This topic is about the challenges people with an ileostomy might face when it comes to medication absorption. An ileostomy is a surgical opening created to allow waste to exit the body after the colon has been removed or bypassed. Sometimes, medications don't dissolve properly and can be found undissolved in the pouch. Here are some helpful tips and insights for managing this issue:

1. Always consult with a doctor or pharmacist before crushing any medication. Some tablets, like extended-release or enteric-coated ones, are not meant to be crushed as it can make them unsafe or ineffective.

2. Whenever possible, ask for alternative forms of medication:
- Liquid or chewable versions.
- Gel-coated capsules, which might be easier to absorb.
- Compounded immediate-release tablets that dissolve earlier in the digestive tract.

3. Avoid or replace extended-release medications, as they often pass through the system undissolved.

4. If a pill can be safely crushed, mix it with water, yogurt, or applesauce to help with absorption.

5. Eating something starchy, like bread, before taking vitamins or supplements can help slow down the digestive process. If the output is particularly fast, consider using loperamide (Imodium).

6. Fish-oil gel caps and some vitamin supplements may not dissolve properly. Consider liquid forms or other alternatives.

7. Always inform your doctors that you have an ileostomy so they can adjust your medication accordingly. Many healthcare providers may not be aware of the specific needs related to an ostomy.

8. Pharmacists can be a great resource for:
- Confirming if a tablet can be crushed or opened.
- Suggesting suitable replacements and contacting your doctor for a new prescription if needed.

9. For essential medications that cannot be reformulated, intravenous (IV) administration might be the most reliable option.

10. Some people may not notice undissolved pills if they use an opaque pouch or don't check the contents regularly.