How to Stay Hydrated with an Ostomy Bag: An Essential Guide

October 16, 2025 •

4 min read

For individuals with a new ileostomy, dehydration is the most common reason for hospital readmission. This statistic underscores why understanding and proactively managing fluid intake is a critical part of living well with an ostomy.

Quick Summary

Proper hydration with an ostomy requires balancing fluid intake with electrolyte replenishment, choosing the right beverages, and adapting strategies for your specific stoma type and output to support overall health.

Key Points

Prioritize Electrolyte-Rich Fluids: Plain water is often insufficient for ostomates due to increased loss of vital electrolytes like sodium and potassium. Oral Rehydration Solutions (ORS) are essential for replacement.
Drink Small Amounts Frequently: Sipping fluids slowly throughout the day, rather than chugging large volumes, improves absorption and helps prevent flushing the gut too quickly.
Separate Fluids and Solids: To manage high output, avoid drinking large quantities of fluid during meals. Sip fluids about 30 minutes before or after eating to allow better absorption.
Recognize Dehydration Symptoms: Be vigilant for signs such as increased thirst, dark urine, fatigue, muscle cramps, and lightheadedness, which can indicate a need for immediate fluid and electrolyte replacement.
Limit Diuretic and High-Sugar Drinks: Caffeine, alcohol, and high-sugar beverages can increase stoma output and exacerbate fluid loss. Limit these and choose low-sugar or diluted options instead.
Track Your Intake and Output: Keeping a log of your fluid intake and stoma output can help you monitor your hydration status effectively and provide useful data for your healthcare team.

Understanding the Impact of an Ostomy on Fluid Balance

An ostomy is a surgical procedure that creates an opening, called a stoma, to allow waste to exit the body. This procedure, particularly an ileostomy, significantly alters the body's ability to regulate fluid and electrolyte balance. The large intestine, or colon, is responsible for absorbing large volumes of water and essential salts from waste material. With an ileostomy, the colon is bypassed, and this function is lost, leading to increased fluid loss through the stoma. People with a colostomy retain more of their colon, so their dehydration risk is lower, though it remains a concern, especially during periods of illness or diarrhea. A urostomy, which diverts urine, also requires careful hydration to maintain kidney health and prevent complications like infections and kidney stones.

Types of Ostomies and Their Hydration Needs

Ileostomy: Highest risk of dehydration due to the complete bypassing of the large intestine, resulting in more liquid and frequent output. Requires vigilant fluid and electrolyte management.
Colostomy: Lower risk of dehydration compared to an ileostomy. However, fluid intake is still important, especially to prevent constipation and during illness.
Urostomy: Requires a steady intake of fluids to maintain diluted urine, reduce the risk of urinary tract infections, and prevent crystal buildup around the stoma.

Recognizing the Symptoms of Dehydration

Knowing the early signs of dehydration and electrolyte imbalance is crucial for ostomates. Being proactive can prevent a mild issue from becoming severe, potentially requiring hospitalization.

Early symptoms of dehydration:

Increased thirst and a dry mouth
Fatigue or feeling lethargic
Headaches or lightheadedness
Dark yellow or concentrated urine (in urostomy patients)
Dry skin and lips

Signs of electrolyte imbalance:

Muscle cramps or weakness
Irregular heart rhythm (in severe cases)
Swelling or bloating
Confusion
Rapid heart rate

Strategic Fluid and Food Choices

Achieving proper hydration is not just about drinking more water; it requires a strategic approach to fluid and food intake. Plain water alone may not be enough, as electrolytes need to be replaced as well.

Best fluid options for ostomates:

Oral Rehydration Solutions (ORS): These are specifically formulated to replace fluids and electrolytes lost in stool and are more effective than sports drinks for serious dehydration. Examples include Pedialyte and DripDrop.
Broth and Soup: Salty broths and soups are excellent for replacing sodium and fluids.
Diluted Low-Sugar Sports Drinks: These can be useful for replacing fluid lost during exercise or hot weather. Diluting them with water lowers the sugar concentration.
Water-Rich Foods: Incorporate hydrating foods like melons, cucumbers, applesauce, and yogurt into your diet.
Milk-Based Drinks: Milk and other dairy drinks can contribute to hydration and may be tolerated well, especially lactose-free options for those with intolerance.

Fluids to limit or avoid:

High-Sugar Drinks: Regular sodas and fruit juices can increase ostomy output and should be limited.
Caffeine: Drinks like coffee and tea can act as diuretics and increase fluid loss, so moderate your intake.
Alcohol: Alcohol is a diuretic and should be consumed in moderation, if at all, especially during periods of high output.
Artificial Sweeteners: Sugar alcohols like sorbitol and mannitol, often found in sugar-free products, can worsen diarrhea.

