This topic is about a person whose husband has been living with a colostomy and an open distal stoma, which was initially left open for a possible future reversal. However, due to non-functional anorectal nerves, a reversal is unlikely. Recently, he has been experiencing severe issues with the distal stoma, including:

- Intense pain radiating through the pelvic floor
- A large amount of clear fluid leaking from the distal stoma

Despite consulting various healthcare professionals, including a primary care doctor, emergency department staff, a colorectal surgeon, and a WOC nurse, the cause of these symptoms remains unidentified. The couple is considering whether recent abdominal weight gain might be stretching the remaining distal colon and causing these symptoms.

Here are some pieces of advice and insights that might help:

1. Consider seeking a different colorectal surgeon, GI specialist, or hospital that will take the case seriously and lead a thorough diagnostic work-up.

2. Insist on comprehensive imaging:
- A CT scan has already been done, but it is just a starting point.
- Proceed with the scheduled MRI and, if needed, push for additional imaging methods like an abdominal or pelvic ultrasound.
- If imaging does not reveal the cause, discuss the possibility of diagnostic laparoscopy or exploratory surgery. There have been instances where CT scans missed significant issues, such as migrated hernia mesh puncturing the colon or bladder.

3. If a reversal is no longer feasible and the distal stoma continues to cause problems, consider making the colostomy permanent and closing the distal stump.

4. Be persistent and advocate for yourself: do not settle for "we don't know." Keep pushing for answers until a satisfactory diagnostic work-up and treatment plan are established.