Topic Explanation
The forum discussion revolves around an individual experiencing severe pain and frequent vomiting related to their ileostomy. The person has a history of cyclical vomiting syndrome and has undergone surgeries for a perforated bowel, resulting in two stomas. They are seeking advice on managing their condition without resorting to emergency services.

Advice and Insights
1. Seek Medical Attention:
- Multiple participants strongly advise seeing a doctor urgently, as the symptoms could indicate a blockage or another serious issue.
- It is suggested to contact a consultant, GP, or a 111 nurse/doctor for immediate advice.

2. Emergency Room Visits:
- If the pain is severe and persistent, going to the ER is recommended to prevent the situation from worsening and potentially requiring emergency surgery.
- Pain should not be ignored, as it could lead to further complications.

3. Managing Pain and Symptoms:
- Oral morphine was prescribed for pain management, with instructions to visit the ER if symptoms worsen.
- The importance of understanding personal pain thresholds and knowing when to seek emergency care is emphasized.

4. Monitoring and Diagnosis:
- A scan and MRI were conducted, showing no blockages, but a diagnosis of Superior Mesenteric Artery Syndrome (SMA) was made.
- Continuous monitoring and follow-up with healthcare providers are crucial, especially with a history of malnutrition and dehydration.

5. Hydration and Nutrition:
- Severe dehydration and malnutrition are significant concerns, and IV fluids are recommended to prevent further health issues, such as kidney failure.
- Participants stress the importance of addressing dehydration promptly, especially with existing kidney disease.

6. Communication with Healthcare Providers:
- Keeping in touch with stoma nurses and doctors is vital for ongoing care and management of symptoms.
- Persistence in seeking appointments and advocating for one's health is encouraged, especially when dealing with complex medical conditions.