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

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?

by Scott Smith

Scott Smith

About the author

I was diagnosed with Ulcerative Colitis and bowel cancer. I had to have a major operation leaving me with an ileostomy. In a few short months I was discharged from hospital - back into my 'normal' life - changed forever.

Recent Comments

  • Jayne

    Very interesting read as always. Defiantly helps having a good stoma nurse .

  • Caroline dick

    I'm glad I came across this. I have terminal cancer. I've been struggling with pain for months. I was referred to the Marie curie team who have me on a pain management plan and as much as they are wonderful I am still struggling. Each week the dosage of medication is increasing.
    Yesterday whilst emptying my bag I noticed a tablet complately whole. It was my oxycodone, the same thing happened later.
    I contacted my nurse who hadn't come across this. She believes I've solved my own problem. Today I will try a patch with liquid oxycodone as required. I also take pregablin which has been switched to liquid.
    I'm feeling hopeful and think there should be more awareness of this issue.
    Xx

  • Jerald E Butcher

    I didn't know there was such a thing as a stoma nurse? I'll have to ask my Family Doctor about liquid medicine?
    thanks
    jb

  • Carden Tilley

    My husband has advanced metastatic prostate cancer and had bowel cancer for which he had an ileostomy formed in 2006. He has been suffering with nerve pain for the past few months. He has been having increasing amounts of oxycodone and also Amitryptaline. Early hours of this morning he was in agony and we noticed an oxycodone tablet whole in the waste coming out of his stoma. He took an immediate release oxycodone a little cream and brown capsule and pain as it has been over past few weeks settled down. We are going to talk to the macmillan nurse this morning

  • Deborah Brown

    Thank you. Very useful. I am losing whole tablets. Will look into it.

  • Peter Ronan

    Interesting reading and hopefully I have helpful tips for illiostomy
    and stoma users.

    About a year ago i got cancer again and had the rest of my intestines out. 16yrs ago when I was 29 I also had aggressive bowel cancer some taken out then too. This time I was given an ileostomy. Also my rectum was taken out and some aggressive cancer spread into liver and peritoneum and also large parts of those were taken and nerve damage from chemo too lower back and trimelgia neuralgia. But I lived..wow.lol. always been very fit and strong. Boxing, martial arts and weight lifting with clean diet etc and no warning signs..anyway..trying to get used to ileostomy I found hard tablets going straight through and undigested food. So I was hungry, thin and in massive pain.

    After my last operation I lost even more weight no matter how much food I ate. Even when I ate high cal and protein foods with slow carbs, bag was still very very watery no matter what i did. I Found liquid imodium made it worse strangely so I tried instant melts imodium 30mg a day! and it helped but ot great . I also have cystic fibrosis and happened to be rushed in to hospital with CF where I was prescribed creon and it solved the weight loss..

    but I discovered a trick..

    The creon was also going straight through me at first even though it was a soft capsule. One day I held them in my mouth as I was distracted..they almost popped in my mouth but when I realised I swallowed them quickly but later i found bag was firm. Unusual for me..I keep a very strict food and meds diary for obvious reasons so i checked my book and saw that the only difference was sucking creon. So I tried doing it again. Sucking tablets until almost soft to give them a head start and yes..it worked. So I changed all my tablets to soft capsules and started holding them in my mouth until almost popped and then swallowing them. Giving them a head start and I noticed a massive difference.

    List of what I take all soft..

    Soft capsules =
    -Pregabalin for nerve damage.
    -creon 2500 for digestion
    - zomorph 10s & 30s

    Effervescent + soluble =
    - paracetamol
    - codeine (sometimes liquid)
    - imodium
    - ondansetron

    Liquid =
    - sodium chloride 5.84%
    - ibuprofen
    - oramorph

    Nebulised =
    - colomycin 2 million
    - dornaise

    There are other meds but not relevant.
    I really hope this helps someone. Pretty much all meds have a liquid or effervescent equivalent. I am lucky as I have awesome drs, stoma nurses and Macmillan nurse. Very lucky indeed.

  • M J Hawken

    Didn't know there were liquid forms of some drugs ,great news.
    I wouldn't take certain things because they come through whole and painfully.
    Thank you .

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