Have ileostomy, stool going other way HELP

[jean60]

I hope someone can respond to this...I just woke up in the wee hours to find I am a mess from leaking watery stool from my anus. I have an ileostomy and I have experienced small amounts of leakage in the past but nothing like this. So far it is not letting up much and I am going to have to wear something protective to even get dressed today. I will call my doc but wanted to see what I could find here...not getting results with search.
This is freaking me out pretty well right now..I need to know if anyone has had something like this happened. FWIW my ileostomy is certainly draining as the fact that it was full is what woke me up.
Help!

Jean

[jjlist]

is there any visible changes in the stoma?

[jean60]

To be honest, I haven't looked at this morning. I will do that. Thanks

[RayGirl]

I drained sporadically for a week or so right after surgery and a couple of times months later. But it wasn't much volume. My surgeon informed me that my colon was still a working organ, it just didn't have anything to work on but it would still occasionally produce something even with a ileo. So it may be normal, but I would still call the surgeon and discuss.

[MrPleistocene]

It is always good to check with the Dr. About 3 months after surgery I had a day with tremendous cramping. I thought I might be having 'phantom' movements. Over the day I laid 3 'eggs'. Fortunately, they were relatively solid. Kind of a hardened mucous, about the size of chicken eggs. Strangest thing. It only happened once for me. A friend's child with Down Syndrome has a ileostomy, and she has all sorts of discharge issues. So, it seems like discharge can vary widely. Hopefully this isn't a persistant issue for you, but don't fret too much. I'm sure your Dr. will be able to restore some piece of mind.

[Rob in PA]

Ah, the ole' stool going the other way syndrome! Yes, it happens. Like others suggested, tell your doc about it but discharge is not uncommon. I had a leak test done to check my anastomosis site one time and the barium fluid they squirted up my butt leaked into my iliostomy bag!! Very weird. So, even though stool is supposed to go into bag, it is possible that because you woke up and your bag was full, there could have been enough volume and gas pressure to push watery stools back into your stoma and down the old poop hatch.

Again, we are not all doctors but we have the role of "been there done that" patient nailed down pretty good.

Best of luck.

Rob

[jean60]

Thanks everyone! I put a call in to my doc who is in surgery today so I will hear from him tomorrow if not today. "Things" have definitely slowed down so I am getting through a day of work. Good info one and all, always makes one feel better to hear someone else's experience.

Rob, interesting leak test! I will be having that done sometime next month I think before I do my reversal in May. Given what happened to you, your comment on my full bag and the ensuing escape to the "old poop hatch" makes some sense. Also, thanks for making me laugh.

Jean

[Rob in PA]

Rob, ..... Also, thanks for making me laugh.

Jean[/quote]



....I try

[mtlimpactfan]

My wife had a temp ileo in the past with a J-Pouch. It actually happened frequently that some 'stools' would go right through the anal canal. That does not mean that the ileo is not functioning properly, we were told that it could be a mix of post-operative fluid and/or gastric enzymes just passing through. When her temp ileo was reversed, there was no issue. Best!

[Caat55]

Once again an old post to the rescue. I was too lazy and tired to get up last night to empty my bag. I felt the hard belly bag there and just refused to get up to empty it. This morning I had a stomach ache, on way to work had an odd feeling of having to go poop. Indeed, I had a b.m. which totally freaked me out. Definitely not the discharge I experienced in the beginning. Got a call from my surgeon's office today to schedule reversal and mentioned it. She just suggested I watch for dehydration and call my doctor if it continued. I like Rob's response and think that pretty much sums it up. It is validating to know that I could control the urge.
S

[NHMike]

There can be mucus discharge which is normal - it's a lubricant the body generates. It's usually clear and doesn't cause a problem outside the wetness. I did have these from time to time.

I've experienced what you're describing though - waste coming through, and it was usually caused by backflow of the bag. This happened because I was sleeping in a way that encouraged the waste not to pool near the bottom, or I let the bag get too full and it pooled around the bottom part of the stoma. There's a hole that the material flows into the bag from and the other side where material can flow down into your lower intestine.

My solutions:

- Wake up at 2:00 AM and 5:00 AM to empty the bag so that it wouldn't get too full
- Sleep in an elevated position.

