Let’s Talk About Blockages

One of the most talked about side effects of an ileostomy is the potential for blockages. However you might think this is because it the most common side effect, or because you’ve read lots of stories about them in support groups and such like. The truth however is that blockages only occur in between 5.4–27.3% of ileostomy cases in the UK. Granted 27.7% is fairly high, however if you compare that to the number of dehydration cases, 20-40%, it seems rather less dramatic, doesn’t it?

I think the reason blockages are talked about so much in the Ostomy world, is because people are so afraid of getting one, and rightly so, to some extent. A blockage, or bowel obstructions as you may hear them referred to, can be an extremely painful and potentially life threatening experience. If left untreated a bowel obstruction can cause a variety of very serious complications, so prompt medical attention is crucial.

Signs of a blockage in an ileostomy usually start with a decrease in output from your stoma, it can also be that you stoma is only outputting water liquid. That being said though, watery output from an ileostomy is not at all uncommon for a variety of reasons too.

Other signs and symptoms can be things such as abdominal cramps and pain, swelling of the abdomen or stoma site itself, a decline in urine output and it may well be dark in colour (but that could also be a dehydration issue too because potentially you haven’t been drinking enough as a result of not feeling well), along with the wonderful world of nausea and vomiting.

There are many reasons that people may fall foul of a bowel obstruction. BUT I think what we folk with stomas often forget, or don’t realise in the first place, is that absolutely anyone can get a bowel obstruction, Ostomy or not. In fact they can occur in both large and small intestines too! Around 22,000 people are admitted to hospital annually in the UK due to bowel obstructions, with the most common demographic being elderly people. Surprising isn’t it!

So, what I’m trying to say is there are many ways that us folk with Ostomies can help ourselves to avoid blockages, and still live a very normal life with a diet full of rich diversity. Don’t be afraid of different foods based on other people’s experiences, created your own experiences. If you like something, try it, be sensible have a small amount to start with, and set reasonable boundaries as to how much of it you are going to eat, in other words don’t over-indulge (to begin with 😉). In my opinion, following some simple rules should be enough to put our minds at rest, and enable us to just get on with our lives, without being held back by the constant fear of ‘is this going to give me a blockage’! If however you do try something and feel like you might have got a blockage this leaflet is particularly helpful.

• Always chew your food well, like to a pulp. As humans we should be doing this away, but we’ve lost sight of the importance of it over time, and now just tend to bite and swallow. This video is really good when it comes to the importance of chewing our food, Ostomy or not.
• Find new ways to enjoy Fibre- Now I love fibrous foods, they tend to be considered things such as fruits and veggies in particular the skins, along with nuts and seeds too. The skins are harder to digest and can lead to blockages (again decreased in part by a damn good chew). I’m not going to stop eating everything with onion in it because I want to negate a risk of blockages – nope! Instead eat it, chew it well and if you cook it at home try making it into a purée. Dead easy to do and you still get all the flavour, without the stress.
• Eat smaller meals more regularly. The less there is in your gut the less there is for it to try and process.
• Keep a food diary – This is really important and a really great tip. Keep a record of what you are eating and at what times each day. Note any patterns that arise with certain foods. If it doesn’t agree with you once, it doesn’t mean it won’t next time, keep retrying things and give your body a chance to learn.
• Don’t be distracted or concerned by changes to your output. All foods will have an impact on your poo. It might be the colour, we are talking variations of anything from English Mustard to Black like tar, and even bright green. It might be the consistency, it makes it thicker, thinner, lumpier, smoother etc. With a stoma you are sort of forced to notice the changes to your poo, after all you are directly looking at it each time you empty your bag. I don’t know many people who poo the more traditional way, and then take time afterwards to sit and investigate it, well not that they admit to anyway 😉. But the truth is food has always altered your poo, even before an ileostomy, so don’t be too caught up with it now.

It’s all pretty simple really, I’m enjoying life and reintroducing lots of new foods, and so far nothing has caused me much of a problem. Changes to colours and consistencies, and the odd bit of wind maybe. However, it’s important to remember everybody has to pass wind, I just can’t use my bottom anymore so it comes out into the bag instead. I’ve eaten cashew nuts, peanuts, walnuts, onions, apples, asparagus, porridge, tomatoes you name it. So far the only thing I have actively avoided has been popcorn.

If you want it, eat it, but do it sensibly 💪 💪 💪

What we should be more mindful of however, is dehydration. Remember me saying at the beginning up to 40% of people with ileostomies have experienced dehydration. It’s no joke, it’s a massive risk for people with ileostomies. It’s the leading cause of readmission after an ileostomy creation and can come on pretty quickly too. The information on this page will show you what to look out for.

Because of the lack of colon, the body absorbs less fluids, meaning that the output from the stoma is more watery and you can loose a lot of fluid like that. So these simple steps should help you stay hydrated:

• Drink plenty of fluids, things like hot drinks, milk and lucozade sport are recommended. Water can move through you very quickly, and with it taking lots of salt, so doesn’t always help hydrate people with an ileostomy.
• Add extra salt to your diet.
• Check your urine regularly, it should resemble the colour of pale straw.
• The more watery your output, the more you need to drink.
• If you drink alcohol, be sure to drink some other fluids with it too. Easier said than done, I know 🫣.

This link is particularly helpful when it comes to maintaining a healthy balanced diet with an ileostomy. Furthermore, this brochure will talk you through staying hydrated.

I wanted the main takeaway from tonight’s post to be – don’t get bogged down in it all, be sensible but enjoy your life, and love your foods ❤️

For many of us, food is something that ruined our pasts, don’t let the fear of it also ruin your future.

Stay hydrated guys and gals, and I’ll catch you tomorrow!