This topic is about finding a solution to prevent leaks after ostomy surgery. Thirteen days post-surgery, the person was dealing with constant leaks, skin irritation, and watery output. An unexpected visit from a stoma nurse led to some changes that made a big difference. Here's what was done:

- The nurse assessed the bleeding and irritated skin around the stoma, as well as the very loose output that was causing issues with the pouch.
- They switched to a different one-piece appliance known as a "dimple" bag, which was chosen because the stoma sits in a shallow dip.
- The barrier film was changed from small wipes to a more robust spray for better protection.
- A large, stretchy moldable ring, similar to a "giant polo-mint," was added. This ring is warmed and shaped around the stoma opening to provide extra security.
- The dosage of Imodium (loperamide) was increased to 8 capsules per day, mixed into yogurt, to help thicken the output.
- The diet was adjusted to include foods that help firm up the output, such as white bread, rice, pasta, noodles, marshmallows, jelly babies, and gelatin desserts.

These changes resulted in the first completely leak-free day since the operation, which was a significant morale booster.

Here are some helpful tips and insights:

1. Stick with the nurse-recommended combination of a "dimple" one-piece pouch, heavy-duty barrier spray, and a moldable ring or seal to maintain a secure seal and protect the skin.
2. Using high doses of Imodium, as approved by a nurse or doctor, along with low-fiber, binding foods, can quickly thicken the output and reduce leakage.
3. Avoid lifting heavy objects or engaging in strenuous activities during early recovery, as this can lead to large parastomal hernias.
4. Humor, a positive attitude, and support from online groups can help many ostomates cope with leaks, body-image concerns, and lifestyle changes.
5. For those facing reversal surgery:
- Bowel prep may be limited to clear liquids after noon the day before surgery, with some surgeons adding an on-table stoma flush once the patient is anesthetized.
- If laparoscopic reversal is possible, the hospital stay is often about 5 days, but open surgery or extensive adhesions can extend this.
- Bring an iPad or phone for distraction and communication during the hospital stay.