This topic is about using proton pump inhibitors (PPIs), like Omeprazole and Pantoprazole, to manage ostomy output and slow down bowel motility. A person with a short-gut ileostomy shared their experience of trying Omeprazole to see if it could help with these issues. Here are some insights and advice gathered from their experience and others:

1. The person started taking Omeprazole 20 mg each morning before breakfast. After four days, they noticed thicker output and fewer bag emptyings, allowing them to stop their usual motility medications.

2. A surgeon mentioned that PPIs can slow motility, although the exact mechanism is unclear.

3. After a week on Omeprazole, the person experienced:
- A change in output consistency from liquid to oatmeal-like, leading to "pancaking."
- Less predictable emptying times, making it hard to establish a reliable "empty period."
- Larger undigested food pieces, indicating reduced stomach acid and poorer digestion, which is crucial for those with a short gut.

4. Concerns about long-term PPI use include potential vitamin and mineral deficiencies, risk of C. difficile infection, liver issues, and fractures. They plan to reduce the dose to 10 mg daily to find a balance between slowing motility and maintaining good digestion.

5. Some people find Pantoprazole (Protonix) more effective than Omeprazole. For instance, one person uses Pantoprazole 40 mg nightly without side effects, while Omeprazole caused headaches and potential vitamin B12 deficiency.

6. Ranitidine (Zantac) was effective for reflux and motility before it was withdrawn from the market, and Pantoprazole has been a good replacement for some.

7. Dosing and timing strategies vary:
- Some take Omeprazole only as needed at bedtime to reduce acid without affecting daytime absorption.
- A high-output ileostomate combines Omeprazole with Imodium and waits an hour before taking other medications or supplements to improve absorption.

8. Be cautious of side effects with long-term PPI use, such as increased risk of infections, deficiencies, and other health issues. Some users report no change in motility with 20 mg Omeprazole, while others find that Zyrtec (an antihistamine) unexpectedly slows output.

9. Practical tips include adjusting the PPI dose to regain predictability in emptying, as too high a dose may over-thicken output. Night-time dosing with reduced daytime use might help with nutrient absorption and reduce visible food chunks.

10. It's important to maintain regular B-complex supplementation and closely monitor nutrition when using PPIs, especially with a short bowel.

11. Other related medications mentioned include Loperamide (Imodium), Diphen-Atropine, Prednisone (for Crohn’s), and Zyrtec.