Topic Explanation:
The forum discussion is centered around individuals' experiences with ileostomy or total colectomy with ileorectal anastomosis (IRA) due to colonic inertia and pelvic floor dysfunction. The original poster is seeking insights on the duration since surgery, post-surgical complications, the necessity of motility agents or laxatives post-surgery, and whether individuals would choose to undergo the surgery again.

Advice and Insights:

1. Ileostomy Experience:
- An ileostomy can significantly improve quality of life for those with colonic inertia, eliminating the need for laxatives and reducing pain and discomfort.
- Post-surgery, some individuals may need to manage their output to avoid nutrient loss, such as magnesium and sodium.

2. Total Colectomy and IRA:
- A subtotal colectomy or abdominal colectomy involves removing the colon within the abdominal cavity, leaving the rectum intact.
- Success with an IRA requires well-functioning sphincter and pelvic floor muscles, as well as an adequate length of rectum.

3. Surgical Decision and Timing:
- Some individuals regret not having surgery sooner due to misdiagnosis or delayed diagnosis.
- It is advised to consider surgery when younger, as recovery can be more challenging with age.

4. Diagnostic and Pre-Surgical Considerations:
- Sitz marker tests can help diagnose colonic inertia, though results may sometimes be misleading.
- Additional tests like EGD, gastric emptying studies, and anorectal manometry are part of the diagnostic process.

5. Managing Life Post-Surgery:
- Post-surgery, individuals may need to adjust their diet and eating schedule to accommodate activities and manage symptoms.
- Participation in programs focusing on the brain-gut connection may provide further insights into managing symptoms.

6. Medication and Treatment:
- Some individuals have experienced success with medications like Amitiza, though others have failed multiple motility medications.
- It is important to work closely with healthcare providers to find the most effective treatment plan.