Question:
I have an ileostomy and am in the 71–80 age group, living in Nova Scotia. I take several vitamin and mineral supplements daily, including vitamin D, vitamin E, calcium, turmeric, a multivitamin, and occasionally a fish oil supplement.
I’ve noticed that after taking them, I often experience very liquid output. I’ve tried to narrow down which supplement might be causing this, but I haven’t been able to identify the specific one.
Can you provide guidance on which supplements are best tolerated for people with an ileostomy, and whether any of the ones I’m taking are known to cause loose output?
Answer:
Based on the supplements you listed, it’s very likely that the fish oil is contributing to your loose output.
Fish oils are known to loosen stools, especially at higher doses (typically above 2–3 grams per day). At these levels, fish oil can act as a mild laxative, which may lead to or worsen liquid stool output in individuals with an ileostomy. This is especially concerning because increased liquid output can result in greater fluid and electrolyte loss, something ileostomates need to carefully manage.
Additionally, depending on how much of your small intestine remains, fat absorption may be impaired, reducing the effectiveness of fish oil supplements and potentially increasing side effects.
Things to avoid when choosing fish oil supplements as an ostomate:
- Enteric-coated capsules, which may pass through the system unabsorbed
- Cheaper ethyl ester forms, which are less absorbable and can irritate the gut
- High-dose capsules (more than 2 grams per day)
Tips for trying fish oil safely:
- Start with 500–1,000 mg total of EPA + DHA per day
- Take the supplement with a fatty meal (or with MCT/coconut oil if fat absorption is adequate)
- Monitor your ostomy output for at least 7–10 days before increasing the dose
As always, it’s important to speak with your healthcare provider before making any changes to your supplement routine.
Answered by
Shabita Teja
Pharmacist & Naturopathic Doctor
shabita@tejawellness.ca
Sinclair Wellness Centre
Office: 604.629.1120 | Fax: 604.683.2565
Unit 228-757 West Hastings St, Vancouver BC V6C1A1
The post Do Vitamin and Fish Oil Supplements Cause Liquid Output with an Ileostomy? first appeared on Ostomy Canada Society.