How Dehydration Affects an Ostomy

Staying hydrated is essential for everyone, but it’s especially important for people living with an ostomy. After surgery, your body may lose fluids and electrolytes more quickly than it did before, making proper hydration a critical part of daily ostomy care. Here, we’ll explore how dehydration affects different types of ostomies along with when to see a doctor.

What is Dehydration?

Dehydration occurs when your body loses more fluids than it takes in, leaving it without enough water to carry out its normal functions. Water is essential for nearly every process in the body, and when you're dehydrated, your body doesn't have enough fluid to maintain these functions properly.

Typically, fluids are lost naturally through sweat, urine, bowel movements, and even breathing, but can be easily balanced by what you eat or drink. However, when you don't drink enough liquids, or in situations of illness where you experience diarrhea or vomiting, dehydration can set in.

For people with an ostomy, especially those with an ileostomy or urostomy, the risk of dehydration is much higher. This is because ostomates may not be able to absorb water as efficiently, depending on the type and location of the surgery. A higher fluid loss through the stoma, such as with high ostomy output, can also increase the risk of dehydration.

How Dehydration Affects Electrolyte Balance

Electrolytes are minerals in your body that help regulate vital functions and fluid distribution. They include things like sodium and potassium, along with magnesium, chloride, calcium, and phosphate. These minerals are dissolved in your body fluids, so when you lose fluids through your stoma, sweat, or urine, you also lose electrolytes.

This electrolyte loss can result in an imbalance that has several different effects on the body. Some of these include:

• Confusion, headaches, muscle weakness, and, in severe cases, more serious complications can occur if sodium levels drop or become too concentrated.
• Fatigue, muscle cramps, and even irregular heart rhythms can occur in cases of low potassium.
• Muscle twitching, numbness, or changes in heart rate may be experienced if you're in a long-standing magnesium deficiency.

Electrolyte abnormalities can typically be solved with an oral rehydration solution like Dioralyte, but some sports drinks also contain electrolytes. To make sure that you avoid the need for medical intervention, it's recommended that you talk to your doctor about risks and keep an electrolyte drink or powder at home. This allows you to replace lost minerals at the first signs of dehydration, rather than after experiencing severe symptoms.

How Dehydration Affects Different Types of Ostomies

While dehydration can affect anyone, people living with an ostomy face unique challenges when it comes to maintaining fluid and electrolyte balance. The extent to which dehydration becomes a concern depends largely on the type of ostomy a person has. Here’s how dehydration can impact individuals with an ileostomy, colostomy, or urostomy.

Ileostomy

An ileostomy diverts output from the small intestine to the stoma opening, bypassing the colon. The colon is the final part of the large bowel (large intestine), and is responsible for absorbing large amounts of water and electrolytes when forming waste. This means that ileostomy patients tend to have increased output that's also more liquid-based, which results in higher levels of fluid loss. It's important to maintain hydration levels throughout the day and replenish lost fluids. If you experience severe signs of dehydration, intravenous fluids may be necessary.

Colostomy

People with a colostomy generally have a lower risk of dehydration compared to those with an ileostomy, since a portion of the colon remains intact and continues to absorb water from stool. Although not as common, the dehydration risk still exists, especially during periods of illness or diarrhea.

Urostomy

A urostomy diverts urine through a stoma using a portion of the small intestine, so fluid is continually being eliminated from the body. Because urine output is ongoing, even during sleep, people with a urostomy are also at higher risk for dehydration, particularly if fluid intake is too low. In some cases, the electrolyte imbalance can also lead to urinary crystals that form around the stoma and on the peristomal skin. Dehydration can also increase kidney strain, which can lead to potential complications in individuals who have already had a urostomy.

The Importance of Hydration When Living with an Ostomy

Regardless of the type of stoma surgery you've had, hydration is an important part of overall ostomy nutrition. When you’re properly hydrated, your body functions more smoothly: digestion is more efficient, electrolyte levels remain balanced, energy levels stay up, and your stoma output is more consistent. On the flip side, not drinking enough fluids can affect everything from your stoma's function to your kidney health and skin integrity around the pouching area. Some of the benefits of prioritizing hydration as an ostomate include:

• Healthy stoma output
• Reduced risk of blockages
• Decreases bloat
• Stronger electrolyte balance
• Helps your kidneys flush out waste efficiently
• Reduced risk of skin irritation
• Fewer problems with the pouch system
• Lower risk of dizziness and other symptoms
• Higher energy levels overall

Tips to Help Prevent Dehydration With an Ostomy

Staying hydrated with an ostomy can be challenging at first, as it can take some time to get used to new habits to balance stoma output. However, understanding how to balance your fluid intake with high output or other stoma-related changes can go a long way in keeping your body feeling its best. Here are a few tips to help you prevent dehydration when living with an ostomy.

• Aim to drink eight to ten cups of fluid per day, or more if you have a high-output stoma or are sweating heavily.
• Choose a mix of water and electrolyte-rich drinks like oral rehydration solutions, low-sugar sports drinks, or broths to replace lost minerals.
• Carry a water bottle with you throughout the day as a reminder to sip regularly.
• Monitor your stoma output; watery or unusually high output may signal the need for more fluids and electrolytes.
• Limit caffeine and alcohol, which can act as diuretics and increase fluid loss.
• Eat hydrating foods like watermelon, cucumbers, oranges, and soups to boost your fluid intake naturally.
• Add a pinch of salt to meals (with your doctor’s approval) to help your body retain fluids.
• Use electrolyte tablets or powders when traveling, exercising, or recovering from illness to stay balanced.
• Keep a hydration and output journal to spot trends and share with your ostomy nurse or doctor.
• Watch for signs of dehydration and respond early.

When to See a Doctor

While mild symptoms due to dehydration may be possible to treat with water intake at home, more serious cases can warrant a trip to the hospital. And even with the best hydration habits, it’s possible for dehydration to occur, especially for people with an ostomy. The key is knowing how to recognize the early signs and understanding when it's time to seek medical help.

Mild dehydration is common and often manageable at home, but that doesn't mean you should take it seriously. Act quickly and keep an eye on how you feel. If things improve, focus on keeping fluids up. Some symptoms of mild dehydration include:

• Feeling thirsty or having a dry mouth
• Headache or lightheadedness
• Fatigue or low energy
• Dark yellow or reduced urine output (or darker stoma output in urostomy patients)
• Dry skin or lips
• Mild cramping or dizziness, especially when standing up

If symptoms don't improve within a few hours, or if you experience them regularly, it's best to contact your doctor.

More serious dehydration can develop quickly and may lead to hospitalization or complications like kidney damage. Call your doctor or seek medical attention immediately if you experience:

• Rapid or significant decrease in stoma output
• Confusion, irritability, or unusual fatigue
• Rapid heart rate or breathing
• Sunken eyes or a dry, sticky tongue
• Inability to keep fluids down (due to vomiting or nausea)
• Little or no urine output for 6+ hours
• Muscle weakness or cramping that doesn’t go away
• Severe abdominal pain or bloating

You should also contact your ostomy nurse or doctor if your stoma changes color, stops producing output altogether, or if you suspect a blockage or infection.

If you're unsure, it's always better to reach out to your doctor, as dehydration can escalate faster than expected. To help with ongoing support regarding hydration, output management, and ostomy products from leading manufacturers, Byram Healthcare can help. In addition to our supplies, we have an array of educational materials and resources to help you learn more about your ostomy.