Loperamide Use with an Ileostomy: Seeking Advice

I'm looking for some advice here. I've discovered that I'm low in magnesium and have gone twice now for infusions. My body is just flushing it out. I have to keep up a good liquid intake because of my ileostomy, but I guess I've been overdoing it. I take magnesium supplements too, and the Catch-22 is that the supplements cause diarrhea, which in turn flushes out the magnesium! I'm going to have one more infusion, then try reducing my liquid intake and reducing the magnesium supplements, and see how it goes. My doctor has suggested I take loperamide (Imodium) for the diarrhea, but I'm unsure how this would work on someone who doesn't have a colon. Are there other ileostomates out there who take loperamide? I've never in my life had to take anything for diarrhea, as the opposite was always my problem, pre-ostomy. I don't want to take something that will stop my intake, and I'm worried that it would have too strong of an effect on someone with no colon. Any advice would be greatly appreciated!

Terry

I rarely take loperamide now, but I used to live on it when I had a high-output jejunostomy stoma. It's a really good, fast-acting, non-addictive medication. It's a fast-acting med, so if you were to take too much, it would wear off very quickly, so you wouldn't be clogged up for more than a few hours. But I can't honestly see it causing any problems. Start off on the lowest dose; if it helps you feel more relaxed about taking it, go from there if you need to take more.

Hi Terry, I take one Imodium after breakfast, and sometimes after supper depending on what we're eating.

Hi Terrrr...

My advice as an ileo like you, - no colon would be to try it. Imodium is what I use. Two tablets either before or after eating.

Sometimes only four per day. Other times six.

Some members live on it.

I agree it is a game changer for sure. It will slow down your output and thicken it. Just experience it with what works for you and your diet.

Yes, you are drinking too many fluids. Stop that! 😆.. can't have you floating away now..

Imodium and Liquid I.V. is my new normal.

I vary drinks. Water, orange juice, iced tea. No coffee. It gets boring drinking water. And water should be taken but not relied on 100%. Nope. Mix it up.

Liquid I.V. is a powder you add to water. Just found a sugar-free brand. That's another thing to watch out for: diabetes.

This works for me, and I'm at a comfortable level with more solid waste and satisfying hydration now.

Let me know what you think after trying it out. It's quite impressive, the change.

I have an ileostomy as well, and although I have a colon, it has been dormant for almost 5 years now. Before I started taking Psyllium Fiber, my output was always just colored water. The fiber regimen, I feel, brought me around to a more normal bodily “process.” It may not be for everyone, but you may want to read about it and talk with your doctor. I am very dehydrated and try all sorts of hydration drinks. My doctor said I needed to drink more water; I ended up drinking too much water - the result was that it flushed sodium from my body. As always, we are all very different, but the bottom line is I am ever in search of information to make the most improvements to issues that sometimes seem to be never-ending. They seem to end for a while, then flare again… for example, the dreaded rash under the tape on my appliance, which I have been fighting for a month now. I change my setup every other day. I finally broke down and went to the doctor… bacterial infection… may be caused because I swim almost every day and rarely dry that pool water on the wet tape. I live in Florida, so it dries pretty quickly on its own… lesson learned… jb

Airport Security Tips Living with an Ostomy with April | Hollister

Hi TerryLT

I have taken loperamide post-op - but not on any long-term basis - Also, I used to use Magnesium tissue salts [but only in low concentrations] - sadly, New Era tissue salts are no longer made, and no other company has taken on the range of products.

I have an ileostomy i.e., no large bowel - so IMHE it is a case of finding a way to balance the magnesium at times when one is losing liquid through the stoma - and yes, finding a personal solution that does not cause an imbalance in the process.

BTW, my own manifestation of low magnesium showed when, due [usually] to dehydration [not enough overall liquid consumed over the day], I have leg or foot cramps - hence the readily absorbable [pretty immediate i.e., placed under the tongue] I found to be the 'rescue' treatment when the cramps were actually happening.

As Alex mentions, it is important not to over-flush the system - and chugging water or other liquids does not regulate - but continually taking in liquid [so long as it is not a diuretic] is the best long-term solution to prevent dehydration.

I hope you find a long-term balance that works for you, Terry

Best wishes

Jayne

BW

J

PS

As a personal question .....

Is there a brand of a range of tissue salts whereby one can take a particular homeopathic dilution of a particular chemical being marketed in Canada / the US or elsewhere?

I am looking for a replacement brand for a like product from the New Era range of tissue salts which are no longer manufactured in the UK

• Be interested in any links to follow up on my own research in this.
• Thank you.

I think a lot of people believe they must consume water as their only liquid. To an extent, yes, but there is a tipping point where too much plain water does nothing but flush your system out. A variety of liquids with nutrients added in, along with plain water, is important. 👍 Don't flush out what your new plumbing is already pushing through your body faster now.

Thanks to all of you for very helpful advice! I've been aware for a long time that too much water is a bad thing, and I've tried to avoid it. I do mix it up, seldom drink just plain water. I have a powdered hydration mix that I sip throughout the day, but I also drink coffee in the morning, V8 juice, tea, milk, etc. I think something in my body has changed, as the magnesium supplement I take didn't used to make my output so loose, but it sure does now. At least I know I don't have to fear the Imodium, so I'll give it a try, but I'm going to wait until after my next infusion. Jayne, you said you were getting muscle cramps from low magnesium, and I have experienced a bit of that, but my main symptom was difficulty sleeping. I had no idea that low magnesium could affect sleep, but it does. I think I may have been low in magnesium for a long time without realizing it. I just know that when my level gets back up to normal, my sleep improves.

Terry

I am allowed to take Imodium twice a day as needed. I know some people take a whole lot more. It doesn't hurt your ostomy so long as you manage how much you take. It slows down the travel time of things through your ostomy. If you take too much of it, it could cause a blockage, but so long as you follow your doctor's orders, you should be fine.

https://martinandpleasance.ca/collections/schuessler-tissue-salts?srsltid=AfmBOorFQoAlrgkOieUNj9Mx0BHDy6OKL0LnCl5xXRkchL4AGoaLUIa_

I use it 2 to 3 times a day. It does help slow down my output. I have an ileostomy too. It helps a lot. Sometimes I can slow it down with foods, but not always. I'm sensitive to medicine and haven't had any issues. Just watch your output—if it thickens up like toothpaste, stop taking the loperamide. Sip your liquids; I used to drink them too fast, thinking I had to constantly chug to stay hydrated.

I take loperamide and I don’t have a colon or a large intestine at all for that matter. 

the thing with an ileostomy is to not drink too much fluids as this will dehydrate you as it will make the output loose, loperamide slows down the function of the small intestine also giving the body more time to absorb some of the fluids, most fluid is absorbed from the large intestine but the small intestine will absorb some. Try drinking less fluids and eat more foods that retain moisture like potato and root vegetables like carrots (though you have to boil the hell out of them) try not to drink too much inbetween meals and avoid anything carbonated.