This topic is about a person who has had a radical cystectomy with an ileal conduit and is now getting back into long-distance running. They are experiencing an issue where their urine turns dark-red when using a horizontal Stealth Belt, but not with a vertical one. They suspect this is due to mechanical reasons and are seeking advice to continue running comfortably and safely.

Here are some helpful tips and insights:

1. Check the flange opening and edge finish:
- Ensure the hand-cut hole in the wafer is perfectly smooth. You can use a warm hair-dryer or rub your finger around the edge to remove any sharp spots.

2. Cushion and protect the stoma:
- Consider adding a barrier ring if you haven't already, or switch to a softer, swellable ring for extra cushioning, like the Hollister Adapt.

3. Verify fit and pressure:
- Bleeding might be caused by the wafer, ring, or belt being too tight, or from the stoma rubbing. Check the tightness and inspect the stoma for any raw areas during each change.

4. Consider appliance alternatives:
- Some people find the Coloplast SenSura Mio Click 2-piece system, including the deep-convex option, to be less rigid than Hollister products, which might reduce friction during movement.

5. Modify pouch length/position:
- If you don't need the full pouch capacity while running, try folding the tail up and clipping it. This allows you to wear the pouch vertically but shorter, which can improve comfort.

6. Reduce impact or change activity:
- To lessen the repetitive jarring on the stoma area, consider substituting some runs with brisk walking or cycling.