Do people with an ileostomy metabolize medication differently?

Hi @g13 and welcome to Mayo Clinic Connect. I also added your post to the Ostomy group that can be found here https://connect.mayoclinic.org/group/ostomy/ so that you can get the opinions of more members that have an ileostomy. I have gastic issues as well and my physicians stated that coated pills and time released medicines may pass to quickly depending on how much working intestine you have.
Did your doctor prescribe a time release medication for you?

I pass most larger hard coated pill medication without being mostly digested. This is why, when available, I request the medicine in liquid form

That is what I do too because I don’t digest thrn either

Yes, they do

IM works best if you are trained to give injections, this way the medication does not go through the intestines. If you have Crohn's with an ileostomy, the large intestine absorbs anything ingested. This is why medication dosages may change depending on if the disease is active or in remission. I have taken pills for Crohn's and they were not absorbed. I could tell this as I saw the whole medication in my ileostomy output. Everyone is different. I have lived with Crohn's for 50 years.

Yes, I've seen medication come out whole. I take medication with meals, if I have to.

I am interested to know about the metabolism of meds with an ileostomy? --- Should meds be regulated differently? I am learning to cope with an ileostomy and am happy to discover this Mayo clinic support group!

I've been an ileostomy'er for 22 years, now 71 years old, and have just been diagnosed with ankylosing spondylitis by a rheumatologist. Been suffering from Back, Hip, Knee, Kidney stone, Muscle ache, nausea pain for 14 years, and now Neck and Shoulder Pain. I also have been curious how fast oral medicines pass through the body of a person without a colon ( ileostomy patent )? I fear the new med that is being proscribed for me, after reading the warning of the side effects of HUMIRA.

G13, you may also wish to join the discussions about ankylosing spondylitis in the Autoimmune Diseases group https://connect.mayoclinic.org/group/autoimmune-diseases/

Might the medications for AS be available in oral liquid form or as an injection as suggested by @kenc and @steve1k ?

Liquid, needle or pill if it still has the same side effects it's something I don't want.