Managing severe gastroenteritis-related ostomy leaks and high output can be quite challenging. This situation involves dealing with very high, watery output from an ileostomy, which can fill the pouch every 30 minutes. This frequent filling can lead to multiple appliance changes in a day, constant worry about nighttime leaks, and can cause skin irritation, sleep disruption, exhaustion, and weakness. Here are some helpful tips and advice to manage this condition:

1. If you experience significant weakness or signs of dehydration, it is crucial to seek immediate medical attention. Many people recommend going to the emergency room for intravenous fluids and a thorough evaluation.

2. To stay hydrated, consider drinking electrolyte solutions like Gatorade G2 "Rain" to replenish fluids and salts lost due to frequent emptying.

3. For appliance adjustments:
- Try using a Marlin pouch with shallow convexity, as it may adhere better and reduce the risk of blow-offs during high-output episodes.
- Have a stoma nurse re-measure your stoma size. After surgery, the stoma can shrink, leading to mis-sized openings and leaks. Pre-cut wafers tailored to the new size can help prevent chronic leakage.

4. Protect your skin by changing appliances promptly and ensuring they are correctly sized. Consulting an ostomy nurse for barrier recommendations can help prevent further skin damage.

5. Consider output-control medications and bulking agents, but only under medical supervision:
- Some high-output patients have been prescribed up to 18 tablets of Imodium (loperamide) per day.
- Soluble fiber, such as Metamucil, can help thicken the output.
- Prescription oral bulking powders are also available to reduce liquidity.

6. Establish ongoing professional follow-up with both a gastroenterologist and an experienced Certified Wound, Ostomy & Continence Nurse (CWOCN) to develop long-term management plans and ensure proper appliance fitting.