Ileostomy and stomach cramps – What could be causing them?

There are several reasons why you may experience stomach cramps with an ileostomy, so it’s important to know the reasons why this happens and what to do about it if you do experience cramping. It’s always worth listening to your body, if somethings hurts it’s usually an indicator that something is wrong. We all get stomach cramps from time to time, but it needs to be taken seriously if you have a stoma. People with all types of stomas can experience stomach cramps, but those with an ileostomy need to be especially careful of blockages.

We all get stomach cramps from time to time, but it needs to be taken seriously if you have a stoma. People with all types of stomas can experience stomach cramps, but those with an ileostomy need to be especially careful of blockages.

Bowel obstructions known as blockages, can often be the root cause of stomach cramps and as they tend to happen quickly for those with an ileostomy it can be quite alarming! Certain foods can often be the culprit in causing issues with a blockage and stomach cramping, but cramping may also be caused by inflammation, scar tissue (adhesions) or twisting of the intestines.

Blockages

Blockages are also known as intestinal obstructions can occur in both the large and small bowel, so people with both colostomies and ileostomies are affected. For people with a colostomy, blockages occur slowly and gradually over a few days, leading to signs of constipation at first, while those with an ileostomy can experience them very quickly and without any warning signs.

For all ostomates suffering from blockage, this is a serious medical condition as it can lead to pain and dehydration. You should therefore urgently consult your GP or stoma care nurse if the constipation does not subside within 6 hours. If the symptoms worsen and you experience muscle cramps in your stomach, which increase in intensity and/or if you vomit or are dehydrated, you should contact your GP or stoma care nurse immediately. Ignoring these symptoms can quickly turn the situation into an emergency, necessitating additional surgery.

What types of constipation exist and what are the symptoms?

Intestinal obstruction can result in a partial or complete blockage of the bowel. A partial bowel obstruction is when a small amount of fluid can make its way around the blockage, resulting in a very watery/mucousy discharge from your stoma, which is usually bad smelling. This can lead to abdominal cramps, possible swelling of the abdomen and, in severe cases, nausea/vomiting. A complete blockage means that nothing can get past the blockage and therefore there is no discharge from the stoma at all. This results in swelling of the abdomen and the stoma, severe cramps and nausea/vomiting.

Recognising the symptoms of partial or complete blockage can help you react quickly. Here are some of the most common signs that indicate a blockage in your bowel or stoma:

Few or watery stools

Bloating and swelling in the abdomen

Stomach cramps

Swollen stoma

Nausea/vomiting or both

Dry mouth

Less or dark urine

How can blockages occur?

If you have an ileostomy, a bowel obstruction can develop quickly and can be caused by eating undigested food. Constipation occurs when undigested food prevents the stool from passing through the bowel in the usual way. When you have an ileostomy, try to stick to the recommended foods and always chew your food carefully before swallowing.

Growths in the abdominal cavity can also be a reason for a blockage during an ileostomy. In general terms, Growths are bands of tissue that attach between abdominal tissue and organs, similar to an inner scar. They are a result of the body's normal healing process and can develop in the first 3-5 days of healing. Over time, they can become larger and firmer and cause problems even years after the surgery. Unfortunately, growths can cause multiple organs to become "fused" together, which can lead to traction or pulling of nerves, causing pain. Growths can kink, twist or pull the bowel out of position and obstruct the flow through the digestive tract.

What can you do if you notice a blockage?

If you suspect that your stoma may be blocked:

Try to avoid solid food for a while and increase your fluid intake at the same time.

In addition to water and hot tea, also choose fresh fruit juices. Sometimes fizzy drinks can also help.

Massage your abdomen and also your stoma to relieve constipation.

Lie down on your back on the floor and roll from side to side, pulling your knees up to your chest.

Try taking a hot bath for 15-20 minutes to relax the muscles in your abdomen.

It is always important to keep moving, as this stimulates digestion.

It is always a good idea to contact your GP or stoma care nurse if you have problems with a blockage. If it is an emergency, please call 112 - untreated constipation can lead to "breakthrough" of the bowel.

Find out how you can best resolve a stoma blockage here.

Gastrointestinal virus

For ostomates, the risk of getting a gastrointestinal virus is the same as for anyone else. If you have excessive loose, bad-smelling stools and abdominal cramps, you should drink plenty of fluids and rest. With a stomach flu, you may get a slight fever and feel generally run down and tired. Take care of your peristomal skin surrounding the stoma to ensure that it does not become sore during this time.

You may also notice that you have to empty or change your pouch much more frequently than usual. If the diarrhoea persists, you should take an electrolyte suspension to counteract the loss of fluid and mineral salts. If you normally use a closed ostomy pouch, it may be easier for you to switch to a ileostomy pouch until the loose stools have stopped.

The gastrointestinal virus and associated discomfort usually subside within a few days and you will be able to drink and eat normally again. If you are still worried, concerned that you are dehydrated or would like to speak to someone, please contact your GP or your stoma care nurse.

Pouchitis

Pouchitis occurs when an internal (ileoanal) pouch becomes inflamed. It is a common complication for people with an ileoanal pouch. The symptoms are usually diarrhoea, which is often bloody, abdominal cramps and a high temperature. Please contact your GP immediately. They will usually prescribe a treatment with antibiotics.

You can find further information about infections of the stoma here.

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