Living with an ileostomy can be challenging, especially when dealing with leaks and watery output. If you're experiencing these issues, here are some practical tips and advice that might help you achieve a longer, leak-free wear time:

1. Consider a two-piece contour system with multiple rings. Some have found success with a contoured two-piece appliance, using a "waffle-like" paste layer and three concentric barrier rings to cushion and seal the stoma, achieving up to 7 days of wear.

2. Try a one-piece ConvaTec ActiveLife drainable pouch. Many users prefer this system and recommend securing the outlet with two tail clips to prevent failures. These products are available from suppliers like Edgepark.

3. Pay attention to skin preparation and application technique:
- Clean the skin around the stoma with non-perfumed soap, such as Ivory, and rinse well.
- Use Unisolve to remove any adhesive residue and let the skin air-dry completely.
- Ensure the skin is bone-dry by patting it dry or using a hair-dryer on a cool setting.
- Apply Smith & Nephew Skin Prep protective barrier wipes to the area.
- Warm the wafer (Stomahesive or Durahesive wafer, ConvaTec) with a hair-dryer or your hands, as it is heat-activated.
- After placing the wafer, press on it from left to right and then top to bottom for about 30 seconds to ensure a tight seal before attaching the pouch in two-piece systems.
- Peel away any adhesive tape backing last to anchor the wafer securely.

4. Consider extra barrier options by adding an additional wax "cushion ring" or barrier ring around the stoma for a tighter fit, or layer multiple rings as needed.

5. Use a support belt. Pairing an Active Seal with a NuHope Comfort belt has helped some users remain leak-free for extended periods.

6. Discuss output-thickening medication with your healthcare provider. Imodium (loperamide), taken at 2 mg four times daily (with each meal and at bedtime), has been effective for some in reducing watery output and leaks, and it may also aid in weight gain.

7. Adjust your diet to help thicken the effluent, which can further support leak prevention.

8. Be aware that leaks can still occur due to defective pouches, over-extended wear time, or accidental pressure. Keeping spare supplies on hand and changing promptly can help minimize these problems.

These tips are shared by others who have faced similar challenges and found solutions that work for them. Hopefully, they can offer some relief and make living with an ileostomy a bit easier for you.