Digesting Hard Medications: Just Another Challenge Ostomates Must Put Up With?

Over the last 8 years and during my brief battle with cancer, I have been very fortunate not to become dependent on too much medication. However, I'm not Superman and even though I may’ve beaten some tough battles, I do still get ill and sometimes need regular medication. At first there was pain relief and, due to a complication during my procedure where I sustained some nerve damage in my legs, the need for amitriptyline. More recently, I suffered from a skin condition that required antibiotics.

I'd taken this medication before, but this time the antibiotics were in the form of a hard tablet, not the soft capsules I have had in the past. Literally within a day, these created an issue.

Having an ileostomy, food that I digest has a very short transit before it reaches my stoma bag. Interestingly, certain foods seem to complete this journey faster (perhaps that's a topic for another blog). Now, I apologise for being crude but, after a few hours, these new hard medication tablets were moving through my digestion, still completely "undigested". Uncomfortably, they were passing out of my stoma whole! I had noticed this before with some magnesium and vitamin c multi vitamin tablets, which were also in hard capsule form. Up until this point, I had just written these experiences off as another challenge we ostomates have to put up with.

Did you know: some medications are available in liquid form

I was concerned, however, whether the antibiotics were getting chance to do their job before they passed out of my system undigested, so I decided to speak to my GP. During this conversation, I discovered something very interesting that I think could benefit others in the ostomy community. Did you know that we are able to get some medications in liquid form? This means more comfortable digestion, without the danger of medication passing out of your system without digesting properly. Win win? My interest was peaked and I decided to make some more enquiries to see what other types of medication were available in liquid form.

PharmaCare’s advice about liquid medications

SecuriCare home delivery service have their own pharmacy service, PharmaCare, that is able to deliver all your prescription medicines along with your stoma supplies. I made contact with their resident pharmacist, Janki Rao, to ask for her thoughts about this topic of liquid medications and thought the response might be worth sharing:

“Our pharmacists at PharmaCare Medical are really well placed to identify when a patient’s medication may not be suitable for them. We review medication regularly with our patients to check that they are getting optimum benefit from their medicines. With a lot of our patients being ostomates, we understand the impact that the right drug formulation can have on their lives.
Prescribing medication for patients with a stoma requires consideration to the type of stoma they have. In particular, tablets in an enteric coated or gastro-resistant form, some capsules, and modified release preparations may not be suitable as they may not allow enough of the drug to be released. Often these formulations simply pass through into the stoma pouch, or the patient may not experience the desired effect from the medicine.
Where necessary, the Stoma Care Nurse or the Pharmacist can recommend alternative formulations such as liquids, tablets that dissolve in the mouth or patches, etc. Unfortunately not all medicines have alternatives, but patients who highlight this issue to their Pharmacist or Stoma Care Nurse will probably discover a solution that works for them. Any recommendation to the prescribing doctor, would be made specifically for that individual patient, so that the doctor can discuss the request with the patient.'

Don’t suffer in silence

For years I had perhaps suffered in silence as some/all of my medication passed undigested. So I wanted to share this information as many may not know this option was available and, like me, were far too polite to query.

As always, the best advice is to speak to your GP, stoma nurse or medical professional. However, the one thing we shouldn't be afraid to do is ask. We encounter enough challenges as ostomates; finding a potential solution to one of them felt like a good thing to share. I hope the information has been useful?