This topic is about dealing with persistent leaks from an ileostomy pouch, as experienced by an adult daughter who had to change her appliance four times in one day. The concern arose after she ate salad the night before, and there is a question of whether this could be the cause of the leaks. Here are some helpful tips and advice to manage and prevent such issues:

1. Check the consistency of the output and adjust the pouch placement accordingly.
- If the stool is thick, it might cause "pancaking," which can push the output under the wafer. You can search online for "ileostomy pancaking" to find ways to prevent this.
- If the output is very liquid, it might seep under a wafer that hasn't fully bonded. Allow time for the adhesive to warm and seal by gently cupping your hands over the wafer to use body heat. Ensure the abdomen is smooth without any skin folds.

2. Prepare the skin properly to ensure a strong seal.
- Use a soap that doesn't contain lotions or oils, as any moisturizer can break down the adhesive.
- Make sure the skin is thoroughly dry. Many people use a hair dryer on a cool setting to ensure the skin is completely dry.
- Some people use medical tape around the edges of the wafer to supplement the adhesive.

3. Consider using accessory products to help prevent leaks.
- Sure Seal Rings can be placed over the flange to create an additional waterproof barrier. Free samples are available from the manufacturer.

4. If you suspect a blockage or slowed flow due to the salad:
- Lie down with a heating pad over the abdomen and gently massage the area.
- If there's no relief, remove the pouch and take a warm shower, letting the water hit the abdominal area while continuing to massage. Repeat as needed until the output resumes freely.

5. General reminders:
- Leaks are common until you find a routine that works well. With experience, the right products, and careful skin care, incidents can be significantly reduced.
- If problems persist, seek detailed skin-prep instructions from an ostomy nurse or experienced users.