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My daughter had her colon removed earlier this year and a j-pouch constructed.  Soon her iliostomy will be closed - IF she can remain stable.  She went back to the hospital once by ambulance and stayed 2-1/2 days due to sever dehydration.  Yesterday she passed out - we are pretty sure she is dehydrating again.  Her surgeon told  us from the beginning that she would need approximately 60 ounces of fluid per day.  Well it is obvious that she is falling short.  She knows the ramifications if she doesn't drink - she is tired of all of us reminding her to drink.  You know the saying, "You can lead a horse to water but you can't make him drink."  It is frustrating and scary to say the least.  Anyone got any tips to make hydration easier?  (A side note:  she does not care for gatorade or such drinks.)

 Reply posted for MomofMouse.

Hi Mom,

I recently had my colon removed (3 1/2 weeks ago) so I am, by no means an expert at this point.  Reflecting over the past few weeks, the most difficulty I'm having is my hydration level.  I'm a 53 year old engineer with a very clinical mind, so I can't imagine how difficult this would be for a child (you didn't say how old your daughter is) or her care takers.  I have a regiment that seems to be working for me right now (of course I’m still very early in this process).  I mix a 32 ounce bottle of generic Gatorade with 32 ounces of water every day and just keep it with me all day and just sip.  I change flavors, but like the grape the best.  Straight Gatorade was just too much for me, but I don’t seem to have much trouble drinking the watered down version.  I usually find that by 4 or 5 in the afternoon, it’s just about gone.  I also drink a small can (5.5 oz.) of V8 juice every morning with breakfast as this contains as much sodium as 96 oz of Gatorade and as much potassium as 290 oz of Gatorade.  Too much water isn’t good, because it can wash out the electrolytes.  Also, I’ve learned to avoid any type of diet drink as the sugar free additives seem to increase my ostomy output considerably.  Good luck, I hope she starts to do better.

 Reply posted for MomofMouse.

I recommend highly salting her food.  The salt will make her thirsty and want to drink more as well as help her retain the water she drinks.

I've had the IAP surgery and sometimes struggle to stay hydrated.  I take Loperamide and salt my food as my doctor instructed.

 Reply posted for MomofMouse.

It can be difficult to get enough fluids and make yourself consume more than the average person; particularly after years of avoidance in order to reduce trips to the bathroom.
 get her involved in what and how she drinks.. .. Make sure she knows this is not a negotiation, it's this or hospitals and not getting the removal of stoma. 

Ideas for involved: Maybe a couple of fun water bottles that clearly mark levels of fluids. decorate with paint pens, sharpies or stickers.   Play around with some smoothie recipes .... Ice and yogurt and fresh fruit, gradually step down the sugar content or amount of mix for drinks like koolaid and tang.  Variety helps with boredom.  Get her in the kitchen playing with recipes for fruit soups, smoothies.   Make sure she understands that if her day is 18 hours long - she needs to empty H2O bottle by (hour, class, breakfast or lunch) and second by (home, fav show, hour, etc) and third by end of dinner.  Or as fits for her needs and size of waterbottle.  

It can take 30 days or more of the same behavior to build a habit, so if you want to ramp up the fluid intake from an easier amount without feeling like a hardnosed parent and having endless battles... Make sure meals are high in fluids for a while.  Watermelon, soups, be creative. summertime is great for fruit and fruit soups.
Hang in there, Mom & Family.  This is the rest of her life.  get her to buy in and be in control.   Have her journal her food and fluid intake in a cool notebook, and ask her to give it to you once a day for review.  that way it's not confrontational, and you have an opportunity to discuss success and challenges, goals, and achievements!

 Reply posted for MomofMouse.

My son has an ileostomy and I am also an enterstomal therapist. All our new ostomy patients are instructed to measure their ostomy output for at least the first 2 weeks and to call the doctor if output is >1200 ml/cc in 24hours. Patient's then are started on immodium or lomotil to decrease the output. Peanut butter, mashed potatoes, applesauce, bananas will help thicken and slow down the output. You can make your own replacement fluids at home using 1 liter water with kool aid or crystal light, add 1 tsp salt and to get the potassium replacement add 1/2 c orange juice. if you dont want to add the juice than eat a banana. She should be drinking at least a glass of fluid everytime she empties. We teach minimum 8-10 glasses a day if you are under 1200ml per day- over 1200 you have to match what you put up. I would just tell her the more re-admissions and complications she has the lower she will have her stoma..so the easiest thing to do would be to stay hydrated while her body adjusts. good luck