This topic is about a person with Crohn’s disease and an ileostomy who experienced severe symptoms like vomiting, cramping, and abdominal pain. During a visit to the emergency room, they were given Buscopan, which provided immediate relief from intestinal spasms. However, their regular doctors have refused to prescribe this medication, saying it is not suitable for someone with their condition. The person is seeking to understand why and how to discuss this with their doctors without causing conflict.

Here are some insights and advice on this situation:

1. Contra-indications and side-effects:
- Buscopan's package insert warns against its use in conditions like megacolon, constipation, and certain bowel issues. It can also interact with other medications and cause blurred vision. These warnings might explain why doctors are hesitant to prescribe it.
- Doctors are concerned that Buscopan might slow down bowel movements, potentially worsening constipation or causing obstructions, especially in Crohn’s patients with strictures or an ileostomy.

2. Effectiveness for spasm pain:
- Many people with Crohn’s, colostomies, or ileostomies have found Buscopan to provide faster and better relief for bowel spasms compared to opioids. Some have received it orally, while others have had it through IV infusion after surgery.
- While morphine and other narcotics often do not alleviate this type of pain, Buscopan can effectively stop it.

3. Usage experiences and practical tips:
- In hospitals, the common dosage is up to 8 tablets per day orally, or through IV infusion for severe pain.
- If oral Buscopan alone is not enough, combining it with 1 gram of paracetamol/acetaminophen (such as Panadol Rapid 500 mg x 2) has been effective for some people, mimicking hospital protocols.
- Some individuals find Buscopan ineffective if the pain is due to adhesions or endometriosis rather than true bowel spasms.

4. Access and cost in different countries:
- Buscopan is available over the counter in the UK and Australia for about AUD $5. Some people have offered to send it to those who cannot get a prescription.
- In contrast, morphine is reportedly available over the counter in the Philippines, while Buscopan requires a prescription in parts of North America.

5. Advocacy suggestions:
- Present evidence of the success experienced in the ER and request a monitored trial, emphasizing a willingness to have the physician supervise for side effects.
- Highlight that hospitals often administer Buscopan, even when there are formal contraindications, because it effectively relieves colic-type cramps.
- If doctors still refuse, consider obtaining Buscopan legally from countries where it is available over the counter, but ensure medical oversight is maintained.