This topic is about managing chronic diarrhea for someone with an ileostomy, specifically considering the use of Metamucil, a fiber supplement, to help thicken the output. The person is also thinking about using it alongside their prescribed medication, Lomotil.

Here are some helpful insights and advice shared by others:

1. The person confirmed that they have true diarrhea, as diagnosed in the hospital, and is curious if Metamucil can be used with Lomotil. In the hospital, they were given 2 tablespoons of Metamucil mixed with 8 ounces (240 ml) of water per dose.

2. Regarding fiber and Metamucil doses:
- One person with very loose ileostomy output was advised to take Metamucil, 3 tablespoons, three times a day.
- Another person with a J-pouch manages diarrhea by taking Metamucil four times daily along with Imodium.
- It's important to adjust the amount of water used (one person used 8 ounces for 2 tablespoons) and to keep an eye on the consistency of the output.

3. On the effectiveness and cautions for ileostomy:
- Many with ileostomies note that the output will generally remain more liquid compared to a colostomy; Metamucil might help a bit but won't create solid stool.
- One person with an ileostomy advises against Metamucil due to the risk of blockages, while another mentions that results can vary, and consulting a doctor is crucial.

4. Alternative medications and products mentioned:
- Lomotil (diphenoxylate/atropine) is already prescribed to the person.
- Imodium (loperamide) is an over-the-counter option often used with fiber to slow down output.
- Milk of Magnesia (MOM) is used by a long-term ileostomate for blockages, not for diarrhea control, but it shows how needs can differ.
- Pepto-Bismol or other bismuth subsalicylate products can help reduce diarrhea and control odor, as they also act on gut bacteria.

5. General guidance:
- Always check with a gastrointestinal physician or a Wound, Ostomy, and Continence Nurse (WOCN) before making any changes, like using Metamucil, Imodium, Pepto, or MOM.
- Ileostomy patients have a higher risk of blockages, so it's important to increase fiber or thickening agents carefully and with enough fluids.
- Clearly identify your type of ostomy when sharing or seeking advice, as management can vary significantly between ileostomy, colostomy, and J-pouch users.