Immodium + My Stoma

[Fizzifish]

When I was in hospital last Autumn, I was kept in an extra 4 weeks because my colostomy output just would not slow down. It got up as high as 7+ litres in a 24 hour period as mentioned in another thread. I was prescribed up to 32 tablets of immodium a day in 4 doses. I was also advised to empty the capsules and mix into a desert or yoghurt as the medicine was being flushed out without taking effect. Food was going from mouth to stoma in about half an hour! I know this because I was eating a white diet of fish, rice and mash. The rice was coming out totally undigested half an hour after I had eaten it! I also managed to pass jelly into my stoma hmm, I would have thought that was impossible.

Anyway now I am at home, in order to get some sort of control over my bag filling up so quickly I am still taking immodium. I open up 8 capsules and mix them into a yoghurt or other dessert. Fortunately the white powder that comes out of the capsule doesnt taste of anything. I then refrain from eating or drinking for the next hour to let the drug take effect and not just get flushed out of the system. If I do this several times a day my bowel effentually slows down a little to give output like porridge rather than soup.

Does anyone else use immodium in such large doses? I know the recommended daily maximum dose is 8 tablets but even 32 tablets a day was having little effect in hospital.

 

[Terriernut]

Fizzi, I think you should be checked for rapid gastric dumping. I have this issue (I have no idea if they'll ever get around to fixing it) I can literally eat and be not finished my dinner yet and out its coming! I have the sad notoriety at the L&D hosp for the barium with follow thru. 7 1/2 minutes from mouth to bag.
http://en.wikipedia.org/wiki/Gastric_dumping_syndrome

 

[2thFairy]

I'm only 7 weeks out from total colectomy and I am taking 8 lomotil a day. I eat and have things come out within 30 minutes. Food is still passing quickly, but it is finally starting to thicken up some. I'm not convinced that the lomotil is doing much, but the high dosage is causing my heart rate to be really high and I've been told not to increase it. So far I've kept dehydration at bay since being home from the hospital.

 

[Lilyw]

I can relate!

Fizzifish,
I too have problems with stoma output but I have an ileostomy and am on TPN through a iv central line in my chest every night because of the high output. I am taking up to 60 Imodium - 20 capsules opened up and mixed with liquid 3 times a day - a day to slow things down (& that's on top of eating a fairly routine diet too) only with this amount can I get it to slow down and get the consistency required (yes, porridge is a good analogy!)
I've been told by my specialists that Imodium is one of the safest drugs there is and I have no noticeable side effects from my high dosage - do you?

 

[DMac]

It is not something that I would in anyway encourage others to do, but I have always used loperamide in conjunction with Codeine. The reason I wouldn't encourage it, is purely because of the addictive qualities that codeine has. People can and do build up a physical dependency upon it. For me personally, loperamide on its own, has little to no effect. I tend to take a couple of loperamide and one 60mg codeine in the morning and that seems to help drastically slow down the output and subsequently gets me through the day.

 

[robbo87]

It is not something that I would in anyway encourage others to do, but I have always used loperamide in conjunction with Codeine. The reason I wouldn't encourage it, is purely because of the addictive qualities that codeine has. People can and do build up a physical dependency upon it. For me personally, loperamide on its own, has little to no affect. I tend to take a couple of loperamide and one 60mg codeine in the morning and that seems to help drastically slow down the output and subsequently gets me through the day.

I'm on the same, I was prescribed loperamide and codeine and have been taking it for about 8 months now. I take 2 mg of loperamide and 30 mg of codeine 4 times a day, roughly about 30 minutes before eating. I have tried without the codeine and things go downhill fast as soon as I stop taking it. Although I do worry if it is some sort of placebo effect taking place!...

 

[bigtruck]

I had a high output ileo which was reversed because I was having problems with magnesium, I now have a high output colostomy and guess what I'm loosing magnesium again! Have any of you guys had problems with any vitamins or minerals depleting. Cos of your output I'm also getting b12 shots as of yesterday as it is low also.

 

[Fizzifish]

Hi, I had terrible problems with low potassium and magnesium when my colostomy was as high as 7+ litres a day! Now that it is down to between 1 and 2 litres my potassium is fine but my magnesium is still a little low. You can take magnesium tablets i believe.

 

[robbo87]

I had magnesium problems too and was given something called magnasparte, a powder which goes into a cup of water. I was told this is a lot better than taking tablets as it is more easily absorbed. maybe worth trying that?

 

[Misty-Eyed]

My stoma nurse told me that you can just empty the capsule onto your tongue. You can also get strips that melt on your tongue too. Maybe these would work better? I rely on loperamide but I always forget to take them before meals rather than after. I kick myself about it daily.

 

[bigtruck]

Yes I'm taking magnaspartate have to get bloods checked again on Monday. Im taking 4 sachets a day as level was very low last week.

 

[DMac]

[robbo87]Although I do worry if it is some sort of placebo effect taking place!..

.

That's a good point. I have on numerous occasions attempted to go for a sustained period of time without using Codeine and I have noticed a considerable increase in my output. I could probably be just as well off without using the loperamide, but I don't feel comfortable only using codeine. From my experience the results of using loperamide are more beneficial if you have a pouch, as opposed to an ileostomy, which is what I have. That is purely a personal opinion though. However, I do agree that the placebo effect can be a contributing influence/factor in re to how we perceive our medication works for us. Who knows?