Diarrhoea with a stoma: Causes and how to manage it

Why do you get stoma diarrhoeas?

Stoma and diarrhoea often go hand in hand, and it can affect anyone regardless of stoma type. Loose, watery output makes changing your stoma bag more difficult, can leave you feeling unwell, and increases the risk of losing vital fluids. It often means changing your ostomy bag more frequently, going through supplies faster, and a higher chance of peristomal skin irritation from the increased bag changes.

If you have an ileostomy, diarrhoea can be a particular concern. Since the colon (which normally absorbs water and electrolytes from digested food) has been removed or bypassed, fluid loss through an ileostomy tends to happen faster than for those with a colostomy, which makes dehydration more likely.

What are some possilble causes of stoma diarrhoea?

The causes of diarrhoea when you have a stoma are often the same as for anyone else, including:

Illness or a stomach bug. Stress or worry. Diet. Food poisoning. Certain medications, including some antibiotics. A partial stoma blockage, which can sometimes cause loose output around the obstruction rather than a full stop in output.

However, diarrhoea and a stoma bag can be a bigger concern than usual, since staying hydrated and managing output is already part of daily life with a stoma.

Diet and stoma diarrhoeas

Diet is one of the most common triggers of stoma diarrhoea. If you suspect diet is behind your diarrhoea and stoma bag issues, try:

Moderating your alcohol intake — it can increase output and, as a diuretic, worsen dehydration. Avoiding fatty or spicy foods or eating them in small quantities. Moderating coffee and fruit juice, as both can increase output. Eating smaller, more frequent meals rather than large ones. Keeping a simple food diary if diarrhoea keeps recurring, to help spot patterns or triggers.

You likely won't have much appetite while dealing with diarrhoea, but it's important to keep drinking fluids. If you have an ileostomy, this is especially important; you may also need extra salt to prevent rapid dehydration. Dry savoury crackers or meat extract drinks like Oxo or Bovril can help if you can't manage much food. For more information about stoma diet, feel free to refer to our respective guide.

Avoid dehydration

Diarrhoea with a stoma puts you at higher risk of dehydration. Signs to watch for include:

Dry mouth. Increased thirst. Weakness or tiredness. Confusion. Fainting. A decrease in urine output. Dark-coloured urine.

To help prevent dehydration:

• Aim for around 8 glasses of fluid a day. Avoid salty food and full-sugar drinks (or let fizzy drinks go flat first).
• Consider oral rehydration solutions if diarrhoea is persistent, as these help replace lost salts and sugars more effectively than water alone.
• Contact your stoma nurse if diarrhoea continues beyond 24 hours.

Stoma skin care during diarrhoea

More frequent bag changes and looser output increase the risk of leaks reaching your peristomal skin. Check your skin at each change and consider using a barrier product if you notice any soreness. If irritation develops, speak to your stoma nurse about suitable skin care products. Speaking of stoma and skin care, here's a respective guide for you.

When to seek help regarding a stoma diarrhoea

Diarrhoea usually settles within a day or two. Contact your stoma care nurse or healthcare professional if:

Your output shows no signs of slowing after 24–48 hours. You experience signs of dehydration. You have severe abdominal pain or cramping. You notice blood in your output. You suspect a blockage alongside the diarrhoea.

FAQ: Diarrhoea with stoma

What causes diarrhoea with a stoma?

Common causes include illness, stress, diet, food poisoning, certain medications, and occasionally a partial blockage. These are largely the same triggers that cause diarrhoea in anyone without a stoma.

Is diarrhoea more dangerous with a stoma?

It can be, particularly for people with an ileostomy, since fluid and salt loss happen faster without a colon to reabsorb them. This makes dehydration a bigger risk than for the general population.

How do you manage diarrhoea with a stoma bag?

Focus on staying hydrated, adjusting your diet (avoiding alcohol, spicy or fatty food, and excess caffeine), and speaking to your stoma nurse about anti-diarrhoeal medication if needed.

When should you contact your stoma nurse about diarrhoea?

If diarrhoea lasts more than 24–48 hours, you notice signs of dehydration, experience severe pain, or see blood in your output, contact your stoma nurse or GP promptly.