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don't ileostomy stomas run on the theory of peristalsis??????

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Posted 10/16/2012 2:55 AM (GMT 0)
My new (3rd) stoma does not peristalse in and out to push out poo. If I drink only liquid it will work but if I eat one solid thing it stops peristalsis in its tracks. Therefore to make poo come out of this well made and open stoma with no kinks behind it, I have to walk miles and swill grape juice. I emailed the doc will peristalsis return or do I have to do this routine forever?

The secretary said don't email the doc call me and I have a resident call you. The resident called and said it depends on how the stomas are made whether they have peristalsis or not. I said my first one that worked 4 years peristalsed in and out and pushed out poo. She said that having to lie on the stoma side, use gravity, and walk, and drink grape juice not all that unusual.

I am not leaving here az to return to mass until I hear from the doc direct about why this stoma does not peristalse. I bet it is caught in new scar tissue. Will it peristalse in time? Is this inflammation? Resident said 1 month for inflammation, this doc says 2, my original retired ileo doc says 6.

Does anyone else own an ileostomy stoma that doea not peristalse in and out?

I thought that was the principle behind these!

Rosemary
Posted 10/16/2012 1:37 PM (GMT 0)
Sometimes my stoma moves in and out, yet when it does nothing comes out, it kind of looks like its stretching or yawning, lol. Most times my stoma just sits there and poops without moving at all! You have said you put out only liquid, I thought that was normal? I never have anything more than soft stuff come out and sometimes food that I didn't chew real well. You say pudding and cereals have a hard time coming out, but how do you know what's actually coming out? It certainly doesn't look like pudding or cereal when it comes back out, especially if your drinking grape juice. Do you have pain after you eat food? How long do you wait before you drink the juice to push it thru? When I eat dinner it is often the next morning before I can see any remnant of what I ate at dinner time. Perhaps the dr's are right and it takes longer for your body to adjust to the new stoma. You were enjoying AZ for awhile, try to continue to do that and hopefully your stoma will enjoy it too:)
Posted 10/16/2012 6:51 PM (GMT 0)
Shem

I wait til the stoma is attempting to put out stool usually about 3 hours before I do the grape juice routine. I feel pressure but not pain behind the stoma. Last nifht even tomato soup gunked up on me and I was so uncomfortable I got up and was swilling grape juice at 2 am. BUT my stoma was outputting the thick tomato soup so maybe had it not been so uincomfortable it may have all been in the bag this morning. So you could cwertainly be right. If not too hot I will get back out there today. Diversion certainly helps. I have not had a new stoma that was so slow in starting to work but who knows? Interesting that you see your dinner way the next morning. Thx for response. Apppreciate it. Rosemary
Posted 10/16/2012 9:04 PM (GMT 0)
The only times I've really watch my stoma function is when I'm changing my bag and it's being very active. Monday I had very stoma active bag change and never really saw my stoma "working" to push things out. Stuff would just start streaming out of it. The only times I really "feel" any type of peristalsis is when I have gas and that's because the stoma will kind of flutter - like you are blowing air into a trumpet with your lips but instead it's my stoma blowing air or an air/liquid mix.
Posted 10/16/2012 10:10 PM (GMT 0)
Rosemary, peristalsis is a wave that the whole small intestine does....if it didn't your food would never get from your stomach through the 20 feet or so of small intestine. The pushing comes from behind more than from the stoma.... my stoma does get bigger and smaller a bit, but I wouldn't say the stoma is "peristalsing".... the stoma is the turtlenecked end of the intestine, and I don't think that part would be able to initiate movement so much with it being inside out and sewn to the skin.

Here is a bit from wikipedia about peristalsis:

Peristaltic movement is initiated by circular smooth muscles contracting behind the chewed material to prevent it from moving back into the mouth, followed by a contraction of longitudinal smooth muscles which pushes the digested food forward.

I don't think there are any "longitudinal smooth muscles" at the stoma....

So if you have an issue w/peristalsis, it's a functional issue, not a stoma issue..... otherwise, something else is up....

Hope you feel better soon.
Posted 10/16/2012 11:32 PM (GMT 0)
I am on my fourth stoma and I can honestly say I have never watched any one of them to see if they move when stuff comes out. Well... once after my very first operation when I was in the ER one day after being released from the hospital with a massive blockage... AS A RESULT OF A SWOLLEN STOMA AND INTESTINES AFTER SURGERY, and a resident was jamming a tube into it to get things going. Seriously, what does it matter what comes out and when.

