This topic is about managing fiber intake when you have an ileostomy and are starting treatment with a medication called Zepbound (tirzepatide). This medication, which is also known as Mounjaro, is a GLP-1 agonist and can often cause constipation. Typically, patients are advised to increase their intake of dietary fiber, protein, and water to counteract this side effect. However, if you have an ileostomy, you might wonder whether to follow these high-fiber recommendations or stick to naturally occurring fiber. Here are some insights and advice from others who have been in a similar situation:

1. People using tirzepatide with an ileostomy have noticed:
- A significant slowing down of stoma output.
- Firmer stool consistency and less frequent output.
- They could stop using Imodium because the medication itself helps thicken the output.

2. It is a good idea to pause using Imodium when starting Zepbound. Using both could slow down gut transit too much, potentially leading to blockages.

3. Instead of focusing on generic high-fiber goals:
- Make sure to stay well-hydrated and maintain adequate sodium and potassium levels to balance the reduced but still liquid output from the ileostomy.
- If you decide to add more fiber, do so gradually and carefully, as a sudden increase can risk causing an obstruction.

4. A dietary approach that has worked for others is to eat regular foods but in smaller portions. There is usually no need for special fiber supplements unless your doctor specifically recommends them.