This topic is about someone who had an ileostomy surgery due to severe colonic inertia and is now experiencing some unexpected issues. An ileostomy is a surgical procedure where the small intestine is diverted through an opening in the abdomen, often to bypass a problematic colon. Here’s what the person is dealing with and some advice they received:

- The surgery was intended to be an open procedure to allow the surgeon to manually address the colon issues, but it was done laparoscopically instead.
- After the surgery, the person was hospitalized for nearly two months. Various attempts to relieve the impaction were mostly unsuccessful, resulting in only a small amount of stool being passed.
- The surgeon's description of the impaction changed over time, and the person was discharged despite ongoing issues.
- Since being discharged, they have been experiencing severe abdominal pain and cramps, which are worse than before the surgery. They have also gained 12 pounds rapidly, with the weight accumulating in the lower abdomen, causing discomfort and issues with clothing and pouch placement.
- There are concerns about the retained colon, which might not have a blood supply and could be full of toxic stool. The person is also experiencing new rashes and weakness and is unsure if these are typical post-surgery issues or complications.
- The surgeon has refused to provide follow-up care, advising the person to go to the emergency room if in pain.

The person is seeking advice on the following:

1. Whether others have experienced similar complications after an ileostomy.
2. If localized weight gain in the abdomen is common after significant weight loss and an ileostomy.
3. Whether they should consult another surgeon to address the problem.

Here are some pieces of advice and insights shared:

- It is important to see a gastroenterologist as soon as possible. Even with a functioning ileostomy, the retained colon might still be causing pain and needs to be evaluated.
- Obtain all surgical and hospital records for a new doctor to review, especially to understand why the surgery method was changed.
- If further surgical intervention is needed, consider consulting a different colorectal surgeon. A second opinion is always a good idea, especially if confidence in the original surgeon is lost.
- Experiencing a rectal urge can be normal after diversion surgery, but if the colon's blood supply is compromised, it would cause severe pain that requires emergency attention. Even non-emergency pain should be thoroughly investigated.
- Conservative management and preserving the colon are standard practices for colonic inertia, but in some cases, resection and creating a continent pouch have been beneficial when constipation persists after a colostomy.
- Abdominal distention after surgery has been observed in other patients with colonic inertia, and outcomes can vary, highlighting the importance of specialist follow-up.