This topic is about understanding the difference between constipation and a blockage for someone who is 12 weeks post-colostomy. The person is experiencing some changes and is unsure if these are signs of constipation or a blockage. Here’s what they’ve noticed:

- Their output has changed from being ribbon-thin to “pebble-like,” and then it became watery.
- They are passing gas and can hear intestinal noises.
- They experienced morning cramping and pain, which went away after walking. Now, they are pain-free, but the stoma is protruding more than usual.
- They are afraid to eat because they worry about the possibility of a blockage.

They are seeking advice from others who might have had similar experiences. Here are some helpful insights and advice:

1. Changes in output are often related to diet and can vary from liquid to a thick paste. Keeping a food diary can help some people predict the consistency of their output.

2. Passing gas and having temporary “pebble” or ribbon-like output is common. Drinking more fluids usually helps to soften the stool.

3. Be aware of warning signs that require medical attention:
- Continuous or worsening pain with no output.
- No output for more than 48 hours.
- A sudden color change of the stoma to a dull grey.

4. Pain from a blockage is often described as severe or “unbearable,” making it difficult to bend or move. Even partial blockages can be very painful and might need hospitalization.

5. It’s normal for the size and shape of the stoma to change, as long as it remains pink to dark red and slightly shiny.

6. It is safe to shower without the appliance. You can gently wash the stoma with a mild soap, like Cetaphil.