This topic is about a person who recently had a colostomy due to diverticulitis and is experiencing a sudden reduction in colostomy output about a month after surgery. Initially, their output was regular, but it has recently become smaller and more solid. They are not experiencing any pain, vomiting, or fever, and they are staying well-hydrated. They are using Ozempic for diabetes, which they know can cause constipation. After taking laxatives, they noticed some improvement but are still concerned and want to avoid another hospital visit. They are seeking advice on how to manage this situation.

Here are some helpful insights and advice:

1. It's common for output patterns to fluctuate in the early months after surgery. One month post-op is still considered early, and changes in output are not unusual.

2. With a colostomy, stools tend to firm up because the remaining colon absorbs water. Having several days with little output can be normal if there are no warning signs like pain, fever, vomiting, or stoma swelling.

3. Anxiety can slow bowel activity, so try to stay calm and focus on the true warning signs before assuming there's a blockage.

4. Always consult your stoma or ostomy nurse or surgeon if you're worried. They can provide reassurance or determine if a medical review is necessary.

5. Regarding diet:
- A soft or low-residue diet, often recommended for the first six weeks post-op, can reduce stool volume and slow transit.
- After this period, gradually reintroducing fiber can help normalize output. Check with your doctor before adding fiber supplements like Metamucil.

6. Keep up with hydration by drinking plenty of fluids.

7. Ozempic, a medication for diabetes, can delay gastric emptying and often causes constipation, especially after dose increases. Review your current dose and timing with your diabetes care team.

8. If you're concerned about the fit of your appliance, know that a pouch opening that is too tight rarely causes true obstruction. A quick call to your stoma nurse can help rule this out.

9. It's normal for many long-term colostomy users to experience variations in output, such as emptying the bag several times one day and then having little or no output for up to two days without issues.