This topic is about dealing with challenges after having two abdominal surgeries, specifically related to a retracted ileostomy stump, pancaking issues, and sore skin. Here are some helpful insights and advice for managing these concerns:

1. **Output Control**
- Consider using Imodium in liquid form instead of tablets. This allows for more precise control over the consistency of the output by measuring doses accurately with a syringe.
- Be mindful that with very rapid, liquid output, Imodium tablets might not be effective as they can pass through the system too quickly without being absorbed.

2. **Pancaking Prevention**
- If you are using Coloplast pouches, keep the small white stick-on filter covers on permanently. This helps block the filter, allowing a bit of air to stay in the bag, which prevents the output from sticking around the stoma.

3. **Skin Protection and Healing**
- Apply Coloplast Skin Barrier Wipe or Spray for immediate relief and faster healing. Some users find it beneficial even though it's not recommended for broken skin by the manufacturer.
- Use 3M Cavilon barrier cream, sticks, or spray, which are available on NHS prescription in the UK, to protect and soothe the skin.

4. **Stoma Design Considerations**
- A longer, well-protruding stoma can help reduce the risk of retraction and direct the effluent straight into the pouch, minimizing skin contact and soreness. Surgical refashioning to bring the stoma back out has been beneficial for some individuals.

Additionally, the person works as a Surgical Care Practitioner and finds that standing twisted for long periods can worsen pancaking. They have recently learned about the purpose of the filter covers in Coloplast bags and are considering stopping Imodium tablets due to their ineffectiveness. They also have access to various supplies through NHS prescription, which can aid in managing these issues.