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Hydration and the Ostomate

Updated: May 2, 2023

An Ostomate's Guide to Staying Active and Hydrated as the Weather Gets Warmer.

Summer is coming, and while proper hydration is essential for everyone, it is especially important for those with ostomies. That is because ostomates have had part or all of their colon surgically removed (or bypassed) and perhaps part of their small intestine as well, both of which are responsible for absorbing fluids into the body. Specifically, 80% of the fluids we ingest are absorbed in the first part of our small intestine (the duodenum). The remaining 20% of the fluids are absorbed from the foods we eat, which happens primarily in the colon (large intestine).

That makes ostomates particularly prone to dehydration since fluids that would otherwise be absorbed through the small and large intestines are flushed from the body through the stoma instead. To compensate for this loss, it is imperative that ostomates diligently monitor and manage their daily fluid intake to avoid dehydration, which can have a significant, adverse effect on one's health.

Causes, Signs and Remedies for Dehydration

Below is a comprehensive, bullet-point summary of the causes, signs, and remedies for dehydration. Please let us know your thoughts and suggestions in the comment section below


Common Symptoms of Dehydration

  • Headaches

  • Dry mouth/tongue

  • Increased thirst

  • Decreased urination

  • Dark yellow-, amber-, or brown-colored urine

  • Dizziness when you stand up

  • Feel weak and don't react normally

  • Increased fatigue

  • Cramps in your legs or abdomen

  • Unable to think clearly (brain fog)

  • Feel tingling in your hands and feet

  • Loss of appetite.

  • Signs of extreme dehydration – go to the emergency room.

    • Confusion

    • Dizziness

    • Shriveled skin

Ileostomy Specific Symptoms (in addition to the above).

  • High output of more than 1,500 mL, or about 6 cups of stool in 24 hours. High output can also result in poor nutrient absorption and weight loss. (Normal output is 800 - 1,200 milliliters (mL) or 3 - 5 cups per day. You will typically empty your ileostomy bag 6-8 times per day when it is half full.)

Urostomy Specific Symptoms (in addition to the above).

  • Urinary tract infections

  • Dark urine

Possible Serious Complications of Dehydration

  • Heat injury (heat cramps, heat exhaustion, or heatstroke)

  • Urinary and kidney problems (urinary tract infections, kidney stones, or kidney failure)

  • Seizures (due to low levels of electrolytes like sodium and potassium)

  • Swelling of the brain (cerebral edema)

  • Shock (low blood pressure and organ failure)

  • Coma (loss of consciousness)

  • Death

Causes of dehydration

  • Vomiting / Diarrhea / High Output

  • Inadequate fluid and electrolyte intake

  • Sweating without fluid replacement

  • Diuretic drugs (often used to treat high blood pressure, kidney problems, and heart failure), including, among others:

    • Microzide (hydrochlorothiazide)

    • Lasix (furosemide)

    • Aldactone (spironolactone)

    • Midamor (amiloride)

  • Diuretic foods (do not avoid, but make sure you increase fluid intake to compensate for their diuretic effect)

    • Parsley.

    • Tomatoes

    • Celery

    • Pineapple

    • Dill

    • Lemon

    • Cucumber.

    • Pumpkin seeds

  • Gastrointestinal fluid losses due to:

    • gastrointestinal fistula

    • intestinal obstruction

    • extensive post-operative fluid loss

    • Excessive output of water and sodium from the kidney

    • Long-term use of diuretics

Ways to Avoid Dehydration

  • Drink 8–10 eight-ounce glasses of water/fluid daily

  • Drink frequently throughout the day (set an hourly alarm on your phone or watch as a reminder)

  • Always drink before you go out (and consider taking a drink with you)

  • Don't wait until you're thirsty to drink fluids

  • Drink more than just water. A drink needs to have a small amount of glucose and some sodium to be efficiently absorbed by the body. This is why sports drinks are often recommended when you have an ileostomy. However, sports drinks have a lot of sugar too. Consider drinking diluted fruit juice with a pinch of salt or have an electrolyte drink.

  • Drink with meals since food slows down the transport of fluids through the intestine.

  • Limit/avoid laxatives

  • Limit/avoid beverages with added sugars, artificial colors, and sweeteners

  • Drink tea and coffee in moderation. Caffeinated drinks can cause dehydration,

  • Limit/avoid drinks and foods that have a diuretic effect, examples include:

    • sweets

    • artificial sweeteners

    • lactose-rich foods and drink

    • alcohol

    • caffeine

    • carbonated drinks

    • legumes, beans, or lentils

    • high-fiber vegetables

    • nuts and seeds

    • whole wheat or corn products such as bran or popcorn

For those with ileostomies

  • Consume potassium rich foods (e.g., bananas, potatoes, oranges)

  • Limit sodium (salt) intake (unless your healthcare provider advises otherwise)

For those with urostomies

  • Reduce the risk of UTIs by drinking 8–10 eight-ounce glasses of water/fluid daily)

  • Drink cranberry juice or take cranberry pills to increase urine acidity, which helps prevent UTIs. (Check with your doctor first if you are on blood thinners)

Replace Electrolytes!

(Electrolytes are minerals that carry an electric charge when dissolved in water. They are involved in many essential processes in your body, such as nerve and muscle function, fluid balance, and pH regulation. Examples of electrolytes include sodium, potassium, chloride, calcium, magnesium, phosphate, and bicarbonate).

Consume the following to increase your electrolytes:

  • Broths/ bouillon

  • Sports drinks (limit the ones with excess sugar)

  • Rice water

  • Orange juice (see enhancement option below)

  • Gatorade (see enhancement option below)

  • Apple juice (see enhancement option below)

  • Cranberry juice/cranberry pills

  • Eat salty snacks (pretzels/crackers) before bed to reduce nighttime muscle cramps.

  • Canned soup

  • Potatoes/bananas (bananas also thicken stools)

Commercial products that replenish electrolytes:

  • Oral Rehydration Salts Packet

  • Ceralyte 50, 70, or 90

  • Drip Drop

  • Pedialyte

  • GU Energy Tabs, NUUN

Homemade oral rehydration solution.

  • 1/2 teaspoon table salt

  • 1/4 teaspoon salt substitute, which is potassium chloride.

  • 2 tablespoons table sugar

  • 1/2 teaspoon baking soda

  • Add water to make 1 liter.

Combine and stir ingredients until dissolved (add Crystal Light to improve flavor).

Gatorade G2 Based

  • 4 cups (32 oz bottle) G2 Gatorade

  • 3/4 teaspoon salt

Combine and stir until salt is dissolved.

Apple Juice Based

  • 3/4 cup apple juice

  • 3¼ cups water

  • 3/4 teaspoon salt

Combine and stir until well mixed and dissolved.

Orange Juice Based

  • 4¼ cups water

  • 1 cup orange juice

  • 8 teaspoons sugar

  • 3/4 teaspoon baking soda

  • 1/2 teaspoon salt

Combine and stir ingredients until dissolved.

And By the Way, Free Money!


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We hope you found the above useful. Now go out and have a “be free” happy, active spring and summer! If you have any suggestions or comments, please let us know in the comment section below.


Please check out our Be Free ostomy odor elimination products. Free samples are available.

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