Topic Explanation
The discussion revolves around the safety and effectiveness of using Imodium (loperamide) to manage high output from an ileostomy and fistulas. The original poster, Poppie from Australia, mentions taking 8 Imodium tablets daily to slow down the output from their stoma, which is eight years old, and seeks advice on whether this dosage is safe or if there are better alternatives through medication or diet.

Extracted Advice and Helpful Insights
1. Imodium Dosage and Safety:
- The recommended initial dose for chronic diarrhea in adults is 4 mg, followed by 2 mg after each unformed stool, not usually exceeding 16 mg per day. If no improvement is seen with 16 mg per day after 10 days, further administration is unlikely to help.
- Some individuals have safely used higher doses under medical supervision, especially in cases of high output ileostomies, with doses varying significantly among individuals.

2. Alternative Medications:
- Some users have supplemented Imodium with other medications like DTO (Distilled Tincture of Opium) or Lomotil to manage high output.
- Questran has been mentioned as an effective alternative for managing output.

3. Dietary Adjustments:
- Incorporating the BRAT diet (bananas, rice, applesauce, toast) into daily meals can help manage output.
- Foods like bananas and oatmeal are recommended for their thickening properties and can make a significant difference in managing output.

4. Concerns and Cautions:
- There are concerns about potential side effects and risks associated with long-term or high-dose use of Imodium, including the risk of blockages and, in rare cases, more severe side effects like visual impairment from overdose.
- It's important to consult with healthcare providers to tailor both medication and dietary responses to individual needs and conditions, especially considering the presence of fistulas and the type of ileostomy.

5. Personal Experiences and Recommendations:
- Many individuals have shared their varied experiences with different dosages of Imodium, highlighting the importance of personalized treatment plans.
- Some have found no relief from Imodium, instead turning to alternative medications or dietary changes.
- Continuous monitoring and adjustments with the help of healthcare professionals are crucial, especially when standard approaches do not yield expected results.