This topic is about finding ways to cope with the challenges that come after developing fistulas following ileostomy surgery. The person who started the discussion is having a tough time managing these issues daily and is reaching out for practical tips and emotional support from others who might be in a similar situation.

Here are some of the main concerns and advice shared:

1. Severe weight loss is a concern, as clothes are fitting loosely and regaining weight seems difficult.

2. Persistent dehydration is an issue, with intense thirst and fluids passing quickly through the fistulas.

3. Appliance issues include fistula pouches leaking after 24–36 hours, requiring daily changes when output is lowest. Standard stoma bags last 2–3 days, but itching starts after 2 days.

4. The emotional impact is significant, with feelings of low self-esteem, frequent crying, and a sense of never being the same as before.

5. There is a desire to find a way to mask the taste of bicarbonate of soda if used to firm up the output.

Advice and insights from others include:

- It's normal for ileostomy output to remain watery for several weeks, with many noticing thickening only after about two months.

- Foods that might help thicken output and slow drainage include pretzels (the salt helps with fluid absorption), bananas, peanut butter, and Cream of Wheat (farina). Some people try avoiding dairy temporarily to see if it helps reduce looseness.

- Bicarbonate of soda, or baking soda, is reported to firm stools and soothe cystitis symptoms. It can be mixed with flavored drink powder or juice to help mask the taste.

- For managing appliances with fistulas and secondary openings, some suggest using separate pouches over each fistula or stoma. One person even wears a second pouch on their back to control leaks. Frequent, scheduled changes, especially in the morning when output is lowest, can help reduce accidental leakage during the day.

- Emotional support is crucial. Feeling overwhelmed, crying, and having low self-esteem are common. It's important to acknowledge the adjustment period and seek help from stoma nurses and online communities. The United Ostomy Associations of America (UOAA) website offers extensive resources on diet, travel, and discussion boards.

- General encouragement is offered, noting that weight gain and routine usually improve gradually. Returning to work or previous activities is possible once effective techniques are in place.