Do you get enough salt? You need salt for your body to properly use water, it's a more common problem them people realize. Try just adding some extra salt and see if it makes a difference.

You might want to mix up and try some oral rehydration solution (ORS) to get better water absorption. Regular Gatorade has too much sugar for optimal water absorption, but ORS has some, along with some other key ingredients. There are recipes that just have water, salt, and table sugar, but the best studied ORS  includes sodium chloride, sodium citrate, potassium chloride, and glucose. Glucose may be replaced by sucrose and sodium citrate may be replaced by sodium bicarbonate, if not available, but the citrate could be helpful for some kinds of kidney stones. Pedialyte would probably also work better for you than plain water.

I should clarify that I drink the Gatorade Zero, so it’s the no sugar kind. But i will look into the things you mention, thank you. I am on the board line level for salt and potassium. It’s not low but like at that lowest number you can be before it’s considered “low.” I’m not sure if I should mention it to my kidney doc or my gastro when I go- not sure which doc should take care of keeping track of that? My daughter was sick a week ago and we got pedialyte for her- she didn’t like it, so maybe I’ll finish off that for her. That stuff is super expensive lol. I’ll give it a shot though! Which it came in drops or something. I’ll look online for something though.

Some folks use DripDrop, which is probably cheaper than Pedialyte. Whatever you choose needs to have to have the correct amount of sugar for proper absorption. None of the Gatorade products seem to get this right.

Liquid IV is god, but not cheap.

+1 for liquid IV- it’s saved me on a few dehydration incidents.  Your situation sounds more persistent, but with a pouch and no colon it’s pretty easy to get dehydrated quickly.  Several times I’ve gotten dehydrated very quickly from diarrhea or even just watery stools…like within a few hours…to the point that I have to go get an IV fluid push at the ER or clinic.  Liquid IV works really well for the intermediate cases that don’t need hospitals, and usually brings me right back around.  Costco carries it for cheaper.

One more suggestion- see if your GI will get you in for IV fluids, maybe for several sessions over a few days, and see if that helps your body get over the borderline chronic dehydration that you’re currently in.  Sometimes you just can’t absorb enough drink to pull yourself out of the dehydration spiral.

I don’t think I need IV fluids per say but something has to change. I’m literally waking up from sleep at 4am like I can’t swallow bc it’s so dry and I’m awake for the next few hours. I’ll try the drip drip…

If it gets bad I won’t hesitate to call the doc. I have had to go to the ER bc of dehydration. My salt and potassium levels were super low. They gave me supplements and gave me two bags of fluids and I was good to go.