This topic is about dealing with the challenges of an ileostomy, specifically when the bag fills up too quickly at night, leading to leaks and exhaustion. Here are some practical suggestions and insights to help manage this situation:

1. Consider using a high-capacity or high-output pouch for nighttime:
- Check with your supplier for "high volume" or "high output" systems, as most major brands offer them.
- Some people find success with extra-large high output bags or even long-drain urostomy-style bags if the output is mostly liquid.

2. Reinforce the seal to prevent leaks:
- Use a barrier ring, such as those from Hollister or Eakin, with each change. Warming your hands over the wafer for a few minutes can help secure adhesion.
- Consider using products like Confiplus for additional leak protection.

3. Reduce gas and "ballooning":
- Determine if the pouch is filling with air or stool. If it's gas, try simethicone or other over-the-counter gas relief tablets.
- Avoid carbonated or caffeinated drinks and other gas-forming foods in the evening.

4. Thicken the output to slow down filling:
- Eat thickening foods later in the day, such as potatoes, bananas, peanut butter, marshmallows, pretzels with peanut butter, rice-crispy treats, riced cauliflower, and other starchy tubers.
- Continue with soluble fiber like Metamucil if it is well-tolerated.
- Take loperamide (Imodium) 2 mg about 2–3 hours before bedtime; some find taking it nightly beneficial.
- Opt for small, frequent snacks during the day and reduce large fluid intake late at night.

5. Manage hydration:
- For those experiencing high liquid loss, use a homemade rehydration mix (water, salt, sugar, and a flavor packet) throughout the day to prevent dehydration.

6. Be patient and expect improvement over time:
- Many people with an ileostomy find that their output naturally thickens and nighttime activity decreases within the first year as the small bowel adapts.

7. Seek emotional support:
- Joining local ostomy support groups can provide valuable tips and help in coping with lifestyle changes.