This topic is about managing multiple stoma outlets, dealing with irregular output, and exploring medication options. The person sharing their experience has three different stoma outlets, each with its own challenges. Here's a breakdown of their situation and some advice and insights that might be helpful:

- They have an ileostomy that produces very liquid output unless slowed down with medications like Imodium (loperamide) or similar gut-slowing drugs.

- They also have a mucous colostomy that usually drains clear mucus but sometimes passes stool.

- Additionally, there is a very small colostomy outlet that tends to back up. When it finally empties, the stool is large, firm, and dry, leading to blockages and several ileus episodes, especially after surgery, anesthesia, or using opioid pain medicines.

To manage these challenges, they have been:

1. Maintaining strict fluid intake and avoiding foods that can cause problems, such as popcorn, mushrooms, peanut butter, and tomato skins.

2. Alternating between stool softeners and stool-firming agents like Imodium, depending on which outlet is causing issues.

3. Previously using tincture of opium, a liquid medication prescribed by their surgeon, which reliably thickened ileostomy output and prevented dehydration. However, Medicare no longer covers it, and it is now very expensive.

Despite the physical difficulties, they find strength through family, friends, and faith, especially during their ongoing treatment for ovarian cancer.

Additional insights and advice include:

- Lomotil (diphenoxylate/atropine) is a long-standing prescription anti-diarrheal that Medicare will cover. It is classified as a narcotic but combined with atropine to prevent euphoria or abuse. One person mentioned needing the maximum dose for 10 consecutive days before seeing results, suggesting patience if it seems ineffective at first.

- A combination therapy of Lomotil, Imodium, and Cholestyramine powder (a bile-acid binder) may be tried when single agents fail. One person reported using all three simultaneously when rapid output persisted.

- Tincture of opium is endorsed by several people as the only medication that consistently thickened ileostomy output when others failed. However, its availability is limited, with only a few suppliers remaining nationwide, which can delay access.

- For general coping support, maintaining perspective is important. Remembering that "yesterday is history, today is a gift, tomorrow is a mystery" can help. Emotional resilience and faith are cited as key tools alongside medical treatment.