really solve pancaking issues is to mix dry, clumping type foods with a more liquid causing foods or drinks while eating.

See a nutritionist for a full list of what foods do this and especially foods that can cause a painful, ER visiting clog. Nuts, tough fibrous veggies and parts of meats especially. Some cause dirrarea and can make getting a fresh bag on very hard (beer). Some cause gas (sodas). Etc. Veggies can be eaten if they are diced into tiny pieces and cooked to mush. Corn anything is usually bad as it doesn't digest at all much. 

I could (and should) post my list here, but it's quite long. It's not available online unfortunately.

Okay here it goes...

[b]Signs of a clogged stoma.
[/b]
No output or only watery output under pressure for a few hours after eating. Could be caused by a covered stoma by improper application of an appliance, typically hole is cut too small or too much paste. Also could be caused by eating hard food. Seek treatment by an emergency room, remove appliance if necessary and wait. If clogged a severe pain will eventually appear which hopefully will clear itself. If not a trip to surgery would be necessary. Unfortunately very high and frequent output will ensue after clearing for quite some time which will likely making putting on a replacement appliance difficult. Use stool thickening tactics (below). If going to an ER, bring your own otosmy gear and a change of clothes as hospital likely doesn't carry or doesn't know how.

[b]What is "pancaking?"[/b]

Pancaking occurs when a vacuum in the bag (likely do to a clogged filter) or super thick stool blocks stool from depositing to the bottom of the bag. Thus can force bag off and cause leaks. Controlling what one eats and by mixing and consuming stool thickening and stool softening foods at the same time to get a balance.

[b]What is "ballooning?"
[/b]
Ballooning occurs when foods eaten produce too much gas and the filter gets clogged (likely due to laying down) and thus forces bag off and causes leaks.

These two conditions can cause premature bag replacement and leaks which burn the skin. It's better to replace the appliance if there is any continuous stinging pain, don't just live with it. Keep an eye on your otosmy supply and have ample reserves.

I've found that caffeine, in coffee, tea and even chocolate causes diarrhea and can assist in controlling flow so stool is more liquid.. Dried Chinese Crispy Noodles, Cheerios or applesauce (peeled apples) are the exact opposite, a stool thickening food. By mixing these with other foods one can manipulate their stool output and counter the issues above. Also the severe thickening helps in cases where one has severe diarrhea and unable to reattach a new bag due to high flow.

[b]Eating Guide
[/b]

Partially copied from my nutritionists guide. Ileostomy Nutrition Therapy from the Academy of Nutrition and Dietetics. (This handout may be duplicated for client education.)

My recommendation is to see a nutritionist for the full guide as not all can be pasted here

I've added my own observations to further clarify 

Chew all foods well to the consistency of paste.

[b]Foods That May Cause Blockage (very bad avoid!)
[/b]
Apples, unpeeled (unpeeled and applesauce are excellent thickeners, don't eat the core, chew well)
Bean sprouts
Cabbage, raw
Casing on sausage (inside fine if no tough parts, avoid swallowing if a chunk is felt)
Celery (avoid)
Chinese vegetables (stir fried crunchy, too hard, need soft veggies with no skins)
Coconut
Coleslaw
Corn (grits also, corn anything doesn't seem to dissolve in stomach)
Cucumbers (skins bad, inside chewed up good seems okay, no seeds)
Dried fruit, raisins
Grapes
Green peppers (red, yellow also) pureed or very very small seems okay in small amounts 
Mushrooms (doesn't dissolve in stomach) pureed or very very small seems okay in small amounts 
Nuts (totally avoid)
Peas (mushy interior okay, like pea soup, skins a problem)
Pickles (skins a problem, inside if chewed up good seems okay, seeds not)
Pineapple (liquid okay, mushy parts fine, hard parts not, tricky)
Popcorn (totally avoid)
Relishes and olives
Salad greens (diarrhea nightmare too)
Seeds and nuts (avoid)
Spinach (doesn't digest, pureed perhaps)
Tough, fibrous meats (for
example, steak on grill, well done, tough parts especially)
Vegetable and fruit skins, (any avoid)
Whole grains (no grits, oatmeal seems to be okay, Cheerios is an excellent thickener)

[b]Foods That May Cause Gas or Odor
[/b]
Alcohol
Apples
Asparagus (stink)
Bananas
Beer
Broccoli (clog hazard)
Brussels sprouts (clog hazard)
Cabbage (clog hazard)
Carbonated beverages
Cauliflower
Cheese, some types
Corn (clog hazard)
Cucumber
Dairy products
Dried beans and peas (clog hazard)
Eggs (don't digest in stomach)
Fatty foods
Fish (cooked salmon in small portions may not, nor stink)
Grapes
Green pepper (red and yellow also, clog hazzard)
Melons
Onions (clog hazard)
Peanuts (clog hazard)
Prunes
Radishes
Turnips
Soda and sipping using straws, (drink from glass instead)
Seafood (oh God does it stink!)

