This topic is about managing the challenges of having both an ileostomy and a colon-conduit urostomy, especially when dealing with very high output and severe dehydration. The person sharing their experience is facing significant health issues, including infections, skin problems, and dehydration, despite using various medical treatments and appliances. Here are some insights and advice shared by others who have faced similar situations:

1. Medication to Reduce Effluent
- Distilled Tincture of Opium (DTO) can significantly slow down ileostomy output, but be aware of the risk of dependence.
- Other anti-diarrheal medications like Imodium, Lomotil, and Questran have been tried; it's important to use what works for you and stop those that don't help.

2. Persist with Specialists
- Consult with a gastroenterologist and an experienced stoma nurse, as general practitioners may not have enough expertise.
- Consider seeking second opinions, especially from centers that specialize in high-output ostomies.

3. Fluid and Electrolyte Strategy
- Be cautious with electrolyte drinks, as they can sometimes worsen diarrhea. Some have found improvement by stopping drinks like Smart Water and Propel.
- For high-output situations, a dietitian might recommend milk with Dioralyte and avoiding plain tea or water.
- Potassium-rich drinks like Gatorade can be helpful if tolerated.
- A short hospital stay might be necessary to correct imbalances in sodium, potassium, magnesium, and creatinine.

4. Appliance Changing Techniques During Heavy Flow
- Eating 2-3 marshmallows a few minutes before changing the appliance can help slow output.
- Briefly holding an ice cube on the stoma or using a small KY-lubricated mini-tampon can pause the flow long enough to clean and dry the skin.

5. Skin Protection and Wafer Security
- Cut wafers precisely to fit the stoma shape and stretch out skin folds when applying.
- Apply skin-prep (no-sting barrier film) only on exposed skin after the wafer is on, and dust raw areas with stoma powder first.
- Warm the wafer with your hand for several minutes to help the adhesive and Eakin seal or paste meld.
- For urostomy, some use moldable two-piece systems and apply extra skin prep on uncovered skin.
- Use adhesive-removal wipes to minimize trauma during changes.

6. Products That Thicken or Absorb Effluent
- Ileo-Gel (Eakin Ileo-Gel) is recommended by several people as it solidifies liquid output, reducing skin contact.

7. General Support
- High output can be exhausting, and dehydration in the mornings is common. Keep advocating with your medical team until a workable plan is found.
- Although it might be undesirable, hospital admission is often the quickest way to stabilize electrolytes and fluid balance.