This topic is about finding affordable options for purchasing loperamide in bulk, which is used to manage high output in individuals with short bowel syndrome. Here are some helpful insights and advice shared by others:

- Loperamide is available over-the-counter in the U.S., so no prescription is needed.
- One person follows a regimen recommended by the Mayo Clinic, taking 16 tablets daily by crushing them into applesauce. They also use Octreotide injections and morphine to help manage dehydration, although their output never fully solidifies.
- A future surgery is planned for a proctocolectomy due to radiation damage, with a meeting scheduled with a new surgeon.
- Dietary adjustments are important, and one person follows a specific diet for short bowel syndrome, experimenting with foods like red grapes to see what can be tolerated.

For those looking for cost-effective sources of loperamide:

1. Life Sciences Pharmacy offers 600 tablets for $35 with free shipping in the U.S. and UK.
2. An eBay listing provides 600 tablets for about $29 with free shipping.
3. At Costco in the U.S., you can ask the pharmacy counter for three 48-count boxes of Imodium, totaling around $3 for 144 pills.
4. Even though loperamide is OTC, a doctor can write a prescription, which might allow insurance to cover it at a reduced cost.

Dosing and timing tips include:

- Loperamide works quickly but doesn't last long, so frequent dosing is often necessary, such as four times a day or after each pouch emptying.
- Liquid or oral solutions might be more effective than tablets for very high-output cases.
- Some people gradually reduce from high doses to lower maintenance doses.
- New ileostomates are advised that long-term use is possible but should be monitored by a healthcare provider.

Additional medications and methods:

- Octreotide injections can slow gut motility but may affect pancreatic function and increase diabetes risk.
- Morphine and other opioids can thicken output but come with their own risks.
- Diphenoxylate-Atropine (Lomotil) is sometimes used alongside loperamide.

Dietary and non-drug strategies:

- Bananas are known to reliably thicken output for many.
- Small, measured amounts of foods that usually trigger output, like grapes, might be tolerated.
- Carol Rees Parrish’s guides on short bowel syndrome offer valuable information on hydration, eating, and bowel adaptation. These guides are available for free online.

General observations:

- Colostomy output timing can be less predictable than ileostomy, so experimenting with dosing schedules is common.
- Loperamide's effectiveness varies widely among individuals.

These insights and resources can help those managing high-output needs find effective and affordable solutions.