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Community Insight Submitted by Gali Member
Jun 09, 02:06 PM

Hydration help with an ostomy

By Andie - Gali Ambassador

Water is essential for daily functioning, it has zero calories, and it’s typically readily available.

Now who thinks they drink the recommended amount of water each day? 🙋‍♀️

The guidelines vary depending on the research you look at, but it generally falls between a recommendation of 8-12 cups for women and 10-15 cups for men. If you have an ostomy (ileostomy in particular), this adds an extra 3-5 cups to your baseline.

Now, who thinks that they drink the recommended amount? 🤷‍♀️

I’ll be the first to admit that this seemingly easy thing may not be so easy.

❓Why does an ostomy increase my daily hydration goal?

💁‍♀️ The answer: the colon’s job is to absorb water- when surgery removes part or all of this organ, water absorption will be affected.

Colostomates have their small intestine and also keep a part of their large intestine; depending on where their stoma is formed, their hydration goal will vary. The more colon they have, the more likely they will be to absorb fluid like the average colon-mate.

Ileostomates have the stoma formed from the small intestine; this means that the large intestine is either not “hooked up” or is completely removed. This limits their water absorption because the small intestine has to pick up the slack of the decommissioned colon. With less intestine working on this important job, more water can get by without being absorbed and dehydration can happen quickly.

Other factors that affect hydration and can lead to fluid loss include:

– Caffeine ☕ and alcohol 🍻: Unfortunately, your morning coffee and brunch-time mimosa may actually take fluid rather than give it. Caffeine and alcohol are believed to induce your kidneys to flush fluid faster and coffee, in particular, is thought to have a compound that stimulates intestinal movement (and why it is generally associated with a morning poop!). Normally, the dehydrating affects are minimal to someone with a colon, but if you have an ostomy, dehydration is a greater risk. This doesn’t mean that you should give up on your favorite beverages but be aware of how it may affect you. Other beverages that fall into this category include; black/green tea, caffeinated soda, energy drinks, and kombucha.

– Exercise 🏋️‍♂️: Water is lost through sweating and breathing. Though sweating is more visible, your body can additionally lose up to approximately 16 oz of water from exhaling- that’s the same as an entire bottle! Even if you didn’t run a marathon or hike up a mountain, it is important to replace this loss by increasing consumption of fluid throughout your workout, and after, in order to help prevent dehydration.

– Illness 😷: during periods of illness such as the cold or flu, excess water can be lost through vomiting, fever, or diarrhea. The first two are pretty clear, but for someone with an ostomy, determining when you’re having diarrhea can be a bit trickier. A good way to determine if you are experiencing diarrhea with an ostomy is to note if there’s been a change in your bowel habits; such as waterier stools, with or without more undigested material, and more frequent emptying. This may be a hint to increase your fluid intake to help replace what you’ve lost.

– Environment ☀️: if you live or travel to a place that is hot and/or humid you may lose more water from sweating. Consider upping your intake to stay hydrated and reduce your risk of heat exhaustion.

❓What are the signs and symptoms of dehydration with an ostomy?

💁‍♀️  The answer: In addition to the typical signs and symptoms of dehydration, if you have an ostomy, dehydration can look like thicker/harder stool, less frequent stoma activity, abdominal discomfort, feelings of incomplete stool passage, and feeling bloated.

🕵️‍♀️ Hint: If you experience constipation with an ileostomy, never take a laxative as this can lead to severe dehydration. Instead, try walking around, drinking fluids, and eating more fibrous fruits and vegetables as tolerated!

If you expect that you are severely dehydrated, contact your physician immediately. Severe dehydration is a medical emergency.

❓What are these electrolyte things that I keep hearing and why are they important?

💁‍♀️  The answer: Electrolytes are extremely small, charged particles called ions (also referred to as minerals), that help balance water in your body to make sure that fluid stays where it needs to be or goes where it needs to go, in addition to other important jobs like enabling muscle movement and brain function. The most common ones that you hear about are probably sodium, potassium, calcium, and magnesium.

❓Does this mean that I should drink a sports’ drink every day?

💁‍♀️  The answer: Not necessarily. Generally speaking, electrolyte replacement is needed when there is an excess fluid loss that makes it hard for your body to function properly. Consult with your doctor to determine the degree and frequency of your electrolyte needs.

❓Is there a natural way to get electrolytes?

💁‍♀️  The answer: Absolutely! A lot of electrolytes can be obtained by eating a variety of fresh fruits and vegetables. Drinks that market being high in electrolytes tend to also be high in sugar; this is important for athletes for an energizing boost during a rigorous workout but may not be the best option for people seeking to replace electrolytes on the daily. Keep scrolling for a list of zero-calorie and low-calorie options to meet your electrolyte needs, in addition to a list of foods that you can choose from!

❓Do you have any tips for meeting my water goal?

💁‍♀️  The answer: of course! There are several techniques that you can use to help remind you to drink water and meet your goals. Here are just a few suggestions:

– Carry a water bottle with you wherever you go – in the car? Take a sip. Waiting in line? Sip-sip. Checking out in the store? Make sure they know you already paid for it- then sip-sip-sip.

– Drink a glass of water with every meal – not only does this help you to stay hydrated, it can reduce your risk of getting a blockage with an ostomy!

– Drink and Replace– what I mean is, if you drink a “loss” fluid like alcohol or coffee, consider replacing the same volume with a “gain” fluid like water. Not only will this help stave off a gnarly hangover, it will lessen your risk of becoming dehydrated when drinking your favorite beverages.

– Have emergency electrolyte replacements on hand – there are a variety to choose from; Liquid IV, Gatorade G2, Powerade Zero, Drip-Drop, or any other electrolyte additive/ beverage that you can store at home, in your car, or in your go-bags. They provide an excellent pick-me-up when you unexpectedly find yourself having more output than anticipated from illness, exercise, or what have you.  As mentioned previously, they can be high in sugar; consult with your doctor to determine the best option for you.

– Stay hydrated the Smart way – if you have a smart phone or smart-wear technology, then there are a variety of free apps or reminders that you can download to keep track of your hydration goal and remind you to drink water regularly.

Foods for Electrolytes: Including Easily Digestible Options

🕵️‍♀️ Hint: Boiling vegetables that are hard to digest can help make them easier to break down but also removes many of the beneficial nutrients. Try pressure-cooking, steaming, or microwaving vegetables to make them easier to digest and retain many of their healthful benefits!

Calcium:

• Milk

• Cheese

• Yogurt

Dairy-Free Calcium:

• Dark green vegetables (kale, chard, arugula)

• Fortified juices

• Dried figs

• Soy and soy products

• Legumes

Magnesium:

• Whole grains

• Green leafy vegetables

• Tea

• Nuts and natural nut-butters (almonds, peanuts, cashews)

• Avocado

• Dark chocolate

Potassium:

• Citrus fruits

• Dried fruits

• Bananas

• Watermelon

• Potatoes

• Coconut water

• Orange juice

• Tea

• Peanut butter

Sodium (the healthier way):

• Canned tuna / salmon

• Canned beans

• Canned olives

• Pickles

• Whole-grain breads

• Beef / chicken / vegetable broth

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