This topic is about managing ileostomy output using a medication called Lomotil. The person who started the discussion has an ileostomy and is dealing with frequent, high-volume output that requires constant attention. They have been prescribed Lomotil to help with this issue and are seeking feedback from others who have used the medication.

Here are some key points and advice shared in the discussion:

- The current dose for the person is 2.5 ml of Lomotil in the morning and at night. They started this regimen the evening before posting.
- Despite taking Lomotil, they experienced a pouch filled to the rim with liquid overnight.
- Their doctor plans to increase the dose to 5 ml four times a day, but they are concerned about the risk of causing a blockage with a higher dose and are asking for opinions on adjusting it.

Advice and insights from others include:

1. Consider trying higher doses of Lomotil and/or combining it with Imodium (loperamide) before moving on to stronger medications.
2. If Lomotil and Imodium are not effective and dehydration becomes a concern, some surgeons may prescribe Distilled Tincture of Opium (DTO). This is taken as 10 drops in 1 oz of water, four times daily, 20 minutes before meals or bedtime. DTO can significantly slow down bowel movements and reduce output, but it is addictive, can cause withdrawal symptoms if not refilled on time, and is not commonly stocked in many pharmacies.
3. For some people, Lomotil is only effective when taken on an empty stomach, as food in the gut might reduce its effectiveness.
4. Diet plays a significant role in managing output:
- High-roughage foods can increase watery output.
- Soft, low-bulk foods can slow down transit, decrease volume, and thicken the consistency of the output.
- Over time, most people with an ileostomy learn which foods help produce a more manageable output.