Can Imodium Help Delay Ostomy Bag Changes?

I have been taking 2 tsp of sennosides and a capful of Miralax every night after dinner. This usually results in me replacing my ostomy bag once in the evening and then a second time around 2 or 3 am the next day. I wear a 2-piece system.

My question is, can I delay the emptying earlier in the evening by taking Imodium? I would like to be able to go out in the evening after eating dinner around 5 pm and not have to change my bag until around 9:30 pm when I get back home. If so, how much Imodium should I take and at what time?

Hmm 🤔 

Sounds counterproductive and/or counterintuitive.

Maybe stop taking the Miralax every other night or earlier in the day.

I've been going with a less active approach using Metamucil.

Not sure what sennosides are.

I don't know why you are taking two laxatives. Have you been directed to do this? Eating triggers your digestive system into action, so if you eat at 5:00 PM, you are likely to have a bowel movement within the next two hours. Taking two different acting laxatives adds an element of unpredictability to your digestion. You should try to stop taking the laxatives and monitor how your ostomy is performing.

You may know sennosides as Ex-Lax.

Hi there,

May I ask why you are taking laxatives and so much of it? Also, do you have an ileostomy or colostomy? You didn't say. With an ileostomy, you shouldn't be taking any laxatives at all.

How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister

I'm confused. The title of the topic is immodium which is anti-diarrhea. But you mention 2 laxatives in your post. 

Also, as Beth asked, do you have an ileostomy or a colonostomy? Advice is very different between the two. 

The only scenario I can envision is using the laxatives to clear food  from the digestive system during the day then to eat a meal at 5:00pm and take loperamide to try an delay output until after 9:30pm. Loperamide is fast acting (≈30 minutes). A high dose would be required (12 - 16 mg). There is a danger with such a high dose of becoming constipated. This only makes sense for a colostomy.

If you used a drainable pouch you wouldn't have to change your appliance when you fill up, just excuse yourself to a restroom and empty it. Then go back to what you were doing. 

Taking laxatives will make you go more and more frequently. You probably don't want to take them if you don't want a lot of output right away.

Basically, if your doctor told you to take laxatives, maybe do that in the morning instead of evening. 

I suspect OP has ileostomy in which case none of this makes sense. 

I agree with all the comments above. Maybe if you consider the way the different laxatives work and how long their effects last, you could sort out your problem better. Sennosides are stimulant, they make your gut contract to push the poo out. Macrogol powders pull water into your gut to soften your stools, so it moves through your gut more easily. Imodium (loperamide) just stops your poo fast and hard. I can’t take it as I have problems with cardiac arrhythmia and Imodium kicks it off. Codeine works like Imodium. In the words of the poet, you’ll shit enough bricks to build a castle! Prunes are stimulants plus they are fibrous, but mainly stimulant. And fibre … gives enough roughage to make the bricks!!😄😄

I actually take loperamide (Immodium) and it doesn't stop the effluent fast and hard. It slows down the motility, if you take an excessive amount you will develop constipation. I don't think that is what the OP wants since the constipation would likewise ruin the afternoon.

Loperamide does not stop me either. I'm glad I'm not alone lol

But it will slow down most people. I can't see a good reason to use both a laxative and Loperamide. That's the confusion.  

I take about 25 Imodium a day - it works well if you take it at least 90 minutes before eating, but that's for my gut. You'd have to experiment - I have an ileostomy. No need for laxatives!

So 50mg per day works for you. According to studies most ostomates should not need more than 48 mg per day. In extreme cases, persons have needed 96 mg per day. How do you distribute your 25 tablets during the day?

Hello, so I have 6 at 6am, then 4/ 5 at 11ish, 4/5 at 2ish, 6 at 5ish then another lot before bed. If I am out - hiking or just on a day trip I may just constantly drip feed them every few hours- 3 or 4 at a time to try and make sure I don't need to find a loo. My gastro consultant has told me to also drink one litre of double strength dioralyte to stay hydrated. 

Thanks 👍 

Thanks 👍 I have a colostomy. I'm afraid of getting a blockage which is why I take sennosides and Miralax

Thanks 👍 I have a colostomy. I'm afraid of getting a blockage which is why I take sennosides and Miralax

Thanks. I have a colostomy. Just afraid of getting a blockage

Thanks. I have a colostomy. Just afraid of getting a blockage Thanks for your suggestions 

Thanks. I have a colostomy. Just afraid of getting a blockage Thanks for your suggestions 

Hey there,

Just a suggestion: I would stop taking all the meds, the laxatives, and the Imodium, and see how your ostomy works naturally. Try different foods to see what thickens things. I'm not sure why you feel the need to take these things, and I am sure there is a deeper reason for you. So please don't take this response in a bad way. I don't know if anyone has told you, but when you're on laxatives like that, your body will end up becoming so dependent on them that it could cause you to have a hard time going naturally, or it can cause damage to your intestinal muscles. And that is information from a doctor. I had lived on laxatives before my ileo because I didn't have a choice not to. Just take them when you absolutely need to. Be careful; you don't want to get dehydrated either.

I agree with Beth, even with a colostomy you should not need laxatives on a regular basis. And the laxatives defeat the purpose of the immodium.

Try stopping both. The immodium slows the colon and that's the opposite of preventing a blockage. The laxatives and the immodium are probably canceling each other out. 

Perhaps switch to adding fiber like Metamucil. That will help keep you moving and is not so dangerous. 

I'd definitely consult my GI surgeon about your blockage concerns. 

I have read studies stating you should not take more than 16mg at a time, with them taken with each meal and at bedtime — you are w/in those guidelines. Further it stated most people should not need more than 48 mg and take no more than 96 mg in a day — again you are w/in the safety guidelines.

Outside of the study, you are the first person I have known that takes such a high dosage. What is the effect? How often do you empty/change your pouch 🤔

Thanks!

I take 1 capfull of the Miralax and 2 tsp Senna syrup after dinner. I'm going to cut down and see what happens 

Thanks I think I will try that

Much of the information warning about blockages does not distinguish colostomies from Ileostomies. If you are more than 6 weeks  past your colostomy surgery then you don't have the same concern as someone with an ileostomy. The internal diameter/circumference of the small intestine (ileostomy) is much smaller than that of the colon (colostomy) which makes it much more prone to blockages. You should chew your food until it's mushy — if you can feel anything solid in your mouth then you have not chewed well enough. I have a colostomy and can eat pretty much anything except seeds and nuts — I had problems with these before my colostomy but I have no problem eating popcorn which I have always been able to eat. Chewing is your friend not laxatives — I never take laxatives.

Chew well and stay hydrated and you will be fine 😉

Thank you! I keep reading stuff about blockages with stomas and so much doesn't make sense to me as a colotomate. 

I completely understand that there would be problems if you no longer have a colon but I still have 90% of mine. It isn't doing a good job removing water but that was a problem before I got sick. In fact, it was a symptom that got worse and was ignored because it was not too far from normal for me. 

But I diverge, it makes complete sense that a colostomy can handle foods an ileostomy cannot. And we need to be mindful of that when giving advice. 

I use milk of magnesia, one dose before bed, and usually empty my pouch around 6 a.m. when I get up in the morning. Works well for me.