Effect of codeine phosphate, Lomotil, and Isogel on iileostomy function

Area of Science:

• Gastroenterology
• Clinical Pharmacology
• Surgical Patient Management

Background:

• Ileostomy output management is crucial for patient well-being.
• Fluid and electrolyte balance is a significant concern for ileostomy patients.

Purpose of the Study:

• To evaluate the effects of codeine phosphate, Lomotil, and Isogel on ileostomy function.
• To determine the impact of these agents on ileostomy output volume, composition, and transit time.

Main Methods:

• A randomized, controlled trial involving 20 ileostomy subjects living at home.
• Subjects underwent two three-day periods, one on treatment and one off.
• Measurements included ileostomy output weight, water, sodium, potassium, and fecal solids.

Main Results:

• Codeine phosphate significantly reduced ileostomy output weight and water/electrolyte losses (p < 0.05).
• Lomotil demonstrated a trend towards reduced output but only significantly decreased sodium and potassium losses (p < 0.05).
• Isogel significantly increased ileostomy output of water, electrolytes, and solids (p < 0.01), potentially worsening dehydration.

Conclusions:

• Codeine phosphate offers a beneficial effect on ileostomy function by reducing fluid and electrolyte losses.
• Lomotil has a similar but less potent effect at the tested dosage.
• Isogel exacerbates fluid and electrolyte depletion in ileostomy patients and should be avoided in cases of excessive output.