Comparison of Hydration Drink Options


Drink Type	Best For	Pros	Cons
Oral Rehydration Solution (ORS)	Treating existing dehydration; high-output stoma	Optimal electrolyte balance; effectively replaces lost salts and water	Can be expensive; taste can be unappealing
Low-Sugar Sports Drink	Exercise; hot weather; general fluid replacement	Readily available; contains some electrolytes	Can still be high in sugar; may increase stoma output if not diluted
Water	Everyday hydration; mixing with ORS/foods	Readily available; no cost; zero calories	Doesn't replace electrolytes on its own, which is critical for ostomates
Broth/Soup	Replacing sodium; comforting during illness	Replenishes sodium; easy to digest	May not appeal to everyone as a primary hydration source

Adapting Hydration Strategies for High Stoma Output

High stoma output, generally defined as more than 1.2 to 1.5 liters in 24 hours, significantly increases the risk of dehydration and electrolyte imbalance. Managing high output is a delicate balance of restricting certain fluids while focusing on others. An expert resource, such as the Diet Guidelines for People With an Ileostomy from the Memorial Sloan Kettering Cancer Center, offers specific guidance for this condition.

Hydration tips for high output:

Separate Drinking from Eating: Sip fluids slowly between meals, rather than gulping them down during a meal. This allows your body more time to absorb nutrients and fluids.
Limit Fluids during Meals: Restrict fluid intake to no more than 1/2 cup during meals to slow down the transit of food through your gut.
Prioritize ORS: When output is high, focus on consuming Oral Rehydration Solutions and limit plain water intake to less than 2 cups daily.
Thickening Foods: Incorporate foods known to thicken stool, such as applesauce, bananas, rice, and smooth peanut butter.

Practical Hydration Habits

Incorporating simple habits into your daily routine can make a significant difference in maintaining proper hydration.

Daily hydration strategies:

Drink Little and Often: Instead of large volumes at once, sip fluids continuously throughout the day.
Use Reminders: Use smartphone alarms or hydration tracking apps, like Ostobuddy, to prompt you to drink regularly.
Always Carry Fluids: Keep a reusable water bottle with you to ensure a drink is always on hand.
Add Salt to Food: With your doctor's approval, add extra salt to your meals to help your body retain fluids, especially if you have high output.
Keep a Journal: Tracking your fluid intake and stoma output can help identify patterns and flag potential issues.

Conclusion

Staying properly hydrated is a cornerstone of health for anyone with an ostomy, particularly those with an ileostomy or urostomy. By understanding how fluid balance is affected, recognizing the signs of dehydration and electrolyte imbalance, and adopting strategic drinking and eating habits, ostomates can significantly reduce their risk of complications. Consistent, mindful hydration—focusing on the right fluids, especially ORS, and paying attention to your body's signals—is the key to feeling your best and living a full, active life.

Frequently Asked Questions

Dehydration is a greater risk for ostomates, particularly those with an ileostomy, because the colon—which normally absorbs water and salts—is no longer in use. This leads to higher-volume and more liquid output, causing greater fluid and electrolyte loss.

While drinking water is important, it is often not enough for ostomates. Water alone doesn't replace the lost electrolytes, like sodium and potassium. It's crucial to also consume electrolyte-rich fluids, such as Oral Rehydration Solutions (ORS).

If you experience high stoma output (over 1.2-1.5 liters in 24 hours), focus on sipping Oral Rehydration Solutions (ORS) and limit other liquids. Separate fluids from meals by waiting 30 minutes before and after eating, and incorporate foods that help thicken stool, like bananas and rice.

Sports drinks can be helpful for general fluid replacement during exercise or in hot weather. However, many are high in sugar, which can increase stoma output. For serious dehydration, Oral Rehydration Solutions (ORS) are more effective.

Key signs of an electrolyte imbalance include muscle cramps, fatigue, confusion, swelling, and a rapid or irregular heart rate. These symptoms warrant prompt attention to replenish electrolytes.

Foods with high water content can aid hydration, including melon, cucumbers, and watery soups. Additionally, foods like bananas, rice, and applesauce can help thicken stool and slow transit time, improving fluid absorption.

To maintain consistent hydration, try carrying a reusable water bottle, setting hourly alarms or using hydration tracking apps, and sipping fluids frequently instead of waiting until you feel thirsty.

An ORS is a drink containing a specific balance of sugar, salts, and water that is absorbed quickly by the body. It is used to effectively rehydrate and replace electrolytes, and can be purchased over-the-counter or made at home.