Ostomy Page Table
Handling the Changes
Our fluids now move more quickly so timing and its effects need attention. This is from a shorter path, controlled with food types and fiber, along with some specific meds.
Your bladder shares some space with your colon and other organs, and now you have some changes. Several muscles in this area may use some toning-up to make-up for change. See the following links about 'Kegel' for info. And remember - muscles work on protein.




Timing & Alkalinity
After eating, we need up to 3 hours to pass 1.5 — 4 pH stomach fluid (Chyme) going to the Duodenum.
The Duodenum connects our stomach to the small intestine, and is the beginning of where 90% of nutrient and medicine absorption occurs while waste products are passed along.
The Duodenum secretes alkaline to blend with stomach fluids. Its secretion goes on till that blend hits 7.0 — 8.5 pH for it to quit. Before Ileostomy this could need up to 1 hour. Pathway is shortened from Duodenum to Stoma which used to take 1—5 hours.
Ileostomy's faster travel moves alkalines away from Duodenum before full blending, but that alkaline secretion is still set for target pH.
Fluid travel time can be improved with Fiber and Anti-Diarrheal meds.
Try Metamucil® or note some pharmacies have their own brand.
Natural Fiber helps balance food + Anti-Diarrheal meds. Available in capsules and no added flavor.
Diets low in saturated fat and cholesterol that include 7 grams of soluble fiber per day from psyllium husk, as in Metamucil, may reduce the risk of heart disease by lowering cholesterol. One serving of Metamucil has 2.4 grams of this soluble fiber, while capsules have at least 1.8 grams.

See your system:  get pH Test Strips.
First, find your own scale by easily reading output each time. That pH level will vary and can help show the effects of Fiber & Anti-Diarrheal meds. Stomach Acid Reflux (GERD) meds can affect stoma output alkalinity.
Check pH of Your Output to Verify*
  Before Ileostomy:      4.0  —  7.0 pH
  With the Ileostomy:   7.0 — 10.0 pH*
Typical Exterior Skin:  4.5  —  5.5 pH

Now our skin is exposed to more alkaline (8—10 pH) fluid than tolerable. Muscles can't limit output as before. Device Leaks beneath the barrier are painful, and even with no leak visible outside, replacement is required. So we try more devices for fit and comfort.

Absorption
Some medicines and nutrients need more time and might be passed along before fully absorbed.

Consider that liquid and gel meds may absorb faster than solids, and Consider that delayed-release meds may be washed away before time to dissolve & absorb.

For nutrition, foods we eat have always required proper chewing (Mom said). Nutrition labels help you get maximum protein and nutrition from smaller meals and daily supplements. Eat less volume per meal and have more meals in a day to accomplish better intake.
Good eating style doesn't require ileostomy, just practice. Pass that on!
Vitamins, Minerals and Protein need attention, liquids and gels give better absorption. Most of us need > 60-80 grams Protein/day. Fiber is now more important.
Click these to see:

There are several drinks with added Protein and other nutrition, try to balance cost with your food for the day.
Click for Nutritional Drinks Ensure, Boost, Resource, Nutren, Pediasure, Nestle, online.


Sleeping
Naturally you should sleep lying on the side appropriate for your stoma pouch to hang down. The stoma defines that side.
BUT if you also have stomach acid or esophageal issues, like ACID-REFLUX or GERD for example, that requires your body on a slope with your head and esophagus several inches above your stomach. Lying on your left so your stomach is positioned hanging down is also desirable.
If you need a stoma pouch hanging down on right side and stomach down for sleeping, your best sleep may need experimenting. Propping up and twisting body with a reclining chair to aid testing has been a start for some. Special firm sloped bed pillows are available for this upward positioning.
Some 2-piece pouch systems may allow special positioning of the pouch for sleeping. Any pouch must be returned to its hang-down walking position when you're awake. See more about 2-piece details. Beware that some pouches are limited to attachment once, others are allowed removal & reuse over again.



Shopping List
Metamucil┬«, Imodium*, wipes, toilet tissue, anti-bacterial-hand-soap, paper towels, protein+nutrient drinks, pH Test Strips, etc., etc.
 *names shown may be generic. Consumables may combine Prescription types.


Patrick Mullins
2018

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