This topic revolves around a 62-year-old woman who uses a wheelchair full-time and is experiencing decreased output from her ileostomy. She has had a prolapsed but non-functioning colostomy for seven years and a functioning ileostomy for three years. Recently, her ileostomy output has significantly reduced during the day and early morning, despite maintaining a diet of fresh foods, soft meals, and good fluid intake. She has also faced low sodium levels, leading to multiple hospitalizations, and experiences mild abdominal distension without vomiting or fever. Although doctors have noted bowel sounds, they have expressed little concern. She is seeking advice on what steps to take next.

Here are some helpful suggestions:

1. Seek further medical evaluation
- Insist on a CT scan to rule out any partial obstruction or other structural issues.
- Request checks for kidney function and potassium levels, and keep an eye on sodium levels.
- Consider getting a second opinion if the current medical team remains unconcerned.

2. Dietary and fluid strategies
- Avoid foods like popcorn and other high-insoluble-fiber items that might cause blockages.
- Increase fluid intake by sipping frequently rather than consuming large amounts at once to enhance absorption.
- Incorporate electrolytes, such as commercially available electrolyte powders or bottled electrolyte water, and add salt to food liberally to help maintain sodium balance.

3. General monitoring
- Keep a close watch on stoma output, as an ileostomy with little or no output while eating normally is unusual and should be addressed promptly.