If you have a stoma or J-pouch, there is something important you need to know about dehydration:
Don’t assume that drinking more plain water is always the complete answer.
Staying hydrated isn’t only about how much fluid you drink. It’s also about replacing the salts and electrolytes your body can lose.
Without a colon, dehydration can happen more easily than it did before surgery. Understanding why this happens, knowing the warning signs and building some simple habits into your daily routine can make hydration much easier to manage.
I have lived with a J-pouch for more than 16 years, and staying hydrated has simply become part of my everyday routine. Here is what I have learnt.
Why Is Dehydration More Common With a Stoma or J-Pouch?
To understand why dehydration can become more of a problem after surgery, it helps to understand one of the main jobs of the colon.
The colon doesn’t just store waste. One of its important functions is absorbing water.
Once the colon has been removed, the way your digestive system handles fluids changes.
Whether you have an ileostomy or a J-pouch, food and fluids can move through your digestive system much faster than they did before surgery. Your output may contain more water, and your body has less opportunity to absorb fluid before it leaves.
This means people living without a colon can be more susceptible to dehydration.
What About Thickening Your Output?
Some people use products containing soluble fibre, such as Metamucil, to help thicken their output.
Something worth understanding is that thicker output does not necessarily mean that all of the fluid has been absorbed into your body. The fibre can absorb water and change the consistency of your output, but that fluid can still leave your body.
Thickening output can be useful for many reasons, but it doesn’t remove the need to pay attention to hydration.
What Are the Warning Signs of Dehydration?
The signs of dehydration can vary, but some common warning signs include:
- Unusual tiredness or fatigue
- Headaches
- Dizziness, particularly when standing up
- Brain fog or difficulty concentrating
- Darker urine than normal
Over time, you will probably become familiar with your own body and the early warning signs that tell you that you need to pay more attention to your hydration.
There are also times when the risk of dehydration can increase significantly.
Hot weather is an obvious example, but illness can be an even bigger risk. Vomiting, diarrhoea or unusually high-output from a stoma or J-pouch can cause you to lose a lot of fluid quickly.
I experienced this myself after catching a severe sickness bug that lasted for more than a week. I became so dehydrated that I eventually needed IV fluids in hospital.
Thankfully, that has only happened to me once, but it showed me how quickly dehydration can become serious when you are losing a large amount of fluid.
If you become seriously unwell, are unable to keep fluids down or are concerned about dehydration, contact your healthcare team rather than simply trying to push through it.
Why Water Alone Isn’t Always Enough
One of the biggest lessons I learnt after surgery was that hydration is not always as simple as drinking bottle after bottle of plain water.
When your body loses fluid through a stoma or J-pouch, it can also lose salts and electrolytes.
This is why oral rehydration products such as Dioralyte have a slightly salty taste. They are designed to replace more than water alone.
Sports drinks also contain additional ingredients such as electrolytes and carbohydrates, although different drinks have different formulations and are not the same as medical oral rehydration solutions.
The important point is not that you should stop drinking water. Water remains an important part of staying hydrated.
The point is simply that water alone may not always be the whole answer, particularly when you are losing more fluid than usual.
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How I Stay Hydrated With a J-Pouch
The biggest thing I have learnt over the years is that it is much easier to stay hydrated than it is to recover once I have become dehydrated.
For me, the solution has been to build drinking into my everyday routine.
I don’t wait until I feel extremely thirsty and then drink a huge amount at once. Instead, I drink little and often throughout the day.
That might mean having an extra cup of tea, keeping a drink nearby while I am working or simply taking regular sips throughout the day.
I also take a drink to bed with me. If I wake during the night, I will often have a couple of sips, and I usually drink something first thing in the morning.
If I am going out for a walk or a day trip, I make sure I take drinks with me.
None of this feels unusual or difficult. Carrying a refillable bottle has become completely normal for many people anyway.
For me, staying hydrated isn’t something I spend all day worrying about. It has simply become part of my routine.
Some Practical Hydration Tips I’ve Used
One tip my stoma nurse gave me years ago was to try crisps and flat Coke if I was starting to become dehydrated.
The idea was to help replace some salt and sugar alongside fluids. I have used this advice myself over the years and found it helpful for me.
I want to be clear that this is something I was personally advised by my stoma nurse and something I have used as part of my own routine. It isn’t a replacement for medical help or an appropriate response to serious dehydration.
If I know I am going on a long walk or doing something physically demanding, I will also take additional drinks with me. On my 10-mile walking challenge, for example, I took Lucozade (the non fizzy version) along for the walk.
I also keep sachets of Dioralyte in my medical cupboard at home.
Hopefully, I will rarely need them, but I would rather have them available than suddenly realise I need them and have nothing in the house.
Hydration Becomes Part of Normal Life
Dehydration is something people with a stoma or J-pouch need to be aware of, but it isn’t something that should put you off surgery or make you frightened of life without a colon.
For me, it has simply been one of the adjustments I have made.
Once you understand why dehydration can happen, learn the warning signs and build a few simple habits into your day, staying hydrated can become part of everyday life.
There is a phrase from Who Wants to Be a Millionaire? that I have always liked:
“It’s only easy if you know the answer.”
I think hydration after stoma or J-pouch surgery can be a bit like that.
Knowing that dehydration is something to watch out for is half the battle. Once you understand the risk and know what works for you, it becomes one more part of life that you learn to manage.
After more than 16 years with a J-pouch, hydration is no longer something I have to constantly think about.
It is simply part of how I live my life.
For videos on life with UC, Stoma, and J-Pouch use this link to look at the official Pouch Heals YouTube Channel.