The latter was sometimes done with several pillows or sleeping in a recliner but the final solution was getting a memory foam triangular wedge from Costco so that my upper body was always elevated.

[MissMolly]

Cat:
With a temporary loop ileostomy, the surgeon brings a segment of small intestine up onto the surface of the abdomen and makes a longtiduninal slit lengthwise along the segment (like slicing a hot dog along its length). The upper and lower ends are each rolled back like a turtleneck, and sewed into place - creating two separate stoma openings.

The upper stoma opening is connected to the upper working digestive tract. It is called the working stoma. Fecal waste from digested food will pass from the working stoma into the ostomy pouch.

The lower stoma opening is connected to the disconnected/resting portion of small and large intestine that will be “off-line” while healing. The lower stoma is called the mucus stoma. The disconnected/resting portion of intestine continues to function as intestinal tissue is meant to. That is, the intestinal tissue continues to secrete mucus and serous fluids and short chain fatty acids. These secretions and sloughed cellular material accumulate and will need to find way to exit the body. This is some of what you are experiencing in passing discharge as you are from your disconnected back-end.

As Mike points out, overflow fecal matter from the working stoma also migrates to the mucus stoma. A certain amount of fecal matter will “go down the hatch,” so to speak, and pass through the disconnected/resting length of intestine. Sleeping with your head on elevated incline can help lessen the amount of fecal overflow while you sleep. Emptying your pouch when it is 1/2 full or more also helps to minimize fecal overflow into the mucus stoma.

Bottom Line: Passing tannish-brown mucus/fecal matter from the anus/backend will be an intermittent happenstance for those with a temporary loop ileostomy. It is a normal and expected phenomenon. Surgeons rarely mention it to patients beforehand, which is unfortunate, as it leads to unnecessary anxiety and concerns.

Sitting on the toilet and allowing the anal sphincters to relax and empty accumulated mucus/serous secretions can be helpful when you feel an impending “mucus poop.” The disconnected lower intestine has no idea that it is off-line. Sitting on the toilet allows the gut-mind connection to act on the accurate urge. Warm compresses and buckwheat packsplaced between the by cheeks can also ease rectal muscle spasms associated with passing mucus poops.
Karen

[Caat55]

There can be mucus discharge which is normal - it's a lubricant the body generates. It's usually clear and doesn't cause a problem outside the wetness. I did have these from time to time.

I've experienced what you're describing though - waste coming through, and it was usually caused by backflow of the bag. This happened because I was sleeping in a way that encouraged the waste not to pool near the bottom, or I let the bag get too full and it pooled around the bottom part of the stoma. There's a hole that the material flows into the bag from and the other side where material can flow down into your lower intestine.

My solutions:

- Wake up at 2:00 AM and 5:00 AM to empty the bag so that it wouldn't get too full
- Sleep in an elevated position.

The latter was sometimes done with several pillows or sleeping in a recliner but the final solution was getting a memory foam triangular wedge from Costco so that my upper body was always elevated.

I was so tired this week I ignored my typical middle of the night trip to empty the bag. At 6 a.m. it was a balloon. It was good to know I had some control over the urge. it has taken two days to feel normal again, if anything about this is normal.

thanks Mike!

[Caat55]

Cat:

As Mike points out, overflow fecal matter from the working stoma also migrates to the mucus stoma. A certain amount of fecal matter will “go down the hatch,” so to speak, and pass through the disconnected/resting length of intestine. Sleeping with your head on elevated incline can help lessen the amount of fecal overflow while you sleep. Emptying your pouch when it is 1/2 full or more also helps to minimize fecal overflow into the mucus stoma.

Bottom Line: Passing tannish-brown mucus/fecal matter from the anus/backend will be an intermittent happenstance for those with a temporary loop ileostomy. It is a normal and expected phenomenon. Surgeons rarely mention it to patients beforehand, which is unfortunate, as it leads to unnecessary anxiety and concerns.

Karen

Thanks Karen. It is all so strange and very simple to prevent, just wanted to sleep all night like I used to. Ah well, up at night again and all is fixed. How did I do this when I had babies?
Susan