This topic is about managing recurrent ileostomy blockages, scar tissue, and adhesions for those who have lived with an ostomy for a long time. It shares the experiences of someone who has had a permanent ileostomy for 20 years and is dealing with complications like blockages and scar tissue. Here are some helpful insights and advice for managing these challenges:

1. Seek Professional Support
- Involve a WOC/ET (ostomy) nurse by asking your GP or surgeon for a referral.
- If you experience blockage symptoms such as no output, vomiting, or severe pain, go to the Emergency Department immediately and request a CT scan to check for twists, adhesions, or fistulas.
- Bring all your pouching supplies and the UOAA ileostomy-obstruction information card to the ER.

2. At-Home First-Line Measures for Partial Blockage
- Enlarge the pouch opening to accommodate stomal swelling.
- Limit intake to clear liquids like Coke, sports drinks, or tea.
- Try a warm bath, abdominal or stomal massage, and positional changes like knee-chest to help dislodge a food bolus.

3. Hydration & Diet Strategies
- Temporarily puree or liquidize all meals and gradually reintroduce solids, ensuring you chew thoroughly.
- Maintain a high fluid intake with water, oral rehydration solutions, or sports drinks.
- Consider using aloe vera juice daily to reduce intestinal inflammation.
- Identify and avoid personal trigger foods, such as pizza, beef stew, or tuna, and avoid overeating.

4. Gas & Motility Management
- For sharp gas pains, use simethicone (Gas-X).
- Lie on your left side with focused breathing or take long hot baths to relax the bowel. Wait for the return of “gurgling” sounds before resuming normal activities.

5. Recognizing When Surgery May Be Necessary
- Recurrent blockages, vomiting, or evidence of fistulas or twists on imaging may require surgical intervention. Delaying surgery can increase the risk of rupture or hernia.
- Some have found success with repositioning or recreating the stoma, which eliminated chronic blockages and leakage issues.

6. Ostomy Irrigation in Emergencies
- This should be performed by a surgeon or trained nurse. It involves a digital examination of the stoma and gentle breaking of the blockage.
- A lubricated catheter can be used through an irrigation sleeve to instill Normal Saline until flow returns, which may take 1–2 hours.

7. Useful Products & Solutions
- Sports drinks like Gatorade and nutritional supplements like Ensure can be helpful.
- For partial blockages, beverages like Coke and tea are recommended.
- In hospitals, IV fluids such as Lactated Ringer’s Solution or Normal Saline are used.

8. Psychological & Practical Tips
- Living alone can increase risk, so have a plan for ambulance transport.
- Keep written notes and questions for consultations, especially with a recommended surgeon who has personal experience with Crohn’s and a stoma.
- Community support sites and forums offer validated guidelines and shared experiences that can be printed for healthcare providers.