This topic is about how often people with an ileostomy should change their pouches. A new ileostomate is trying to figure out the best routine for themselves, as they sometimes find they need to change their pouch multiple times a day. They are also experimenting with chewable Metamucil gummies to help manage their output. Here are some insights and advice from others who have experience with ileostomies:

- Some people change their pouches every day, especially if they sweat a lot.
- Others change every other day, often in the early morning when output is minimal.
- Some change every 3 days, as recommended by an ostomy nurse, when the wafer and ring start to degrade.
- For those with high output, changing every 3-4 days is common.
- Some manage to go 4-5 days, or even up to a week, but never more than 7 days.
- A twice-a-week schedule, such as Monday and Friday, works for some using a Hollister two-piece system.
- A few can stretch it to once a week, around 7-8 days.

General advice for those using a drainable system is to change the pouch only when there is leakage, odor, wafer erosion, or heavy sweating. Otherwise, just empty the pouch.

For cleaning a drainable pouch:
- Fold the Hollister Lock-and-Roll tail backward to keep output off the Velcro.
- Rinse the inside with water after emptying, and keep a water bottle, wipes, and deodorizer drops handy.
- Use flushable or baby wipes to clean the tail; minor staining is cosmetic and not a reason to replace the pouch.
- If the tail develops pinholes, you can snap on a new pouch if using a two-piece system.

To improve wear-time and skin seal:
- Try different brands if you need to change multiple times a day.
- Barrier rings, especially moldable ones, can be very effective in preventing leaks.
- Offset the wafer opening slightly if the stoma is close to the navel.
- Some recommended products include Hollister two-piece systems, Coloplast SenSura Mio, and Coloplast Mio Flip.

For thickening or slowing ileostomy output:
- Foods like bananas, rice, potatoes, mashed cauliflower, applesauce, and marshmallows are recommended.
- Taking 2 mg of loperamide about 2 hours before bedtime can significantly reduce emptying frequency.
- Be cautious with Metamucil or fiber supplements, as they can have different effects on different people.
- Limit high-sugar drinks, regular soda, and caffeine; opt for zero-sugar or low-sugar sports drinks.

Additional practical tips:
- Do major changes when the stoma is "asleep" (early morning) to minimize mess.
- Expect to empty a drainable pouch many times daily (5-10+); this is normal and doesn't mean the whole appliance needs replacement.
- Over time, you'll develop a routine that balances cost, skin health, and comfort.