This topic is about someone who has been dealing with dietary challenges and Irritable Bowel Syndrome (IBS) after undergoing an abdominoperineal resection (APR) for stage-1 bowel cancer. Since the surgery, they have been experiencing issues with their colostomy output and are seeking advice on how to manage their diet and IBS symptoms.

Here are some key points and advice shared:

1. The person had surgery in December and has since found that many foods are no longer tolerated, leading to very loose or diarrhea-like colostomy output.

2. Before surgery, their IBS-D (Irritable Bowel Syndrome with Diarrhea) was well-managed with a high-fiber diet, but now high fiber is not an option. IBS flares occur once daily every 3–4 days, affecting their mood.

3. A food diary has not revealed any specific dietary triggers.

4. They are waiting for an MRI to check for a suspected perineal hernia, as the perineal area remains uncomfortable.

5. IBS was only occasional before surgery, but now the colostomy output is consistently loose if fiber is increased.

6. After an initial 12-week low-fiber period post-surgery, attempts to reintroduce foods like whole-meal bread and porridge resulted in very loose output, so the diet is currently limited to low-fiber foods like white bread, rice, and pasta.

7. They are looking for ways to safely expand their diet without worsening stoma output or IBS symptoms.

Advice and insights from others include:

- Consulting a colorectal surgeon or a wound/ostomy/continence (WOC) nurse about the persistent IBS-D and loose output, as medical or product adjustments might help.

- Some people with long-term colostomies manage a high-fiber diet without issues. Gradually reintroducing fiber while monitoring the output is possible for many.

- Experiences can vary: for instance, one person with IBS-C (Irritable Bowel Syndrome with Constipation) found that a colostomy reduced bloating and discomfort, even though IBS symptoms remained, showing that outcomes can differ depending on the IBS subtype.