This topic is about finding ways to prevent leaks for someone with an ileostomy, especially after significant weight loss and skin changes. The person in question is recovering from a stroke and wants to resume physical therapy without worrying about leaks. Here are some helpful tips and insights shared by others:

1. Seek Professional Help and Samples
- Schedule a session with an ostomy nurse to review how to apply the products correctly.
- Request free samples from different suppliers to find the best fit and formulation.

2. Use Hollister Adhesive Spray Wisely
- Consider it as an emergency fix when an edge starts lifting, not as a primary method to prevent leaks.

3. Reconsider Flange Size and Style
- Some have found success by switching to larger flanges, which can help prevent leaks.
- Avoid using separate hydrocolloid sheets or rings under the flange if they tend to channel output.

4. Follow Hollister’s Barrier-Fit Guidelines
- Measure the stoma with each change and ensure the barrier fits snugly with no skin showing.
- Use stoma powder on weepy skin and stop once it’s dry.
- Change the system regularly, typically twice a week, before it loosens or the pouch gets too heavy.

5. Support During Activity
- Wear supportive garments like ostomy wraps, running tights, or Lycra shorts, and always empty the pouch before exercising or engaging in intimate activities.

6. Use Convexity and Gap-Filling Products
- Convex barrier rings can help level out skin creases and prevent seepage. These can be purchased online if not available through your supplier.

7. Consider the Hollister New Image Two-Piece High Output Drainable System
- This system, when used with its adhesive ring and wafer, is reported to be very reliable, even during activities like swimming or running.

8. Pay Attention to Application and Removal Techniques
- Apply the barrier slowly and firmly, smoothing it from the stoma outward.
- Remove the wafer gently from top to bottom, supporting the skin to prevent damage and future leaks.

9. Manage Output
- Reducing dietary fiber, if medically appropriate, can thicken the output and reduce pressure on the seal, helping the barriers stay in place.