[vallynails]

I havent been able to find clear enough answers from the ostomy forums or some of the big nutritional supplement companies. They seem to have so much to say but as soon as this issue comes up, everyone acts dumb. It is a concern amongst a lot of ostomates, so i speak on behalf of others. Certain pills pop out of the stoma and therefore dont dissolve at all, so when purchasing any medicines, how is it possible to find out if that pill will dissolve in the gastric juices in the stomach in time before it leaves the stomach and goes into the small intestine. For example, if i drink a cup of coffee, the coffee is in my ostomy bag within 20 minutes max, so that tells me i need to make sure that any pills i take dissolve in 15 minutes. I am presuming that i should not take any slow release or sustained action medication.?? with less than a metre of small intestine left, nutrition can be critical and therefore supplementation is necessary, but could it be risky in terms of obstruction or on the other hand, it could be an expensive excercise if its going straight through.
Any ideas would be welcome.
(one major nutritional company who seems to know everything about everything, was clueless about the dissolve time of the gelatin and suggested I cut the omega 3 capsules open and pour in on my food. I would not like to do this - can you imagine???

[jetlb]

I , too, have short bowel and it is hard to get things to absorb. There are meds that can be taken to slow the motility of the gut down and allow the absorption of foods and meds. The meds that work well are Paragoric, otherwise known as Tincture of Opium, or lomotil. In some , severe , cases Octreotide a generic for Sandostatin is used. Though, many insurance companies will not want to pay for this med, it is very pricey. It is an injection that is given but has been shown to be very effective.

I, personally, take the Octreotide injections twice daily and supplement with the tincture of opium for breakthrough high output. Since starting this regimen, I am nolonger being hospitalized for IV fluids weekly, I am maintaining a weight and not noticing my meds in my ostomy bag. Things are greatly improved. I would speak to your physician about these meds. It took a great deal of fighting with the insurance company to get coverage for the Octreotide and continues to be a battle at times. It is not a cure, but it does help a great deal.

I am with you on the opening meds and putting them on foods. Obviously, these people have never done this. If they had, they would NEVER suggest that anyone do it. First of all, I would worry about the discoloration of your teeth with many meds. Second of all, food is to be enjoyed and when one has had a chronic illness, it is hard enough to enjoy it, let alone make it taste like s*)* with an open capsule dumped on it. I mean no offense, just being realistic.

Wish you well. Know that not all are 'dumb' in this area. It is just an area that is not well versed and many get lost in the shuffle. It is an area that is not understood as there are not alot of answers, so it gets 'avoided' alot.

[Cats Meow]

For your condition ask for sublingual medication, as it will dissolve under your tongue.
To find the absorption rates of specific meds read the drug monograph, it's available from the pharmacist, it's in everyone of his master pill bottles, or Google the drug name plus monograph.

If your pill isn't a controlled release med, under doctor or pharmacists recommendation, crushing and placing into food or drink is an acceptable alternative, it need be in only one bite if the taste is disagreeable to you, or see if the drug is available in capsule form.

If it's pain medication, ask about a transdermal patch.

[vallynails]

Thanks for replying, i am more concerned about the nutrition than pain meds. I was surprised that some of the nutritional supplemtn companies have so much to say and know exactly what their products will do for you and they make so many claims but as soon as you ask about absorption, they seem to act dumb. Surely it is something that is tested in their labs??? anyhow, i appreciate your comments and will be back with news.