This topic is about someone who has had an ileostomy for 18 months and recently joined the Slimming World weight-loss program. After losing 1 stone (14 pounds) in 7 weeks, they experienced a severe kidney malfunction and dehydration, leading to hospitalization. They are concerned that the dietary changes they made, such as cutting out processed foods, salt, and sugary items, might have contributed to this health issue. They are reaching out to see if others with an ileostomy have had similar experiences while following the Slimming World program.

Here are some helpful insights and advice for those with an ileostomy:

1. General hydration risks with an ileostomy:
- People with an ileostomy often lose large amounts of fluid and electrolytes, making them prone to chronic dehydration and kidney stones.
- Hospital visits for IV fluids, low potassium, and procedures like stent placement between the kidney and bladder are not uncommon.

2. Monitor hydration and electrolytes:
- Keep an eye on urine color, use the skin-turgor "pinch" test, and get regular blood work to check electrolytes and kidney function.
- Nephrologists often recommend drinking 8–10 glasses of fluid daily and having monthly lab tests.

3. Water alone is not enough – replace sodium and glucose:
- The small bowel absorbs water effectively only when sodium and glucose are present in the right ratio.
- The World Health Organization suggests an Oral Rehydration Solution (ORS) made with 25 g sugar and ½ tsp salt per 1 liter of water.
- A quick method is to split 1 quart of regular (not sugar-free) Gatorade into two bottles, add ½ tsp salt to each, top up with water, and sip throughout the day.
- Some doctors recommend a bottle of Gatorade daily or a 50/50 water–Gatorade mix, while others prescribe sodium bicarbonate tablets.

4. Do not over-restrict salt:
- Since ileostomies excrete sodium quickly, a modest salt intake is necessary. Some surgeons advise patients to "salt everything."

5. Weight-loss pace:
- Losing about 2 pounds per week might be too fast for some with an ileostomy, as rapid weight loss can worsen electrolyte imbalances.

6. Kidney stones and specific management:
- Those with an ileostomy are more prone to calcium-oxalate, uric-acid, or bacterial stones.
- If you pass a stone, have it analyzed to guide dietary adjustments, such as low-oxalate or low-potassium diets.
- Low urinary citrate can be addressed with a prescription citric-acid/sodium-citrate solution.

7. Practical tips:
- Keep water or ORS handy and sip constantly, especially in hot weather or during exercise.
- Consider weekly outpatient saline infusions if oral intake isn't sufficient.
- Avoid excessive protein-only drinks unless approved by a doctor.
- Consult a dietitian experienced with renal issues and ileostomies to adapt Slimming World menus.