This topic is about understanding what happens to the intestines after a total colectomy, which is when the entire colon is removed, and an ileostomy is created. The discussion focuses on how much of the bowel remains, how the ileum (the last part of the small intestine) can adapt to take over some of the colon's functions, and other related concerns.

Here are some helpful insights and advice shared by others:

1. **Typical Intestinal Lengths and Functions**
- The small intestine is about 19 feet long, while the large intestine is around 5 feet. The large intestine mainly reabsorbs water and forms stool. Without it, expect liquid output, but the ileum can adapt over time to reabsorb more fluid.

2. **Minimum Small-Bowel Length for Survival**
- Some people manage well with as little as 2 to 4 feet of small intestine, though very short lengths might require nutritional support like parenteral nutrition or tube feeding.

3. **Hydration and Electrolyte Replacement**
- It's important to drink plenty of fluids, at least 12 glasses a day. If more of the small bowel is removed, dehydration can happen faster, especially for those with Crohn’s disease.

4. **Thickening or Slowing Output**
- Foods like bananas and other starchy, low-fiber items can help. Medications such as loperamide, codeine phosphate, and low-dose morphine tablets are often used. Be cautious with over-the-counter stool-bulking products to avoid blockages.

5. **Dietary Pointers**
- Focus on protein, cooked vegetables, and peeled fruits. Limit fried foods, skins, nuts, seeds, and high-fiber cereals. Some find carbonated drinks cause excess gas. One person’s surgeon suggested daily red wine and olive oil for digestion.

6. **Supplements and Energy Boosters**
- Vitamin B-12 injections or liquid B-12 have helped with fatigue. High-pH alkaline water was also recommended by a member.

7. **Managing Watery Output or High Output**
- Use anti-motility drugs and consider TPN if absorption is inadequate. Discuss long-term care and risks with a healthcare provider.

8. **Blockage Prevention and Treatment**
- Avoid high-fiber and poorly chewed foods. Introduce new foods slowly. Watch for cramping, reduced output, nausea, or vomiting as early signs of blockage. Hospital care might be needed, and some have had successful surgeries to remove adhesions.

9. **Post-Reversal or Colostomy-Specific Notes**
- After reversal, stools may remain loose for years but can gradually firm up. Sudden constipation can be managed with stool softeners, prune juice, water, walking, and sometimes digital assistance.

10. **Information Resources**
- Wikipedia for detailed anatomy, WebMD for doctor Q&A, and a personal ostomy info page shared by a member.

11. **Brands and Products Mentioned**
- Remicade for Crohn’s, Codeine Phosphate tablets, Loperamide, NOW brand B-12 liquid, Morphine SR, and TPN solutions.

12. **Key Take-Home Points**
- The ileum can adapt, but expect liquid to creamy output. Staying hydrated, following a selective diet, and using anti-motility medication are crucial for a good quality of life. Even with a very short bowel, many people can maintain good function, though some may need extra nutritional support.