The topic at hand is about using Imodium (loperamide), an over-the-counter medication, to help reduce the wateriness of ostomy output. This can be important for those looking to decrease the risk of dehydration. Here are some insights and advice from people who have shared their experiences:

1. Effectiveness
- Many people find that Imodium effectively thickens their output and slows down gut movement. Some even describe it as a "game-changer" for managing high-output ostomies. However, a few have noticed little to no benefit.

2. Dosage and Timing
- A common starting dose is 2 mg (one tablet) once a day, with many adjusting to 2–4 mg twice daily, in the morning and evening.
- Those with higher output might take 3 doses of 2 mg per day, 4 mg four times a day, or start with 24 mg/day post-surgery, tapering to 4 mg/day later.
- Liquid Imodium is also used, with doses ranging from 10–30 ml or 30 ml four times daily.
- It's recommended to take Imodium 20–30 minutes before meals, or an hour before if transit is very fast. Some add a bedtime dose to manage nighttime output.
- Tablets dissolve faster than capsules, and prescription bottles can be more convenient and cost-effective than blister packs.

3. Duration and Frequency
- Imodium acts quickly, but its effects wear off within hours, so any accidental over-dosing usually resolves on its own.
- Some people use it only for travel or on high-output days, while others take it daily for extended periods.

4. Side Effects and Cautions
- Most users report no side effects, but there is a risk of blockage if doses are too high. One person experienced obstruction at 16 mg/day.
- It's crucial to maintain hydration, as thickening output doesn't proportionally reduce fluid loss.
- Chronic dehydration poses a greater risk to kidney health than the medication itself.

5. Hydration and Electrolyte Support
- Options include oral rehydration salts (ORS), IV saline, Ultima Electrolyte powder, coconut water, adding salt to food, and salt tablets.

6. Food-Based Alternatives or Supplements
- Some people use Metamucil/psyllium, mashed potatoes, bananas, applesauce, rice, pasta, toast, marshmallows, gummy candies, and pretzels.
- Once output stabilizes, some rely solely on diet, using Imodium only during flare-ups.

7. Other Medications
- Lomotil (diphenoxylate/atropine) is sometimes alternated with or added to Imodium.

8. Practical Tips
- Start with a low dose, assess the effects, and adjust as needed. Keep some tablets handy for emergencies or travel.
- If output becomes too thick, reduce the dose and increase fluid intake.
- Consult with a WOC nurse or GI doctor, as many have received formal approval for long-term use.
- Prescription loperamide covered by insurance is often cheaper and comes in larger bottles without blister packs.

These insights come from various users who have shared their experiences with managing ostomy output using Imodium and other methods.