Common Vitamin and Nutritional Deficiencies of Ostomy Patients
The large intestine is the final portion of the gastrointestinal tract. It performs the vital task of absorbing water in addition to vitamins and nutrients that have been produced by gut bacteria. Since some of your body’s nutrition is absorbed in the large intestine, those who have received an ileostomy are more susceptible to nutritional deficiencies. Colostomy or urostomy patients also have distinctive dietary variables to consider.
Your doctor and nutritionist will guide you in managing your dietary needs. By all means you should look to them for final say on all nutritional decisions. That being said, we know that anyone who is about to undergo, or has recently received, a colostomy, urostomy, or ileostomy has questions about nutrition right from the get-go. InnerGood is happy to provide you with some pertinent information about the deficiencies you may need to manage to live your life to the fullest, and then some.
Vitamins, Minerals, and Other Nutrient Deficiencies that those Living with an Otsomy Need to be Aware Of
Vitamin B-12
For all intents and purposes, B is the beginning of your nutritional alphabet. Vitamin B-12 is the most common of nutritional deficiencies. Studies show that an estimated 25 percent of all people who have received an ileostomy have developed a B-12 deficiency. You don’t want that. A lack of B-12 in your body can result in anemia, with further repercussions that include irreversible nerve and/or brain damage. Sounds scary, but with a nutritionist-advised schedule you can consume a B-12 supplement to abate these concerns. One item worth noting, is that B-complex may cause an odor, so many people opt for a B-12 injection or nasal spray. B-12 is not absorbed as well via an oral route so the injection or spray simply makes good sense.
Folic Acid
Some of you may be taking Sulfasalazine. Sulfasalazine can affect folate absorption, so you may have to take a folic acid supplement to balance the effects. A deficiency can result in mucosal impact in the intestinal lining. Folic acid is also absorbed near the ilium, so once again those who have received an ileostomy will need to be especially mindful.
Folic acid is a tricky one to monitor. For the most part, you can’t get too much B-12. But you can get too much folic acid. Here’s the catch, B-12 and folic acid work together to the point that a deficiency in one may be mistaken for a deficiency of the other (without proper testing). Since folic acid is absorbed in pill form (as opposed to a physician-supervised injection), you must be mindful and monitor your prescribed intake. If you’ve had an ileostomy you will also want to check to see if the folic acid pills are going through your digestive tract whole. If so, it is not being absorbed and you will need to look at an alternative form of delivery for this vitamin.
Potassium
A loss of potassium though the stomach and intestines is common to those living with an ileostomy. Ileostomies are susceptible to sodium and water depletion. Increased sodium output from the ileostomy is associated with a reduction in the sodium: potassium ratio. Your physician will measure sodium and potassium concentrations and determine a lack in the latter. However, if you notice a combination of fatigue, muscle weakness, shortness of breath, decreased sensation in arms and legs, and/or a gassy bloated feeling you may have a potassium deficiency. You will need to consult with your doctor immediately. Traditionally, potassium is most effectively delivered via food such as bananas and dark leafy greens. The issue, is that to get enough to account for a deficiency, you may have to eat a lot, to the point excessive weight gain. Thus, a supplement is recommended to complement your diet.
Other
Vitamin B-12, folic acid, and potassium are the most common nutritional deficiencies. But there are others you may need to supplement with. These include Vitamin B1, Vitamin B9, Vitamin D, Vitamin K, calcium, iron, magnesium and zinc. As with everyone, a healthy balance of protein, complex carbohydrates, and essential fatty acids will help you not only maintain your health, but will allow you to maximize your potential for all sorts of activities, sports, and physical regimes.
Every person is different and nutritional requirements can vary by age, gender, conditioning and overall activity. Educate yourself further with this Ostomy nutrition guide and consult with your physician and nutritionist before ordering from our dietary supplements page. And of course, feel free to contact InnerGood anytime, with any questions you may have.
Had full ileostomy. Except for folic(pill form)and b12 shots, take all other supplements in soft-gel form. Is this a good choice? Have no idea if anything is going where it should? Please advise
Hi Michaele,
First off, we cannot provide any direct medical advice on this topic. With that said, speaking as a fellow ileostomate, it’s hard to know exactly what we might be deficient in. When your surgeon cut the large intestine from the small, a centimeter either way can yield different vitamin uptake. You are on the right track with the soft gel pills as anything that can break down quickly (gels and liquids) will be absorbed more quickly.