If your having pancaking issues a small amount of something above (like having a soda during a meal) could introduce some air into your diet and thus into the bag. Also by avoiding too much thickening foods by themselves which often contribute to pancaking.

[b]Foods That May Help Relieve Gas and Odor[/b]

Buttermilk
Cranberry juice
Parsley
Yogurt with active cultures (Greek yogurt)

[b]Foods That May Cause Diarrhea (looser or more frequent stool)
[/b]
Alcohol (including beer)
Apricots (and stone fruits)
Beans, baked or legumes
Bran
Broccoli
Brussels sprouts
Cabbage
Caffeinated drinks
(especially hot)
Chocolate
Corn (in my experience corn anything doesn't digest in stomach,  just passed through and out, kernels/popcorn will clog)
Fried meats, fish, poultry (KFC, supermarket rotisserie chicken very bad, anything soaked in brine)
Fruit juice: apple, grape, orange (small amount okay)
Fruit: fresh, canned, or dried (small amount okay)
Glucose-free foods containing mannitol or
sorbitol
Gum, sugar free
High-fat foods
High-sugar foods
High salt foods (KFC, supermarket rotisserie chicken)
High seasoned foods (blackened)
Licorice
Milk and dairy foods (small amounts okay)
Nuts or seeds (bad, clog hazard)
Peaches (stone fruit, one rarely okay)
Peas
Plums (stone fruit)
Prune juice or prunes
Soup
Spicy foods
Sugar-free substitutes
Tomatoes
Turnip greens/green leafy
vegetables, raw
Wheat/whole grains
Wine
Rice (1/4 cup in mixed in food okay), refried beans (1/4 cup okay) pasta (one cup max).
Any foods soaked in brine or fried (rotisserie chicken, Kentucky fried chicken etc)

[b]Foods That May Cause Diarrhea (looser or more frequent stool)
[/b]
Alcohol (including beer)
Apricots (and stone fruits)
Beans, baked or legumes
Bran
Broccoli
Brussels sprouts
Cabbage
Caffeinated drinks
(especially hot)
Chocolate
Corn (clog hazard, even grits, doesn't digest)
Fried meats, fish poultry
Fruit juice: apple, grape,
orange
Fruit: fresh, canned, or
dried
Glucose-free foods
containing mannitol or
sorbitol
Gum, sugar free
High-fat foods
High-sugar foods
High salty foods
Licorice
Milk and dairy foods
Nuts or seeds
Peaches (stone fruit)
Peas 
Plums (stone fruit)
Prune juice or prunes
Soup
Spicy foods
Sugar-free substitutes
Tomatoes
Turnip greens/green leafy
vegetables, raw
Wheat/whole grains
Wine
Soylent nutritional drink 

[b]Foods That May Help Thicken Stool
[/b]
Applesauce (unpeeled apples, no cores)
Bananas
Barley (when OK to have
fiber)
Cheese (cheese food may be a clog problem, use real cheese)
Dried Chinese Crispy Noodles (severe thickening, mix with other food that causes diarrhea)
Marshmallows
Oatmeal (when OK to have
fiber)
Pasta (sauces may increase
symptoms) (in my experience more than a cup of pasta causes diarrhea)
Peanut butter, creamy only, nuts clog (makes skin oily)
Potatoes, no skin (skin clogs, more than a cup causes diarrhea)
Pretzels (salty may cause more flow water consumption)
Metamucil, mix or crackers (mix in cup of water and drink before it gells up)

I'm adding to this list based upon experience.

A few months back on this forum, someone posted about using aspirin instead of a deodorant, I have been doing that ever since.  Just recently I tried a couple drops of peppermint essential oil.

The pH level of human skin is typically between 4.7 and 5.75, making it mildly acidic.

