Living with an ileostomy since 2010, the person in this discussion has been facing a challenging issue: night-time leakage or "blow-outs" from their pouch, especially around dawn. Despite trying different strategies like eating earlier, eating less, or even fasting, these accidents continue to happen. This situation has become so concerning that it affects their ability to share a bed with a partner. They reached out to the community for practical advice on how to stop or at least minimize these nocturnal leaks. Here are some helpful suggestions and insights shared by others:

1. Night-time emptying and alarms:
- Consider setting one or two alarms or phone reminders to wake up and empty or "burp" the pouch during the night.
- Some people find it helpful to empty every 4 hours overnight and every 2 hours during the day until the morning output slows down.

2. Use a larger or high-output pouch at night:
- Ask your supplier for a longer or high-output appliance; many people switch to a larger pouch just for sleeping.
- A specific recommendation is the Salts Healthcare XND1352 drainable pouch, combined with a Salts Washer for extra security.

3. Venting gas and reducing ballooning:
- Choose pouches with built-in filters and change to a fresh filtered bag before bed, especially if using a two-piece system.
- If filters block quickly, manually vent by pricking 2-3 tiny holes at the top with a toothpick, then cover with a small piece of deodorizing filter sticker or gauze if odor is an issue.
- Limit high-gas foods after mid-afternoon, avoiding "windy" foods after 3–4 p.m.

4. Body position while sleeping:
- Avoid sleeping on the stoma side and use an ostomy belt to keep the pouch flat and centered.
- Place pillows against your sides or back to prevent rolling fully onto the pouch, as many leaks start when side-lying compresses stool into one edge of the wafer.

5. Extra wafer reinforcement:
- "Box" the flange with 2-inch HypaFix tape before attaching the pouch to prevent edge lift.
- Salts Washers or similar barrier rings under the wafer can add another seal layer.

6. Alternative management options:
- If anatomy and medical team allow, some colostomates irrigate to stay output-free overnight; this is not usually done with ileostomies but is mentioned for completeness.