Living with an ostomy for four years without any major issues is quite an achievement. However, experiencing constipation can be a bit unsettling, especially when it comes out of the blue. If you're looking for ways to get things moving again, here are some suggestions that might help:

1. Consider using prescription or over-the-counter laxatives and stool softeners:
- Miralax (polyethylene glycol 3350) is often recommended by surgeons for constipation related to a colostomy.
- Colace (docusate sodium) is another option that has been advised by post-operative care teams.

2. Try some natural approaches first:
- Drinking prune juice or a strong cup of coffee can help stimulate bowel movements.
- Eating a large quantity of oatmeal-raisin cookies has been humorously noted to be both delicious and effective.

3. Be cautious of potential obstructions:
- If you experience pain, nausea, or a complete lack of output, it might not just be constipation. It could be a blockage, so it's important to see a doctor promptly.

4. For more information, you can check out educational resources:
- The American Society of Colon & Rectal Surgeons offers a detailed patient guide on constipation. This resource covers causes, prevention, and treatment options, which can be very helpful in understanding and managing the condition. You can find it on their website.

These tips should provide a good starting point for addressing constipation with an ostomy. Remember, it's always best to consult with a healthcare professional for personalized advice.