This topic is about managing chronic dehydration after ileostomy surgery. The person sharing their experience has faced several challenges, including multiple emergency room visits due to severe dehydration symptoms like nausea, vomiting, abdominal pain, and headaches. Despite efforts to stay hydrated, maintaining fluid balance has been difficult, and sometimes their symptoms are mistaken for panic attacks. Living alone and feeling depressed, they are seeking practical tips and reassurance on how to manage hydration effectively.

Here are some helpful insights and advice:

1. Consider using an oral rehydration solution (ORS) specifically designed for high-output stomas. Options include St Mark’s Solution (a recipe you can find online) or commercial powders like H2ORS, Liquid IV, Pedialyte, and Gfit. Some people dilute sports drinks like Gatorade or Powerade to reduce sugar content.

2. Sip fluids slowly and frequently rather than drinking large amounts at once. This helps improve absorption and prevents the loss of important electrolytes like sodium, potassium, and magnesium.

3. Plain water alone is not sufficient and can lower electrolytes if consumed in excess. Include electrolyte-rich sources in your diet at least a couple of times daily.

4. Some electrolyte-rich beverages and foods to consider are V-8 Juice, orange juice, coconut water, and milk. Salty snacks like pretzels, Fritos, and potato chips can help with sodium uptake. You can also make a homemade mix with water, lemon or lime juice, honey, and a pinch of salt.

5. To thicken output and reduce fluid loss, try incorporating fiber like psyllium husk powder (such as Metamucil) into your diet. Start slowly and consult with a healthcare professional, as some people may experience blockages.

6. Regularly check your serum sodium, potassium, and magnesium levels. You may need oral or IV supplementation. Imodium can be used to slow output if fiber is not tolerated.

7. Aim for about 64 ounces of fluid daily, taken in frequent sips. Limit caffeine and opt for decaf coffee or herbal tea if desired. Keep a bottle with you at all times and alternate between plain water and electrolyte drinks.

8. If home management isn't working, don't hesitate to seek emergency care. Request bloodwork to check electrolytes and renal function, and ask for IV fluids if needed. Some people have PICC lines for scheduled IV saline or TPN when dehydration is persistent.

9. Dietary adjustments that have helped others include eating half a banana daily for potassium, having oatmeal later in the day, and carefully adjusting medication doses under medical supervision.

10. Monitor your blood pressure, as excess sodium can raise it. Balancing sodium and potassium intake is important.

11. Experiment carefully with these suggestions, keeping track of your personal responses and adjusting in consultation with healthcare professionals.