Managing night-time high output from an ileostomy can be a bit challenging, especially when caring for someone who has limited mobility, like a stroke survivor. If you're noticing unusually heavy output during the night, even when the person stops eating by 6 p.m., it can be puzzling. Here are some insights and tips that might help you understand and manage this situation better:

1. Normally, food takes about 4 to 6 hours to pass through an ileostomy. So, if the person eats around 6 p.m., the output might start filling the pouch between 10 p.m. and midnight. Additionally, the body's gut activity tends to slow down at night, which can cause the output to shift towards the early morning hours.

2. The level of hydration plays a big role in the volume and speed of stoma output. Ensuring the person stays well-hydrated can help manage the timing and consistency of the output. You might also consider using rehydration solutions that enhance absorption.

3. Since the person has limited mobility due to a stroke, this can slow down intestinal movement, which might change when the output appears.

4. It might be helpful to switch to a two-piece system with a higher-capacity pouch. This can accommodate larger night-time output and reduce the risk of the appliance detaching and leaking until the output becomes more stable.