The output from an ileostomy varies between person to person. You may find the stool from your ileostomy tends to be watery in the morning as you have not eaten during the night, but it will thicken up during the day. The ideal consistency of your stool should be mushy, such as that of thick porridge. Ideally you should need to empty your ileostomy pouch 4-5 times during the day and once at night. You may already have started on Loperamide in hospital. If this is not the case, you will be given a box of Loperamide to take home with you.
What is Loperamide?
Loperamide is one of a group of drugs called anti diarrhoeals. These drugs are designed to thicken your stool and reduce diarrhoea or output from your ileostomy.
How does it work?
Loperamide works by slowing down the passage of food through the gut and encouraging more uptake of water by the body as it passes through your bowel. The longer the food takes to pass through the gut, the more time there is for water to be absorbed through the gut wall. The stools that are then produced are thicker and occur less frequently.
When do I start taking Loperamide capsules?
It is possible that you may never need to take Loperamide. However, the output from an ileostomy can vary dramatically. It is possible you could become dehydrated if the output increases. If the stool passed from your ileostomy is filling the pouch more than 6 times a day and the stool is watery most of the time, it is important that you start to take some Loperamide.
What dose do I take?
A suggested starting dose will have been discussed with you. People vary a lot in response to Loperamide. It sometimes needs some adjustment to find the dose that will control your bowels without constipating you.
The more you take the thicker your stool should become. If you do not take enough your stool will remain watery. It is usual to start on a low dose and build It up slowly over a few days so you can judge how your body is responding. Loperamide comes in capsules and tablets or as a syrup. The syrup is usually not recommended if you have an ileostomy due to its high sugar content. Capsules or tablets are more effective.
It is best to take Loperamide half an hour to an hour before a meal. This will help to slow down the usual gut activity that is stimulated by eating. Most people find that the stool is waterier in the morning as you have not eaten overnight. Taking Loperamide will help most if taken before breakfast. Loperamide starts to work within half an hour.
Side Effects
Do not take more than 8 tablets per day without medical advice.
All medicines may cause side effects, but many people experience no or very minor side effects from Loperamide. No common side effects have been reported with Loperamide. However, seek medical attention right away if any of these severe side effects occur when taking Loperamide.
Severe allergic reactions
Rash, hives, itching, difficulty breathing, swelling of the mouth, tightness in the chest, constipation/obstruction, decreased urination, stomach bloating, swelling or pain and red, swollen or blistered skin.
Stoma Care Team 0161 206 4204 or email stomacare@nca.nhs.uk
Date of Review: August 2024
Date of Next Review: August 2026
Ref No: PI_SU_1397 (Salford)