This topic is about someone experiencing unpredictable stoma output and abdominal discomfort nine months after having a colostomy due to pelvic floor dyssynergia. Initially, their stoma output was regular, but now it varies greatly, causing discomfort and requiring strong laxatives for relief. Despite consulting with two gastroenterologists, no clear explanation has been found. Here are some insights and advice that might help:

1. Keep a detailed record of your diet and fluid intake. Even small changes can affect your colostomy output.

2. Make sure to drink plenty of water. Not getting enough fluids can lead to irregular or delayed stoma output.

3. Consider asking your gastroenterologist to perform an upper endoscopy and relevant lab tests, including a liver panel. The combination of heartburn and upper abdominal pain might indicate an issue in the stomach or small bowel rather than just the colon.

4. Request cross-sectional imaging, like a CAT scan or MRI, to check for any kinks, strictures, or partial blockages. Some people find that warm, deep baths can help ease minor blockages.

5. Discuss the possibility of testing for conditions like SIBO, IBS, bile-acid malabsorption, and other digestive disorders to identify any non-mechanical causes of your symptoms.

6. Consider trying medications like Lamodil/Lomotil (diphenoxylate-atropine) to help regulate motility and output, as suggested by another person with similar experiences.

7. If your current gastroenterologists are unable to resolve the issue, it might be beneficial to seek out a tertiary-care GI specialist with extensive experience in ostomy care. Some people have had varying experiences at institutions like Johns Hopkins, Washington Hospital Center, and Georgetown, so sharing any good specialist names you find could be helpful.