This topic is about a person who has a temporary loop ileostomy and is dealing with a very tight neorectal stricture. This stricture was caused by pelvic radiation treatment they received a decade ago for rectal cancer. The stricture is so narrow that only a small gastroscope can pass through it. Because the intestinal contents can't pass through easily, they back up, causing severe pain. With additional chemotherapy on the horizon, finding a solution is urgent. The person is seeking advice from others who might have experienced something similar, especially since the nurses they contacted have not encountered this specific situation before.

Here are some pieces of advice and insights shared by others:

1. Consider seeking evaluation at high-volume colorectal centers like the Mayo Clinic, Cleveland Clinic, Johns Hopkins, or the University of Pennsylvania. These centers have extensive experience with rare complications and might offer solutions or referrals. A phone inquiry to these centers is a low-cost option.

2. One person shared their experience of having radiation, chemotherapy, and multiple prior dilations. They eventually opted for a permanent end colostomy, after initially having a loop colostomy. This decision, made with specialists at the University of Pennsylvania and local surgeons, eliminated their pain, recurrent abscesses, and stricture problems, providing long-term relief.

3. If the rectum is not causing symptoms, it might be left in place without needing an abdominoperineal resection (APR). In the shared experience, once the bowel was completely diverted, the original stricture was no longer a clinical issue.

4. Initially, a loop diversion was attempted to see if the stricture would regress when not in use. When this did not work, converting to an end colostomy eight months later resolved the issue.

5. It's important to stay optimistic and persistent in seeking specialized care. While patient characteristics like age and resilience, as well as national healthcare systems, can differ, moral support and determination are key.