Struggling with Loose Output Despite Imodium

Hey all, I am at my wit's end with Imodium and loose output. I've tried all manner of foods 30/40 minutes after taking two Imodium. Still loose. The only thing that works is porridge and banana, but I can't live on that forever. Any suggestions, please? 🙏

Have you tried mashed potatoes? Breads or dinner rolls?

Peanut or almond butter. Applesauce. Both work way too well for me. Also...no coffee.

Hi Fox,

Whether you can thicken up your output or not depends on more than what you eat. The first thing to consider is how much, if any, small bowel you are missing. If it's substantial, it will be very hard to thicken output all the time... or even sometimes. What, when, and how much you drink will also impact the consistency of your output as well, and has been discussed on here ad nauseam. The best thing to do is keep a log of what you eat and drink, including the time and amount... and note your output. Once you've got a few months of data, you can see what works, what doesn't, etc., and tailor your eating and drinking habits accordingly. Don't try to rely on memory alone.

;O)

Hey Foxglove.

A couple of items I noticed: Chili stayed light on kidney beans, but it worked well. Also, mango smoothies: 1 cup of mangoes with approximately 1/2 cup of yogurt, 1 banana, and add milk to the desired thickness.

 

Words of Encouragement from Ostomy Advocates I Hollister

Eat 1 US cup size portions of each food group (meat, starch, vegetable juice) max between am and 2 pm. After that, just small pudding size snacks. This will help with bathroom visits during the night or overfilled bags in bed.

Avoid fried, brined, or salty foods. Avoid coffee; try tea instead. Avoid alcohol. Avoid anything hard or has tough fibrous like beans, corn, pineapple, etc. However, liquidified or consistency like pea soup is fine.

Take a multivitamin with B occasionally, drink mainly clean water with occasional electrolytes. Less sodas and other drinks.

Avoid using solid bananas for flow control as it's a clog and pancake problem, pureed is better. Applesauce is best.

Avoid coffee as it can make burn pain worse. Try tea.

Sleep only on your back with a pillow under each arm to keep you in place.

 

[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, 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. 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 the 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 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 the 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 the 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 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 a cup of water and drink before it gels up)

 

I'm adding to this list based upon experience.

I have seen a lot of people say they have the same problem with coffee; it doesn't affect me like that.

Hello F

Get a small bag of psyllium husk powder. You can mix a spoonful in a glass of water and quickly drink it before food, or you can sprinkle it over your food. It's the same as Metamucil but without the sugar, etc. There is plenty of information on the internet about it, and it is cheap and easy; experiment with it. I have used it, and it worked for me when I wanted something like this. Is the loose output really a problem for you?

"Also no coffee"

I can second the heck out of that.

I've been struggling with wafer issues, leaks, severe burns and depression because of coffee.

I have a near flush stoma and a belly fold which makes leaks more common.

It seems to me the body just flushes the coffee and stomach acid right out with it into ones bag. When a leak occurs it's not just digestive enzymes eating the skin, I think it's just hydrochloric stomach acid.

My leak burns pain intensity level has gone down considerably since I've given up coffee.

Now they are just a dull ache instead of rip the bag off NOW sort of pain.

Tea has been a lot more gentle on my system and I still get my caffeine.

None of those work. ☹️ Rice doesn’t work either. 

I'll second axl's question, is the loose stool really a problem for you? Or better yet, why is it a problem? 

Since you seem to be having such trouble thickening it, there may be a solution that will make it more live-able. 

G-Day Foxglove, Personally, I prefer my output to be runny. It's easier to empty and not as messy. Regards, IGGIE

That is so true. LOL

I am on 14mg loperamide and 45mg codeine, both 4 times a day, to thicken my output, and it has regulated. I was hospitalized due to dehydration and then again due to malnutrition, so a massive upscale on meds was necessary. Have you tried jelly? Not made-up jelly, but packs, and then eat the cubes. The gelatine really helps.