For ostomates, seasonal changes can bring noticeable differences in stoma output. The cold winter months can affect digestion, hydration, skin condition, and daily routines—all of which influence how a stoma behaves. Understanding why these changes occur and how to manage them can help improve comfort, confidence, and overall stoma care during colder months.
How Cold Weather Affects the Body
During winter, our bodies naturally respond to lower temperatures by conserving heat and energy. Blood flow is prioritised to vital organs, and we tend to sweat less. These physiological changes can impact digestion and fluid balance. Additionally, many people adjust their diet and reduce activity levels during winter, which can also affect stoma output.
Hydration and Output Consistency
One of the most common winter-related changes for ostomates is that their stoma output may appear thicker. In colder months, people often drink less water because they feel less thirsty. Hot drinks like tea or coffee may replace plain water, but these can have a mild dehydrating effect. Opt for decaffeinated tea or coffee and herbal fruit teas for hydration and variety.
For ileostomy patients particularly, reduced hydration can lead to this thicker output and increase the risk of dehydration or blockage. Watch for signs such as darker urine, fatigue, dizziness, or very thick stoma output. Make a conscious effort to sip fluids throughout the day—even when you don’t feel thirsty. Try to limit or avoid alcohol, as it can also be dehydrating. Many people take part in Dry January, an annual challenge by Alcohol Change UK, where participants give up alcohol for the month to reset their relationship with it.
Dietary Changes
Winter diets often lean toward heavier, comfort-style foods such as soups, stews, casseroles, bread, and sometimes processed meals. While these can be nourishing, they may also be lower in fibre or higher in salt, fat, and starch, which can alter stoma output.
- Those with a colostomy, may find their output becoming more constipated or irregular due to reduced fibre intake. Introducing fruits and vegetables, fruit juices, prunes, and slowly increasing grains such as porridge and bran whilst increasing the amount of water in your diet can help .
- Individuals with an ileostomy may find the winter diet helps to thicken their output with starchy foods such as potatoes, pasta, rice and white bread, apple sauce or increase in volume with certain soups and hot drinks.
- Urostomy output may become more concentrated if fluid intake drops, so try to look at your fluid intake and stick to any advise given to you by your hospital or community stoma team. Monitor your urine output looking for signs of dehydration such as dark cloudy urine. Try herbal teas and look at ways of adding electrolytes.
Reduced Exercise
Shorter days, colder weather, and icy conditions often lead to less physical activity in winter. Movement stimulates digestion, so reduced activity can slow bowel function—especially for colostomy patients—resulting in firmer stools or decreased output frequency. Gentle indoor activities like stretching, light housework, or short walks outdoors can support healthy digestion and a more predictable stoma output.
Skin and Appliance Considerations
Winter conditions can affect the skin around the stoma and the performance of stoma appliances. Cold, dry air and indoor heating can dry out peristomal skin, making it more sensitive or prone to irritation. Thickened output may also increase the risk of leaks if it doesn’t flow easily into the bag.
Adhesive performance can change in cold temperatures. Bags may feel stiffer when cold, reducing adhesion if applied straight from a chilly environment. Store supplies in a warm place and warm the bag between your hands or under clothing before application for a better seal.
Illness and Medication
Winter illnesses such as colds, flu, and stomach bugs can affect stoma output. Feeling unwell often reduces appetite, increasing dehydration risk and causing output changes. Monitor your output closely during illness.
Eat small, frequent meals of easily digestible, bland foods, and stay hydrated with water, squash, or herbal teas. If output becomes looser, avoid high-fibre foods and focus on starchy options like bananas or jelly babies (if not diabetic).
Be cautious with over-the-counter remedies. Some cold and flu medications contain codeine, which can thicken and slow stoma output. Decongestants may cause mild dehydration, so compensate with extra fluids. Tablets with enteric or slow-release coatings may not fully break down in ileostomy patients and could appear in the bag—consult your pharmacist for alternatives.
When to Seek Advice
While seasonal changes are normal, significant or persistent changes in stoma output should not be ignored. No stoma output, a very high output, ongoing constipation, abdominal pain, nausea, or signs of dehydration warrant advice from a healthcare professional. If you are worried, try speaking with your stoma care nurse or GP for advice and support.
