This topic is all about finding ways to stop leaks for those with a high-output ileostomy. If you're dealing with this issue, here are some practical tips and insights that might help:

1. **Check Stoma Profile and Wafer Fit**
- Measure your stoma carefully each time you change your appliance and adjust the opening size as needed.
- If your stoma sometimes retracts or sits low, consider using a light or deep convex wafer.
- Think about surgical revision only if your stoma is consistently flush or below skin level.

2. **Skin Preparation Basics**
- Clean the area with plain water or mild soap, then rinse with water only. Avoid oils, creams, or moisturizers.
- Make sure to remove all adhesive remover before applying a new wafer.
- Ensure your skin is completely dry before application.

3. **Barrier Rings and Films**
- Many find barrier rings essential; press them firmly onto the wafer to avoid slipperiness.
- Use a no-sting barrier film over the entire wafer area to improve adhesion.
- Some prefer a "less is more" approach: using a deep convex wafer plus a belt without rings or paste to reduce failure points.

4. **Extra Adhesion Techniques**
- After heating the wafer, keep a warm hand pressed over it for more than 5 minutes to set the adhesive.
- Press the whole system down firmly with your palms after attaching the pouch.
- Apply very sticky paper tape over any edge that starts to lift.
- Wearing a support or hernia belt 24/7 can extend wear time to 10–15 days.

5. **Surface Prep Variations**
- Some users wipe the peristomal skin with 91% isopropyl alcohol, let it dry, then apply multiple layers of barrier wipe, drying between coats, before adding a sticky barrier ring.

6. **Custom Baseplates and Inserts**
- Homemade baseplates cut to the exact stoma shape and fixed with prosthetic glue can eliminate gaps.
- Tapered plastic inserts or 90° "waste-bends" inside the pouch guide output downward and away from the skin.

7. **Controlling Output Consistency**
- Aim for a "just thick enough" consistency by adjusting your diet, timing fluid intake, and using medicines like Imodium.
- Reduce very fibrous foods or fiber supplements if output becomes pasty and causes pancaking; add modest fiber if output is too watery.
- Drink extra fluids when eating high-fiber meals to prevent overly thick, forceful output.

8. **Preventing Pancaking and Pressure Build-Up**
- Before closing the pouch, introduce a small air pocket at the top so the stoma can move and output can drop to the bottom.
- Avoid tight clothing or tucking the pouch inside the waistband; allow some "air space" to reduce back-pressure.

These strategies, including precise sizing, proper skin prep, correct convexity, secure belts/tapes, and managing output thickness, have helped others achieve leak-free wear times of 5–15 days.