I would recommend that speak with your doctor and perhaps look into a routine blood test. Likely this will be the best guide to know your body is receiving all the nutrients needed.
Thanks for the question!
AJ
I ve had an ileostomy since 1988. First of all start with labs and determine your deficiencies and then take appropriate supplements. I am a VA patient and the VA did not offer much help in determining my vitamin deficiencies. Over the years and some terrible times, I was able to finally recognize and request the proper meds and supplements. I was the key to everything, you have to be able to read your labs and with some consulting eventually take the proper doses. It takes a very personal attention to your labs and to your condition to achieve the proper dos of vitamins subsequent to a ileostomy. Do not rely entirely on the doctor to identify your condition. Some doctors are good but most are not as involved as they should be. take care of yourself and be involved in your own care. You are the real key to your own health, no one cares more than you.
Does any fellow ostomates… (nutritionist, ostomy nurses or doctors) out there know if they have experienced a really foul oder from their fecal matter… like an eggy smell… and it never stops.. like for months on end, no matter what you eat, smell is always the same. Could this be a fungus, bacteria, virus or parasite? The reason I ask… it NEVER changes… no matter what different foods I eat. It is ALWAYS a pungent eggy / broccoli / meat smell. So strange. I am also VERY tired since this started. I wonder could it be a vitamin deficiency… or maybe ‘Short Bowel Syndrome’… or ‘Malabsorption’. There is Something weird going on… just not sure what. Thanks for any advice! Thank you!
Hi Carol, only just read your post and I have a mucus for days sometimes that smells as you said. My doctor is referring me to a dietitian as I could be deficient in something. Hope you have managed to sort your problem out.
Malabsorbtion can cause smelly stools… due to Surgical resection or diseases of the small intestine which may result in varying degrees of malabsorption depending on the site of resection or disease.
Diseases involving the duodenum may be associated with lactose intolerance, poor tolerance of concentrated sugars, and decreased absorption of iron and calcium. Almost all nutrients are usually absorbed in the first three to five feet of the bowel. The absorption of most minerals especially iron, calcium and zinc, as well as most vitamins occurs in the upper part of the small intestine.
Resections of the lower parts of the small intestine (ileum) may result from surgical intervention for Crohn’s disease. The ileum plays a major role in reabsorption of bile salts, substances produced by the liver to help digest fats that are recycled by the body for use with future meals. The ileum is also important in vitamin B12 absorption. If bile salts are not absorbed properly, the amount of these substances in bile falls and fats and fat soluble vitamins (A, D, E, K), cannot be properly absorbed. A further problem is that if bile salts reach the colon, they can cause large amounts of fluid to be secreted causing watery diarrhea.
If large portions of the bowel are lost to surgical resection, rapid transit of nutrients through the remaining bowel occurs, causing malabsorption.
Another possiblity for malabsorbion could be possible Pancreatic disease or also a liver and bladder disease (where fats are not absorbed).
When fats are not absorbed… this can lead to smelly stools.
What causes oily fecal material in ileostomy? It is NOT mixed in the fecal matter, it seeps out under my appliance and floats it right off my skin. I have notice it the most when I eat anything with Canola Oil, gel vitamins, cheddar cheese, and some processed meats. My doctor ignores the problem as she evidently not familiar with ostomies.
Hi Sherry,
We are not trained to say what may be causing this to happen.
We recommend you reach out to your local nurse for further help.
We can say that leaks often happen when not in the right fit. A nurse or the ostomy companies are able to help you troubleshoot this.
Visit https://memberscaet.ca/find.phtml to find an NSWOC closest to you.
Hope this helps.
Can I go swimming with an ileostomy?
Yes
Hi there,
All ostomy bags are designed to hold in their contents and can go in water. Absolutely take the plunge pending you are healed from any recent medical procedures.
If it can keep it the stool, it can keep out the pool!
The fabric bags do well with a towel dry or cool setting of a hair dryer and the Sensura Mio line just needs a towel dry.
You got this!