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Imodium questions

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Posted 3/12/2014 5:56 AM (GMT -5)
Hey all,

Things have been going pretty good and I have been adjusting nicely to my ileo, starting to look toward the next surgery at this point. I went to my GI last week and I have to do mesalamine suppositories for a month to calm my rectal inflammation then they will do a scope and check. No big deal.

I just have a few questions about regular Imodium use. So I was having very liquidy output, especially at night which was causing me to empty a lot more often so my doc gave me some Imodium with the instructions to take it twice a day. What a change, my output is very thick, I can almost feel it coming out. With that, can it be to thick? Can I get constipated? Will it increase the risk of blockage? Could I become dependent on it? Could long term use affect motility? Lastly, could daily use have any negative affect with my future jpouch surgery?

As usual thank you so much!
Posted 3/12/2014 7:27 AM (GMT -5)
When I had my ileo I tried taking Imodium too. I hated how it turned my output to paste. I couldn't empty it out of the bag and would have to toss the bag and get a new one. So I stopped taking it and dealt with the liquid output. It was just easier. In some people under certain circumstances there may be a slight chance of a blockage. But in general I don't think you would have to worry about that. If it helps you then you should take it under direction of your dr. Many people take it with their j pouch. My stool is firm enough now a few years later that I don't even need it. You'll probably find that for yourself too over time after you have your j pouch.
Posted 3/12/2014 8:01 AM (GMT -5)
Imodium can be a big help, but I am also bothered by very pasty output. I have also had two blockages, so you can certainly overdo the immodium. The trick is to find the balance. I don't like taking it too much, but it is great when you need it!
Posted 3/12/2014 10:14 AM (GMT -5)
what dose do you guys take? I'm planning to use Immodium if need be, & know that you have to sort of play around with the dosage.. I figured start with 1 teaspoon, see what that does, then increase if needed. I'm used to swilling like 1/4 with UC! This is one of my "Ask the WOCN" topics for my pre-op appt. Liquidy output shoudl really only be a nuisance during the nighttime, right??? I wonder if Immodium lessens the dehydration chances too...???
Posted 3/12/2014 10:52 AM (GMT -5)
Imodium is weird for me because it often seems to affect intestinal motility rather than effluent consistency, meaning that I can take it if I am going somewhere and slow my output sufficiently to be able to be away from a bathroom for several hours, but I when I return home I often empty 3 times in an hour after the imodium wears off. It just seems to delay it (which can be very useful!) rather than affecting absorption.
Posted 3/12/2014 11:36 AM (GMT -5)
well, that's how it works in a colon too- shuts it down, basically paralyzes your colon. then after the dose wears off, starts right back up again! It's how I use it nowadays, if I have to. Just enough to get me to work, etc. Interesting that it does the same to an ileo- everyone seems to think it thickens things up???? Maybe it's a little of both- by stopping motility, output just gets thicker- maybe due to more of it getting packed down, sort of? Whatever.... I hope I'm able to figure out a dose that will give me a nice balance. Actually, hoping I won't need it at all, but...!!!!!
Posted 3/12/2014 12:55 PM (GMT -5)
Imodium slows down gut movement while fiber (ex: Metamucil or Psyllum types) increases the bulk in stool...which is why if you take Imodium, for a specific time, you go many more times when it wears off.

It's really personal preference for the most part but there are times when a person's output is way too high and they need to regulate it with medications and your doctor is involved! Personally, I had to pay close attention right after surgery (per my doc), but once I started eating a more varied diet, i could regulate output with my food choices.

Just remember that ostomates shouldn't always follow the directions on fiber supplement bottles!!
Posted 3/12/2014 2:01 PM (GMT -5)
You will not become dependent on it and long term use does not affect motility. I had the same concerns because I needed to take a lot of Imodium with my loop ileostomy in order to stay hydrated (6 tablets per day). I took 6 tablets per day for the three months between surgeries 2 and 3, but I have never needed Imodium with my j-pouch.

You definitely can make your output too thick and in some cases cause blockage. Initially I was prescribed 8 tablets per day but it was too much -- I had a few partial blockages. They all resolved at home, but obviously it was uncomfortable and made me nervous.

The effect of Imodium actually builds up in your system over several days, so if you're going to change the dose up or down, adjust it slowly and wait a few days to see how your body reacts to the new dose.
Posted 3/12/2014 8:32 PM (GMT -5)
I take 6 to 8 tablets per day (so 3 or 4 doses). It depends on when I'm eating, but my general instructions are 1 dose upon waking, a dose before each meal, and a dose at bedtime. I'm a person who tends to get dehydrated though.

Immodium can help prevent dehydration. Because it slows down movement through the intestines, it gives the intestines more time to absorb fluid.

As for output causing problems....very liquid output can be more caustic to the barrier. On the other hand, thicker stool can get stuck around the ostomy output, causing stuff to not come out or get stuck behind the barrier (aka pancaking). It's a balance.
Posted 3/12/2014 11:09 PM (GMT -5)
Ok, is it just me? What's the problem with liquidy output? And before you use the Imodium, did you try a diet change first? For instance, when i first had my ileo, bananas would do the trick. Mine is quite liquidy in the AM, so breakfast is some instant oatmeal, and I'm good. Try mashed potatoes or rice, or I know some ppl eat marshmallows before bed to slow things down. I've never taken Imodium since I had my surgery back in June
I just don't like taking something if there is another solution.

I should add that if you try eating different things, don't eat too many too close together! Give them time to work. Like others mentioned about the pasty output...that can also happen for example, if you eat oatmeal for breakfast, have banana for a snack and have mashed potatoes for lunch...Wowsers!

Post Edited (JodyGM) : 3/12/2014 10:13:54 PM (GMT-6)

Posted 3/14/2014 3:47 PM (GMT -5)
Thanks for all the responses.

I've been taking the ammonium twice a day and really feel more comfortable with things. I don't have to empty nearly as much. Thanks again!
Posted 3/14/2014 8:31 PM (GMT -5)
Liquid output is a greater leak risk and leads to dehydration more quickly. I personally would rather take immodium instead of loading up on carbs. I'm a reactive hypoglycemicc so heavy carbs put me in a blood sugar spike/drop cycle.
Posted 3/14/2014 9:33 PM (GMT -5)
Sorry activeUCer, I was just following what my ostomy nurses had said, and personally, I'd rather not take any drugs if at all possible, and like other posters had mentioned, sometimes a person might go overboard with it and end up with 'paste', which isn't easy to get out of a bag.
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