This topic is about someone who has been living with an ileostomy for a year and is facing some tough challenges. They are dealing with ongoing skin issues around the stoma, frequent leaks, high output, and significant pain. Here are some insights and advice that might help:

1. The person uses a Hollister one-piece precut Extended Wear pouch with convexity, which is the only bag that hasn't leaked. They change it every 24 hours to avoid worsening the skin condition.

2. Their skin care routine includes cleaning, applying Nystatin and stoma powder, covering with skin prep, and using an Adapt barrier ring under the wafer. However, this hasn't resolved the issues.

3. Despite trying various medications and diet changes to manage high output, nothing has worked so far. They also haven't found a two-piece system that doesn't leak.

4. Working long shifts makes the skin pain and bleeding worse.

Here are some suggestions from others who have faced similar issues:

- Some people have found that not using skin prep under Hollister wafers, as advised by Hollister technicians, improved their situation. They recommend using an adhesive remover, washing with mild soap, patting dry, applying a light dusting of ostomy powder, and then applying the flange. It's a good idea to call Hollister for personalized advice.

- An alternate method involves cleaning with water only, drying well, dusting with ostomy powder, dabbing with skin prep, letting it dry, and repeating this 2-3 times before attaching the wafer. This has helped reduce irritation for some.

- To lower ileostomy output, it's suggested to identify and limit triggers like wine, raw salads, and high-fiber vegetables. Balancing meals with binding foods like bread, rice, and potatoes, and eating bananas can help thicken the output.

- Switching from a one-piece to a two-piece system allows for morning wafer inspection and cleaning, which might extend wear time to three days for some. Others find that using single-use pouches changed every 24 hours reduces skin reactions.

- Products that have helped soothe or protect skin include Hollister Karaya Powder, Instilagel for rash relief, Mylanta dabbed on raw skin, Salts Peri-Prep wipes, and Appeel medical adhesive remover. The general advice is to use the least amount of creams and powders necessary.

- If the rash and leak cycle persists, a dermatology referral might be helpful. One person discovered their issue was psoriasis, which was treated successfully with narrow-band UV-B light therapy.

- General practices to save skin include scheduling appliance changes when you can leave the area open to air for a few hours, watching for adhesive intolerance, and considering shorter wafer wear or different brands if needed.

- Online resources like C3Life.com offer Q&A with stoma nurses and product reviews, which might provide additional support and information.