Drugs and The Ostomate
Issue Nine


"Your pharmacist can also advise whether or not medications you buy over the counter may affect the purpose and performance of an ostomate prescriptions."

This helpful guide line was developed by a southern California pharmacist and is presented here in abstract form.

The local pharmacist can be a particularly useful and helpful friend to an ostomate. This is especially important because each ostomate has his or her own distinct needs. In addition, ostomates require equipment, medication and skin care programs which provide simple and practical answers to your physical and body chemistry needs.

Please do not misinterpret what I am saying. Your pharmacist cannot take the place of your doctor or ET, but rather can be most helpful in recommending certain equipment, understand the purpose of a prescription, its most effective form of intake and the most desirable time to take medicine. The pharmacist can also advise you on whether or not over the counter medications may affect the performance and effectiveness of other prescriptions written specifically for ostomates. Finally, the pharmacist is there to remind you to always check with your doctor when further clarification is needed.

It is also important that you know what (probable) physical response the body will have with particular medication. For example, take a prescription written for a child who has an ileal conduit. Your pharmacists is there to remind parents that the drug being prescribed has a urinary dye which will create a red color in the urine. You can imagine how frantic that parent would be if he or she did not know this important fact. A pharmacist can be most helpful in advising you of any natural reaction you may encounter from a new prescription.

One other important item to note about medication and that is: medication is absorbed in different ways in the body. For example, vitamin E is a very important contributor to skin health and should be taken on an empty stomach, preferably before breakfast. So, let's take a look at how your body takes its medicines. There are tablets that are placed between the gum and cheek where they will dissolved and be absorbed. The reason for such placement is because it acts more promptly and is not destroyed by stomach acids.

The stomach, of course, is where a great number of drugs are absorbed, such as aspirin, some forms of penicillin, some forms of erethomycin and many other drugs for what ails you. But the stomach is a highly acidic area and is not always very friendly to medication. Medication is sometimes destroyed in this area rather than distributed to its point of need. For that reason drugs such as nitroglycerin are absorbed through the wall of the mouth and others are encapsulated or protectively coated so that they will safely pass on into the small intestine or lower cavities of your body where they will be broken down and assimilated.

The small intestinal tract

This intestinal tract actually consists of three sections: the duodenum, the jejunum, and the ileum. This area is where most drugs, nutrients and fluids are absorbed. As an example, vitamin B12 is best absorbed in the lower portion of the ileum. If you are an ileostomate you may not have that intake capacity. In that case, you may get injections of B12 periodically. But most of your drug and vitamin needs will be absorbed in the upper two sections of the small intestine.

Now to the large intestine, the colon. This is not a critical area for medication absorption. It mainly serves to reabsorb leftover moisture or function as a holding site for feces.

So what should we know as ostomates when it comes to maximum intake of prescribed drugs and vitamins and minerals? The stomach is the least effective as a source of exchange for needed drugs/vitamins because it is highly acidic. We likewise know that the most efficient location for absorption is the small intestine. Some medications are irritating and should be taken with food. Meals should be light and less fatty than your usual diet prior to medication.

Liquid medicine is the best form of medication because it is already dissolved and ready to be absorbed, but drink some additional water or milk with your liquid medication.

Other medicine and vitamins in tablets or capsules form require them to be taken with liquids. The critical that you drink no less than an 8 oz. in quantity (whether it be water, milk, juice or soup)!

Remember, do not lie down immediately after any medication input. Hopefully, take a short walk or at least stand up for a time. This is important for proper medication timing and body intake.

Avoid highly-compressed or heavily-coated tablets and prolonged-acting or time-released tablets and capsules. Never overdose just because you think extra amounts of medication will offset the loss through non-absorption or premature "quick" passage into your pouch. Medication, taken properly, will be sufficiently absorbed. Overdosage can be toxic!

Finally, whenever in doubt, consult with your pharmacist or doctor. He or she is always eager to answer any questions and help you with a better understanding of your personal "ostomy-prescribed" needs.