This topic is about managing a specific challenge faced by someone with a retracted colostomy who needs to take daily calcium supplements. The calcium is causing the stool to become thick and pasty, which complicates the management of the colostomy appliance. Here are some helpful suggestions and insights to address this issue:

1. Examine the type of calcium supplement:
- Avoid supplements containing bone meal or dolomite, as they can lead to constipation and may contain harmful heavy metals.
- Consider calcium supplements that include magnesium, like Citracal Plus with Magnesium, to help prevent hardening. However, consult with a doctor first, especially if there are any kidney concerns.
- Discuss with a healthcare provider the possibility of switching to a once-monthly prescription calcium formulation to avoid daily tablets.

2. Improve dietary calcium absorption:
- Opt for food sources with higher calcium bioavailability, such as milk, yogurt, hard cheese, cottage cheese, and broccoli.
- Be cautious with green vegetables like spinach, as they can interfere with calcium absorption, similar to rhubarb and bran.
- Ensure adequate Vitamin D intake to support bone health.

3. Maintain softer stool through general measures:
- Increase fluid intake by about 1 liter per day.
- Incorporate more fruits, vegetables, and high-fiber foods into the diet; prunes at breakfast can be a simple aid.
- Engage in regular physical activity if possible.
- Consider doctor-approved stool softeners as an option.

4. Appliance management tips for thick output:
- Use non-stick cooking spray or a small amount of cooking oil inside the pouch to help the stool slide to the bottom.
- Peppermint oil can also be used inside the pouch as a lubricant and to mask odors; it can be transferred to a small spray bottle for convenience, but keep it away from the pouch filter.

5. Irrigation perspective:
- Once irrigation is established, it may help break up the paste-like stool, potentially making the issue easier to manage.