The pH of acetylsalicylic acid (aspirin) is 3.5.

The pH of gastric juice in the human stomach is about 2 to 3.

The pH in the small intestine (this is the output of enzymes) is about 8.

The pH of antacids ranges from 8.5 to 10.5.

The antacids are safer as they only raise the pH slightly, just enough to render the enzymes neutral and thus don't make any more odor.

On the other hand, aspirin is almost as acidic as stomach acid, and having had stomach acid exiting my stoma and leaking onto my skin, the burns are far worse than normal. It would also burn the stoma more as its pH is about 8 as well.

8 - 3.5 = 4.5 difference in pH with aspirin.

Versus 0.5 to 2.0 difference with antacids.

So although aspirin can work, it's just not as safe.

Of course, if antacid water remains in constant contact with the skin, like during a leak, it, like stoma output, can cause caustic skin burns as well. But leaks are usually just temporary and often remedied in short order.

The thing is, aspirin can burn the stoma if a concentrated amount touches it, whereas the antacids not as much and still do the job of rendering the output enzymes inert.

That’s good to know Henry. Especially with your length of experience. 

Actually Henry what is occurring is the baking soda is raising the pH level of the output thus killing or nearly neutralizing the digestive enzymes found in the lower intestine (pH 8) which causes the odor.

However baking soda has a pH of nearly 8 itself, antacids predissolved in water are slightly higher at 8.5 to 10.5 so it's more effective and in easy pill form instead of fiddling with powder. People see antacids and it's no big deal than baking soda and wondering why you have that in your car. 😆 

I leave a little of the fresh antacid concentrate in the bag after flushing to mix with future output to kill odor. Also assists with pancaking issues.

What's even cleaner is using antibacterial dish soap and water during a bag flush. I use this more often as it cleans the bag of oils and such also.

Mouthwash and hydrogen peroxide are much too expensive.

Been there, done that.

Predissolved antacids in a water bottle work great and can be used in the car, etc. Big generic bottle versions work well.

Although antibacterial dish soap and water work even better, having a bottle of dish soap around isn't as easy in the car, etc., as antacids.

Hi Alex.   I’ve been using hydrogen peroxide full strength for years, since 2018 when I had my ileostomy.    Just a cap full is all that’s needed.    Hasn’t caused any irritation for me.    It’s cheap too😊

hi, I usually don't worry about odor, but after certain foods it can be intense. An old ostomy nurse told me to use peroxide, about 3-5 cc will do the job. Use like a rinse or flush and leave some in your bag. It's cheap and works well.

Hi there,

I have a friend who swears by Listerine. I use a spray of Poo-Pourri, scented hand sanitizer, or a room spray. I get the last two from Bath and Body Works. They come in small sizes so I can travel with them easily.

I've been using Safe and Simple deodorant/lubricant - I find it great and it's about $13 on Amazon when I need to add onto my monthly allotment 

Nothing works as well as M-9. I have tried everything over 40 years. Four drops of M-9 is all that is needed each time.

Can I ask what M-9 is? Guessing deodorant drops. I just use Brava lubricating deodorant on a 2-piece system for a colostomy. Little spoiled here in Australia with all ostomy products ordered (there are limits per month) paid for by our Medicare system.

Avoid alcohol; it damages the skin. Use only 8-10 drops of M-9. If you have a spicy (onion/garlic) and fish diet, you need it. If not spicy at every meal, don't use it. Dumping other liquids into your pouch can ruin the seal. Baking soda can work.

It's an ostomy use product, so it should be covered. You should ask your husband's ostomy supply company (whatever vendor he gets his pouches through) to order it for him in his next order. On each Safe N Simple product, they put the product number somewhere, so just provide that number to his ostomy supply vendor. Be sure to give them the product number. I made the mistake of asking for XYZ Brand wipes and ended up with a pack of baby wipes instead of the individual single wipe packs, and now have a half-dried-out pack of wipes. So, keep in mind the people you are ordering from or who are supplying the supplies probably know little to nothing about the individual products, so always supply the exact product number/product code - if possible. Smiles (aka make it idiot-proof for them so they can't mess it up and order the wrong thing.)

Good luck!

Agreed.👍

I use white Tic Tac breath mints. You have to use at least five of them. They don't eliminate odor but make it more tolerable!

Good luck.