This topic is about managing high ileostomy output, which can be quite challenging and stressful. The person dealing with this issue is looking for effective medication strategies and daily routines to help slow down the output. Here are some helpful suggestions and insights:

1. Medical follow-up
- It's important to consult with a colorectal surgeon, gastroenterologist, or certified ostomy nurse, especially when taking high doses of medications like loperamide and tincture of opium.

2. Stress and routine management
- Stress can increase bowel activity, so finding ways to reduce anxiety and accepting the need for frequent emptying can be beneficial.
- Understanding your "bile-dump cycle" can help you plan activities like showering, driving, and changing your ostomy barrier during times when output is predictable.

3. Showering tips
- You can keep your appliance on while showering and dry it afterward with a towel or hair-dryer.
- If you prefer to remove it, cover the stoma with cling wrap or tape, or time your shower right after a bile dump.

4. Medication experiences from others
- Some have found that taking liquid Imodium before long car rides can reduce output temporarily.
- Diphenoxylate-Atropine (Lomotil) has helped some people more than other medications, but it can numb the stoma, so tapering off slowly is advised.
- Tincture of opium hasn't been beneficial for everyone.
- For those with true short-bowel syndrome, medications may have limited effects because the issue is more about gut length than speed.

5. Diet approaches
- Eating "thickening" foods like white toast with peanut butter, bananas, applesauce, and canned fruits can help.
- Keeping the digestive tract comfortably full throughout the day can reduce the flush-through of liquids and gas.
- Some people avoid excessive simple carbs and use fluid-absorbing sachets in the pouch to reduce emptying frequency.

6. Hydration and electrolyte management
- High-output ileostomates are at risk of dehydration, and plain water can sometimes worsen output.
- Oral rehydration solutions (ORS) that are hypotonic can help maintain electrolytes and reduce effluent volume. Brands like Liquid I.V., Nuun, DripDrop, SOS, Hydrant, Vitalyte, and Pedialyte are recommended.

7. Supplement and absorber ideas
- Banana flakes available on Amazon may help slow effluent.
- Pouch fluid-absorbing sachets can thicken output and extend the time between emptying.

8. Educational resources
- Websites like www.shortbowelsyndrome.com, www.ostomy.org, and the Crohn’s & Colitis Foundation offer valuable guides and information.
- An article titled “A Clinician’s Guide to Short Bowel Syndrome” by Carol Rees Parrish, RDH, is available online.
- To find a dietitian experienced with short gut or ostomy, visit www.healthprofs.com.

9. Key takeaways
- Medication alone may not be enough to manage high output with a short gut. It's important to combine smaller, timed doses, diet adjustments, ORS, stress management, and careful planning.
- Any changes in medication, especially high doses like 26 loperamide tablets a day, should be supervised by a knowledgeable physician.