This topic is all about finding the best ways to sleep comfortably and avoid leaks at night for someone with a right-sided ileostomy. Here are some helpful tips and insights:

- The person initially wore their pouch vertically, but due to leaks, they started rotating it sideways with the drain pointing to the right. This allowed the output to drop away from the stoma while sleeping on the right side. However, this position caused sharp waist and nerve pain, especially with warm output against the skin, which is slow to heal due to chemotherapy.

- Elevating the upper body worsened back pain, so they are looking for alternative sleeping positions, pillows, or appliance setups that prevent leaks without causing discomfort.

- They cannot use their usual 2-piece wafer because a mid-line hysterectomy incision prevents the larger flange from sticking. They are 163 cm tall and weigh 45.5 kg, and the pouch lies very flat when worn vertically.

- They use cooling gel pads for abdominal pain and have found a routine that helps: having the last meal before 19:00, emptying the pouch at bedtime, wearing the appliance vertically but slightly tilted to the right, and using maternity underwear and a long night-shirt to support the pouch.

- Products tried include Alcare one-piece (current appliance), Convatec Active (wafer too large), and Stomahesive powder & paste with skin-barrier wipes, which have reduced leaks. They have no access to stoma nurses and are learning by trial and error.

Advice and insights include:

1. General Sleeping Positions:
- Many people with ileostomies sleep on their left side first and then alternate sides. Some avoid lying flat on their back to prevent output pooling.
- Recliner chairs or a foam wedge can keep the torso angled so output flows down the pouch.
- A pregnancy pillow, wedge, or regular pillow between the knees can add stability and ease back strain.

2. Appliance Orientation/Systems:
- Keeping the pouch vertical at night helps gravity draw output away from the stoma. Two-piece systems allow rotation from horizontal to vertical after getting into bed.
- Horizontal wear can work during the day, but rolling onto that side may compress the pouch and cause blow-outs.
- Leaks often indicate wafer/skin-contour issues, not pouch direction. Consider convexity, an O-ring, or a different brand.
- Some users found that SenSura Mio 2-piece bags stopped leaks completely.

3. Skin Protection and Sealing:
- Using Stomahesive powder and paste over a skin-barrier wipe forms a stronger seal and prevents paste from melting, resolving excoriation and leaks.
- Long T-shirt fabric folded between the pouch and skin, or tucking the pouch into maternity/high-waist underwear, prevents rubbing and supports the weight of a filling bag.
- Cooling gel pads can ease local nerve pain from warm output.

4. Drainage and Diet Timing:
- Empty the pouch immediately before bed and set an alarm or get up once during the night.
- Stopping food by 19:00 reduces nocturnal output, and drinking water at bedtime thins output.
- A squirt of pouch lubricant/deodorizer helps output slide to the bottom and prevents pancaking.

5. Miscellaneous:
- Back sleepers using CPAP can tip the pouch slightly to the side without leaks.
- Rolling side-to-side throughout the night keeps output moving and relieves prolonged pressure on one hip.