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How do I manage constipation with a colostomy?

A colostomy will usually produce semi-solid to solid stool. For a healthy person, you would expect to see ½ – 1 cup of stool per day, so if you are seeing much less than this or going days without passing stool then you are probably constipated. Constipation usually happens when you are not passing enough stool regularly and then the colon becomes too full. The longer the stool stays within the colon the harder and drier it becomes, as the colon continues to draw water out of the stool. Your stoma does not have the ability to stretch like an anus does when you pass a large stool, so it is very important to take notice of your output and prevent constipation. Some tips that may help prevent you getting constipated are:

  • Make sure that you drink enough clear fluids during the day, this will help soften the stool. The recommendation is 2 litres or 6-8 glasses per day, unless your doctor has instructed you otherwise. Clear fluids are water, herbal teas, apple juice, etc.
  • Eat a balanced diet, including fruit and vegetables.
  • Consider taking a bulking agent like Metamucil (available from your pharmacy) as it will help with the consistency of the stool. It adds bulk and improves water content in the stool so it is more easily passed. Bulky agents are only helpful though if you are drinking the right amount of water to help it be effective.
  • Be as active as you can, as this helps the movement of stool around your colon.
  • If stool consistency is too thick despite attention to diet and fluid then a stool softener or laxative may be useful. Discuss with your Stomal Therapy Nurse or doctor what might be useful.