This topic is about a person who has been dealing with some challenging health issues after receiving a permanent ileostomy in December 2021. Initially, things seemed to be going well, but starting in April 2024, she began experiencing high output from the ileostomy, leading to severe dehydration and kidney problems. Despite multiple hospital visits and tests, the exact cause of her symptoms remains unclear. Here are some insights and advice that might be helpful:

1. High output from an ileostomy can be expected when a significant portion of the small bowel is removed. Dietary changes to thicken the output often don't help much.
- Medications like Lomotil or loperamide (Imodium) taken regularly can help reduce the output.

2. Hydration is crucial:
- Use oral rehydration solutions instead of drinking large amounts of plain water, which can worsen dehydration.
- Opt for low-sugar or no-sugar formulas, as too much sugar can increase bowel output.
- Consider using commercially available low-sugar electrolyte powders or making a home-made oral rehydration solution like St. Mark’s Solution, which includes sodium chloride, sodium bicarbonate, potassium chloride, and glucose. Adding liquid magnesium might also be beneficial.
- Limit daily intake to about 0.5–1 liter of these balanced fluids rather than consuming large volumes of water or sugary sports drinks.

3. Be aware of medication history and potential risks:
- Some medications can weaken the bowel walls, increasing the risk of perforations. It's important to review any medications with healthcare providers.

4. Seek support and a second opinion:
- It's important to work with medical teams that take symptoms seriously. Seeking a second opinion, especially at a specialized center, can provide new insights and possibly uncover overlooked causes.