This topic is about someone who recently had a diversion ileostomy surgery due to severe colonic inertia and a full-length fecal impaction. The surgery was supposed to be an open procedure to manually remove stool, but it was changed to a laparoscopic one at the last minute. Since the surgery, the person has been experiencing ongoing issues, including pain, a disconnected colon, and rapid weight gain in the belly area. Here are some insights and advice that might be helpful:

- After the surgery, the person spent five weeks in the hospital as the staff attempted to flush the still-connected colon, but only a small amount of stool was removed. The surgeon discharged the patient, claiming only a small amount of stool remained, but has since refused further communication, advising the patient to visit the ER if in pain.

- At home, the original pain, cramps, and urgent sensations persist, sometimes even worse, despite adequate ileostomy output. The disconnected colon reportedly has no blood supply.

- Since being discharged, the person has experienced rapid weight gain, particularly in the lower abdomen, which is causing a distended appearance and affecting the fit of the ostomy pouch. The limbs remain very thin.

- The person is concerned about whether others have experienced a similar situation with an un-perfused colon packed with stool after an ileostomy and whether the sudden belly-only weight gain is normal or a sign of a problem that requires re-operation.

- The person is taking several medications and supplements, including BOOST® PLUS shakes, cranberry-pomegranate juice, IV fentanyl, Cipro®, and others. They are also experiencing large, itchy hives and are concerned about whether these are due to self-intoxication from the retained colon or a reaction to Cipro®.

- Finding a new surgeon who accepts both Medicare and Medicaid in NYC has been challenging, and the person is considering whether to use the term "patient abandonment" to prompt care from the current surgeon's office.

Here are some pieces of advice and insights:

1. Share your situation in the "Ostomy-Related Questions" section of the site to get responses from WOC/ET nurses.

2. Do not remain in uncontrolled pain; visit an Emergency Department if discomfort or distention worsens.

3. If your current surgeon is unresponsive, consider transferring care. Teaching hospitals often accept Medicare/Medicaid and may treat you without upfront insurance issues. Ask your primary doctor for a referral to another surgeon, possibly citing "patient abandonment."

4. Unexplained abdominal distention should be medically evaluated to rule out obstruction, retained stool, infection, or medication side effects. Do not assume it is only fat.

5. Rapid, centralized weight gain after long periods of starvation is common. The body initially stores calories in the abdomen, but distribution should even out over time as nutrition stabilizes.

6. For clothing, consider using elastic button extenders on trousers until your size stabilizes.

7. Review your medications, as Cipro® can cause delayed-onset hives. Discuss alternative options with your doctor and consider antihistamines like Zyrtec®.

8. Arrange a scheduled 3-month post-op visit, which is standard care after an ileostomy. Persist politely with the surgeon’s nurse if necessary.

9. Keep communications civil with your surgeon. They may respond better when not feeling accused. Small gestures, like offering a favorite beverage, might help reopen dialogue.