Need Advice On Imodium

[tex]

Hi All,

Every time I see the surgery followup team at the hospital, one of them recommends that I start taking Imodium, on a regular basis, in order to turn the output of my ileostomy from a liquid, into a paste.

On the surface, it sounds as though that might be beneficial, since they claim that doing so will reduce my risk of dehydration, (and also reduce the output volume, which is fairly substantial, normally). So my question is: How much should I use? I realize that I will probably need to fine-tune the dose, but where do I start? Bear in mind that this is not the same as D, since the output of the ileum is virtually always predominantly liquid. I definitely don't want to wind up with C, since ileal stomas are relatively small in diameter.

Any suggestions?

Thanks,
Tex

[Gabes-Apg]

question (for them not you) is the imodium the only solution??

at what stage does the water removal need to happen?

[Pat]

Tex,

I am certainly not an expert on Imodium but have taken it off and on for years. I would start with 1/2 per day then work up to what works for you. You may have to take 1/2 at each meal or maybe a whole twice a day, etc. Start low and work up. Hope that helps.

Pat

[Rosie]

Tex, I wonder what affect your hydration level has on your ileostomy output. You don't want to get dehydrated, but like Gabes I wonder how your body's fluid balance has been affected by your surgery.

I haven't had to take much Immodium, but I've noticed that it dries out my mouth and eyes too. Also, if you take it on a regular basis, wouldn't it lose some of it's effectiveness as your body became habituated to it?

Rosie

[tex]

question (for them not you) is the imodium the only solution??

Well, it doesn't really require a solution, since most people in this situation, just let the chips fall where they may, (so to speak). It's just better to not waste all that water, (and have to replace it), and it's better to not have to deal with all those pouch changes, (or cleanings, for those who use a recleanable pouch - that's why most people with an ileostomy use a recleanable pouch - for better economy).

There aren't any other practical options, that I'm aware of.

at what stage does the water removal need to happen?

Probably about 95% of water removal normally takes place in the colon, but since that's no longer an option for me, anywhere in the stomach and small intestine is the only possibility. The only liquid that the stomach will absorb, is alcohol, so that eliminates it from the competition, and leaves only the small intestine. Eventually, my small intestine will "learn" to take out some of the water, so that over enough time, that will help to resolve the problem. In the meantime, though, especially during the hotter months of the year, it would be nice to minimize the dehydration risk, and cut down on the pouch changes, and Imodium appears to be the simplest way to do that, from what I am told.

Tex

[tex]

Pat,

That makes sense - I'll try that plan. I just thought it might take a lot more, because the doctor who suggested it today, said that 2 pills, 3 times a day would be "safe". That seems like an overkill, but I guess we'll see where I wind up, (I'm going to start low, though, as you suggest).

Thanks,
Tex

[tex]

Rosie,

Well, according to some of the surgical team docs, the more I drink, the more I'll lose, especially if I drink water with meals.

My body was retaining a lot of fluids, when I got out of the hospital, because they gave me a lot of fluids by means of IVs, for a number of days. Pretty much all of that is gone now, though, and I've shrunk down considerably.

Hmmmmmm. I don't like the sound of drying out the mouth and eyes. Of course, I've already noticed that I have to drink water much more frequently, or I get dry mouth. I would hope that it wouldn't make that issue even worse.

Also, if you take it on a regular basis, wouldn't it lose some of it's effectiveness as your body became habituated to it?

I queried the doctor who was promoting it, today, about the risks of taking it possibly every day, for the rest of my life, and he said that there wouldn't be any problem with doing that. Hmmmmmm. I'm not sure whether to take that with a grain of salt, or not.

Thanks,
Tex

[Gabes-Apg]

i would start really small dose and increase if necessary. Easy to monitor improvements and backtrack when necessary.
I wonder if what you are eating affects moisture content.

can definately understand the benefit of making maintenance of your new system alot easier....
also hope you have all your necessary supplies and maintenance is easier.

[Gabes-Apg]

From the net.....

Loperamide works by acting on opioid receptors that are found in the muscle lining the walls of the intestines. By acting on these receptors, loperamide reduces the muscular contractions of the intestine (called peristalsis) that move food and faecal matter through the gut.

This reduces the speed at which the gut contents are pushed through the intestines, allowing more time for water and electrolytes to be reabsorbed from the gut contents back into the body. This results in firmer stools that are passed less frequently.

based on the fact that you said the colon would normally do this, will taking imodium assist this process????

[Gabes-Apg]

it is from 1981 - interstingly they used codine with the lomotil to reduce the volume

http://journals.cambridge.org/action/di ... id=5803116

[Gabes-Apg]

this one talks about treatment options and status of long term use

it answers my question is it the only choice.... based on this article yes

http://www.treatment-options.com/articl ... pe=Article

[Issy]

Tex,
I have been using Imodium regularly for the past 3 years. According to my GI, I have a mild case of LC because I only need to use it (one pill) about once or twice a week. However, the first year I used it more frequently, until I learn to control my D with diet.....especially eating NO RAW VEGGIES.

I have tried other medications along the way (Pepto Bismol and Bentyl), but none seem to work as effectively as the Imodium.
I personally have not had any side effects at all and the Imodium gives nice form to my BM's.

Although the Bentyl greatly helped with D, I had to discontinue it because it gave me a dry mouth and throat. Also it made me drowsy.

The only side effect that I have had with Imodium.....if you could call it a "side effect" is that sometimes I will not have a BM the following day. But I have not had any "cramping" or anything else. Therefore, I would agree with your medical team, that Imodium is a very safe drug to take long term with virtually no side effects.

Shortly after I was diagnosed with LC, I met a woman who has had most of her colon removed and for the past 30 years she has taken one Imodium pill daily and has had no side effects whatsoever. She also drinks a glass of Metamusil every morning to give volume to her stools.

I realize that your situation is different, but maybe this information will be of some help.

Oh and one more thing, the lady I mentioned above told me that her GI doctor continues to "prescribe" Imodium so that her insurance company will cover the cost.

I had always though that Imodium was an over the counter drug and was surprised to learn that when it was first released it was by prescription only.

Since you may need to take Imodium long term, perhaps your physician can write a prescription for it.


Issy

[Gabes-Apg]

same same

my GI specialist gave me script and the govt exemption for the concession rate on 6 month supply of the stuff! works out half the cost than buying over the counter

[tex]

Gabes,

I wonder if what you are eating affects moisture content.

Definitely. Apples, for example, result in more liquid, while bananas result in less liquid.

also hope you have all your necessary supplies and maintenance is easier.

I wish. I'm still waiting on supplies that I ordered over two weeks ago. In the meantime, I have to make do with components that aren't quite right, but so far, so good - I'm getting by OK.

based on the fact that you said the colon would normally do this, will taking imodium assist this process????

According to the doctors it will, and we all know that doctors are always right. Seriously, I'm pretty sure they're right about this, because I'm certainly not the first person in the world to be the proud owner of an ileostomy.

Thanks for the links. That looks like good information.

Tex

[tex]

Issy,

I appreciate the advice on getting a prescription for the Imodium. I never would have thought of that. If all I have to take is one caplet or less per day, it won't amount to much, but if someone has to take a lot of this stuff, it adds up.

I can see how the Metamusil would change the consistency from liquid to paste, (or gel), but I'm concerned about the added volume. I've already got more than enough volume to satisfy me.

Thanks for the tip,
Tex