Managing Fluids on a Liquid Diet and Its Effects

I’ve had to manage the amount of fluids I’m losing lately because I went on a liquid diet. 
I am now back on solid foods and having the liquids as a supplement . My output is looser than usual with half of my calories coming from liquid. 
I’m drinking about 1750ml of fluids a day (750ml from the drinks of the hospital) and eating 4 small meals. 
Output is about 700-800ml over a 24 hr period. 
Just curious to what anyone else’s total output is. 
Thanks again 

Tom 

I don't measure in ml; I measure in cc's and average around 1,000cc a day. Sometimes more, sometimes a little less. If you are on a half liquid diet, then you will have looser stools and more volume. But you need to get nutrition, and you need to stay hydrated. Just understand that you will have looser output. Do you have an ileostomy or a colostomy? If you have an ileo, you are going to have more liquid output anyway, as a rule of thumb.

Hey there, so 700-800 is good. You don't want to go over 1200 CC of output. And to help with the thinner output and to help keep your liquids, eat thickening foods.

Thanks. 
I have an ileostomy. 

Be happy you have a normal flow ileostomy; mine is high volume at 1800 mL per day. 😢 

It presents some challenges, believe me. I only eat between 8 am and 2 pm, then only two small cookie-like snacks afterwards to keep off hunger. If not, I wake up with overfilled bags that force the wafer off and cause a blowout.

The thing is to watch that you're urinating and its color is either light yellow or clear, not nothing or orange. Orange-colored urine means you're dehydrated. Orange-colored urine can occur after taking a vitamin as well.

Drink more water and less of other types of liquids, but ensure you're getting electrolytes and taking multivitamins, especially with B, as the area of intestines responsible for absorbing B was removed. If you're having nerve pain like in your fingers, it could be a lack of B or diabetes. Watch for that.

If you like coffee, my suggestion is to switch to tea if your leak burns are severe.

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Thank you 

Thanks for the reply.
Hope everything works out.

Why did you change your diet to begin with?

How much of your fluid intake is just plain water? You should be drinking around 2 liters a day. You're not far off, plus you will be gaining fluids from the food you're eating as well. All of us have to be careful with fluids and getting the right amount we need to prevent kidney problems in the future.

I have no idea what my output is. The only time my output was measured was after I first had my ileo and again when I had my temporary jejunostomy stoma by nurses. I have loose output and drain the bag around 10 times a day.

To settle inflammation down in my small bowel, I am on a liquid diet called Modulen to give my bowel a rest.
It does seem to have helped, and I have gained some weight back.

Just remembered I drink through the night when I wake up to go to the toilet. So my fluid intake is around 2 liters.
750 ml Modulen shakes, 750 ml camomile tea, 500 ml water.

"I have loose output and drain the bag about 10 times a day."

That would be about what I do, so you have a high output ostomy.

You can reduce this by limiting your starches (rice, potatoes, pasta) to about one US cup per meal, as well as your meat to the same amount.

No alcohol. Review this list; it should help control your diet better.

 

[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 due to improper application of an appliance, typically when the hole is cut too small or too much paste is used. It could also be caused by eating hard food. Seek treatment in an emergency room, remove the appliance if necessary, and wait. If clogged, 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 make putting on a replacement appliance difficult. Use stool thickening tactics (below). If going to an ER, bring your own ostomy gear and a change of clothes as the hospital likely doesn't carry or doesn't know how.

 

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

Pancaking occurs when a vacuum in the bag (likely due to a clogged filter) or super thick stool blocks stool from depositing to the bottom of the bag. This can force the bag off and cause leaks. Control 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 lying down), thus forcing the bag off and causing 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 ostomy 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. However, coffee makes output very acidic, making burns worse. 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 is unable to reattach a new bag due to high flow.

 

 

[b]Eating Guide[/b]

Partially copied from my nutritionist's 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 the 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 hazard)

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 you're 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 the 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 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 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 a cup of water and drink before it gels up)

I'm adding to this list based upon experience.

Do you measure with a measuring cup, or what? I have never done that. Is there a reason to? Like, you have a pile, and it would differ from liquid or applesauce texture.

Hi missb, over time you can measure by the eye, and you know if you have had too much liquid output versus thicker, and that's what you have to watch because you don't want to lose all your liquids and get dehydrated.

Then you should expect more output and looser output. That is just how ileostomies are. I have an ileostomy and sometimes, well most of the time, at night when I get up to empty it's like tea coming out of my bag. It's that liquid.

I used to measure with a measuring cup they gave me two at the hospital when I had my relocation surgery. Now I just kind of know how much my bag is full and how much that is. You get the hang of it after a while. And for a while I would guess how much it was going to be and then measure it. I would be right on the mark too. So then I stopped measuring it in the cup and went with what I thought was a close approximation. But yes at first I did use a cup to measure it in a measuring cup. I have a lot of output that is pure liquid. It would be hard to measure something that was as thick as applesauce in a cup. I think you could do it but it would be a challenge. 

I was told to drink 8 glasses a day. I found potatoes, pasta, rice, pretzels, bread, and cookies (yum) thicken my output. I eat 3 marshmallows, 30-45 minutes before cleaning and changing. Little to no output. Easier.