This topic is about a caregiver's experience with their 35-year-old son, who is non-verbal and autistic, and has had an ileostomy for about eight months. Recently, he has been experiencing intermittent low or no output from his stoma, along with abdominal pain. This is followed by a sudden release of very watery output. Despite clear imaging results, the medical team is unsure of the cause and is seeking advice from others who might have faced similar situations.

Here are some insights and advice that might be helpful:

1. Check the fit of the ostomy appliance:
- If the barrier ring or wafer opening is too small, it can constrict the stoma and block the flow. It's a good idea to have a WOCN (Wound, Ostomy, and Continence Nurse) check the stoma size and ensure the wafer is sized and applied correctly.

2. Immediate checks at home:
- A simple finger examination or gentle catheter insertion through the stoma can help identify an obstruction just inside the abdominal wall.

3. Consider possible internal causes:
- There might be intermittent kinking from scar tissue, which is more common in long-standing stomas or in patients with Crohn’s disease.
- Bowel loops might twist after consuming large or dense meals. Foods like beef stew, pork-chop dinners, or very large meals could be potential triggers.

4. Imaging recommendations:
- The quality of a CT scan can vary, and small-bowel issues might be missed. An MR Enterography (MRE) is now considered the best imaging method for assessing the small bowel, as it provides superior soft-tissue detail and real-time motility views without radiation.
- An upper endoscopy might also be necessary to visualize the proximal small bowel.

5. Supportive measures:
- During episodes of low output, applying warmth with a hot-water bottle and performing gentle abdominal or stomal massage can help promote flow.
- Monitoring the diet by trying smaller, lighter meals and noting any correlation between specific foods and symptoms can be beneficial.