This topic is about understanding the challenges faced by someone living with an ileostomy, particularly when dealing with issues like intestinal blockages, scar tissue, and the functioning of the small intestine. It also touches on how to support a friend who is hospitalized due to these complications. Here are some helpful insights and advice:

1. Hospital and Specialist Care
- Ensure that your friend is receiving care at a high-volume research or teaching hospital with a top-notch GI motility specialist. These facilities often have access to advanced treatments and surgical options.
- Check if she is on total parenteral nutrition (TPN) and if a multidisciplinary nutrition team is involved in her care.

2. Understanding Obstruction Management
- NG tubes, though uncomfortable, are effective in relieving pressure and can help avoid surgery.
- Adhesions, or scar tissue from previous surgeries, are a common cause of blockages. Surgery to remove them can create more adhesions, so it's usually a last resort.

3. Adhesion vs. Food-Related Blockage
- Blockages can also be caused by food getting stuck where the bowel is narrowed by adhesions. Keeping a food log and avoiding high-fiber foods like peanuts, seeds, and certain vegetables can help prevent this.

4. Small-Intestine Length and Survival
- It's not possible to live without any small intestine. A minimum of about 4 feet is needed for survival. If the intestine is shorter, it can lead to Short Bowel Syndrome (SBS), which may require lifelong IV fluids or TPN, but many people live well with this condition.

5. Ileostomy vs. Colostomy
- An ileostomy is created from the small intestine, while a colostomy is from the colon. Since your friend's entire colon was removed, she has a permanent ileostomy, which requires careful management of fluids and electrolytes.

6. Motility Medications and Alternatives
- Motegrity (prucalopride) is one medication that can help with motility. Other drugs are being studied, and it's important to evaluate for any underlying nerve disorders that might affect motility.

7. Gastric/Electrical Stimulators
- Gastric pacemakers can aid in stomach emptying but might increase the risk of small-bowel obstruction. This should be discussed with her medical team.

8. Surgical and Transplant Options
- If her condition becomes critical, small-bowel transplantation might be an option at specialized centers. Other procedures like pyloroplasty or intestinal lengthening could also be considered.

9. Psychosocial Support
- It's important to provide emotional and practical support to both your friend and her daughter. Counseling can be beneficial for children dealing with a parent's chronic illness.

10. Information Resources
- Look for information on forums and reliable medical websites about adhesions, blockages, and Short Bowel Syndrome to better understand and prepare for potential future needs.