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If you have an ostomy—especially an ileostomy—you probably spend plenty of time thinking about your stoma, your output, what you eat, and whether you're getting enough fluids.
But how often do you think about your kidneys?
I've had my ileostomy for about five years, and I don't have a colon anymore. One thing I've learned is that hydration is a much bigger deal for me now than it was before surgery. What I hadn't really considered was how that could affect my risk of developing kidney stones.
Why an Ileostomy Can Affect Your Kidneys
Your colon normally absorbs a significant amount of water and electrolytes. If you have an ileostomy and your colon has been removed or bypassed, you've lost some of that ability.
Instead, more fluid can leave your body through your stoma.
That makes dehydration something we need to pay closer attention to. When you're dehydrated, you produce less urine, and that urine becomes more concentrated.
The more concentrated your urine becomes, the easier it is for some substances in your urine to form crystals. Eventually, those crystals can become kidney stones.
It's a connection I hadn't thought much about before: ostomy output, hydration, urine, and kidney health are all related.
Don't Just Watch What You Drink
One of the most interesting things I learned while researching this topic came from the United Ostomy Associations of America (UOAA).
They recommend paying attention not only to how much you're drinking or what's coming out of your ostomy, but also to how much you're urinating.
UOAA recommends a minimum urine output of about 1,200 milliliters per day to help protect kidney function.
I'd never really thought about measuring that.
We're constantly told to "stay hydrated," but drinking a certain amount doesn't necessarily tell the entire story. With an ileostomy, I can drink a lot—and I can also lose a lot.
What goes in matters, but what comes out can tell you something too.
Hydration Isn't Just Drinking More Water
With an ileostomy, hydration needs can change quickly.
Exercise can change them. Hot weather can change them. Illness can change them. Higher-than-normal ostomy output can change them.
And we're not only losing water. We're losing electrolytes too.
That's why electrolyte drinks or oral rehydration solutions can sometimes be useful, depending on your individual situation.
For me, the bigger lesson is simply becoming more aware:
- How much am I drinking?
- What's happening with my ostomy output?
- What does my urine look like?
Those are all pieces of information my body is giving me about what's happening inside.
What About Food?
Food can play a role in kidney stones too, but this is where I think we need to be careful about giving blanket advice.
There are different types of kidney stones, so I'm not going to tell every ostomate to suddenly eliminate foods like spinach, chocolate, or almonds.
I've learned from living with an ostomy that everybody's digestive system is a little different. There are foods other people with ileostomies can eat that I personally stay away from because I've experienced intestinal blockages.
If you've actually had kidney stones, that's a conversation worth having with your doctor or dietitian. Knowing what type of stone you're forming can help determine what dietary changes actually make sense for you.
Know the Warning Signs
Kidney stones can cause some pretty obvious symptoms:
- Severe pain in your side or lower back
- Blood in your urine
- Pain when you urinate
- Nausea or vomiting
Vomiting is something I'd take particularly seriously with an ileostomy because now you've potentially got another source of fluid loss on top of what you're already losing through your stoma.
If something doesn't feel right, don't try to be a hero.
Get checked out.
Take Care of the Whole Person
I've lived with my ileostomy for about five years now, and I'm still learning things about this body.
That's probably never going to stop.
Kidney stones were another reminder for me that living well with an ostomy isn't just about taking care of the stoma. It's about taking care of the whole person.
So stay hydrated.
Pay attention to your output—and maybe start paying a little more attention to your urine too.
Then go live your life.
Life is bigger than your ostomy.