You might be uncomfortable for a few months after surgery because everything has been touched, moved, and ends up swollen, and sore sore. But as long as stuff is coming out into your ileostomy bag and you are not vomiting, I would definitely try to not think about it at all. There really is no reason for you to worry about what ends up in the bag and when.. as long as you are not in pain and you are not vomiting. I would stick to soft GI foods, stay hydrated, and go out and enjoy the lovely country where you are. I don't see the need to keep chugging grape juice.
good luck rosemary
Posted 10/17/2012 12:50 AM (GMT 0)
Random, but the other day I had a meal heavy in gravy at 6:30...and I was STILL getting gravy output at 9:30 the next morning. I could smell it during the bag dump!
Posted 10/17/2012 3:40 AM (GMT 0)
Rosemary you need to try some real food and give your stomach a chance to get it out, on its own. Try a small piece of baked or grilled chicken, then just leave it alone. It took 6 hours for my chicken to come out today. I get a pressure feeling sometimes too, I think that's just something that happens not cause for alarm. If stuff is coming out, let it be, your grape juice thing is only making your intentines weaker. Some of the things you are eating, crackers, noodles, yogurt will make it thicker anyway. Just try some real food, don't puree it and just give it time! I understand why you are worried, after my adhesions I freaked at first if stuff didn't go right through, then i had to just calm myself down and remember not everything goes through right away. Unless you have pain, not pressure, and have nothing at all coming through then its prbably not a blockage. I agree that you need to get out and do stuff, take your mind off things!
Do you by chance take an iron pill? If you do those can really slow thingsdown.
Posted 10/18/2012 2:31 AM (GMT 0)
No iron pill. I do take 5 mg valium to sleep tho would that mess things up?

I think the pain is muscular am on tylenol only for that. Do you really eat real chicken? I have only been doing baby food chicken and eggs. Then all those protein drinks. I really have to cool on the starchy stuff as that is what really seems to have an awful time getting out of the stoma and prompts all the grape juice need.

Been to the Heard museum, univ of az, botanical gardens, old twon scottsdale, fashion mall, scottsdale trolley, tomorrow am planning to go on the scottsdale art walk at night. And maybe shop during the day. Gotta have a day time activity lined up too. Weather still 90's but dry. Last weekend was great it was 70's.

Sorry I did not scroll above to see who it was but 4 stomas oh God bless you! Being my third I sure hope this one lasts. It is so much to go thru.

R
Posted 10/18/2012 4:15 AM (GMT 0)
I don't know about the valium, it might slow things down since it relaxes your muscles.
Of course I eat real chicken! I also eat hot dogs and pizza and sandwiches. All that baby food has thickners in it. And that's not helping at all. Get a piece of deli ham, or a piece of chicken or a hamburger and eat it! Don't eat any noodles, or crackers or baby food. Then you have towait until your stomach does the work. I know it will be hard, but just try it. Be sure you chew well and drink plenty of water.
Posted 10/18/2012 4:27 AM (GMT 0)
Yikes I would not go near a piece of pizza. Even cottage cheese clogged up my stoma one night. Can ham be chewed well enough to break it into tiny enough pieces? Hamburg, I gotta admire you! HOw does all that stuff pass?
Posted 10/18/2012 1:02 PM (GMT 0)
If you aren't able to pass cottage cheese, or other foods, you may have inertia problems higher up. Have you had this ruled out?

Sue
Posted 10/18/2012 2:25 PM (GMT 0)
No. Don't have inertia. Cottage cheese made it to the stoma in only 3 hours but could not make it out of the stoma. Due to the stoma not peristalsing in and out like my first one did. Seems like it could be hung up on some scar tissue further in. Yet no kinks or narrowings further in showed on retrograde enema. So far no sbo's and that is the main thing but I have to eat pretty bland with this stoma. First stoma could actually peristalse in amd out enough to push out a banana that thing was incredible.
Posted 10/18/2012 8:37 PM (GMT 0)
Once the 4-6 weeks passed after surgery, I ate pretty much everything with my stomas! I avoided a few things like celery, nuts, popcorn, etc but had no issue with most foods. Sometimes it takes awhile for things to go through. I typically wouldn't pass most of my food until I ate my next meal. Dinner usually didn't come out until the next morning. I know it is scary with all you've been through but, try eating a small meal with normal food and then just wait and let your body process it. If your mind/anxiety won't allow you to do that then I think you should consider some therapy. You've been through so much and it might help to talk to someone.
Posted 10/18/2012 9:08 PM (GMT 0)
There doesn't seem to be anyone to talk with about this. The hospital chaplain was very nice. Understood my anxiety and my past. She thought it reasonable that I get some answers direct from the doc as to why nothing but liquid will go thru me without all the grape juice and the lying on my right side stuff. They don't fix you up with other docs. The residents not sure why I owned peristalsis in the hospital and no longer own it. So I have to wait til nov. 14 to meet with the doc. Seems to me they could just forward this one question to her no matter where in the world she is and ask. But that is the system. If I no longer own peristalsis then how is the stoma going to function? Gravity? Laxative juices? Do adhesions kill off nerves that give you the ability to peristalse? Who knows.

In the meantime I am sight seeing and walking my feet off. They are all into keeping busy and I am enjoying the sight seeing but it isn't bringing me peristalsis. R
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