This topic is about someone who has a diverting colostomy, known as a Hartmann’s pouch, and is experiencing symptoms that might suggest an intestinal blockage. They are preparing for a CT scan and are seeking advice on how to manage their situation and what to expect. Here are some helpful insights and advice:

1. The person has been passing very little stool for about a month, with almost no passage in the last week. They are experiencing symptoms like extreme abdominal and rectal fullness, nausea, bladder pressure, intermittent rectal mucus, minimal gas, no appetite, and fear of eating.

2. Their current routine includes taking Colace and Miralax at night, drinking prune juice, and staying hydrated with fluids like Gatorade, coffee, apple juice, and water throughout the day.

3. They have questions about how blockages are cleared, whether irrigation is ever required, how to cope with a nasogastric (NG) tube, typical blockage symptoms, what foods are safe to eat right now, and whether the CT scan will show an obstruction versus simple fecal loading.

4. They are concerned about the logistics of getting medical help, as their doctors are over 70 miles away and transportation requires 48 hours' notice through Medicaid.

5. They are slowly increasing their intake of clear liquids, but nausea persists. They plan to give the CT technician their full surgical and imaging history and ask for a preliminary read of the scan.

6. Their family doctor, who is only available on Tuesdays and Thursdays, defers all colorectal issues to specialists. They attempted to eat chicken-noodle soup but felt worse after taking Miralax and liquid Colace.

7. They have great anxiety about enemas or stoma irrigation, as a previous digital exam through the stoma caused sharp internal pain. They live in a rural area near the NY/PA border.

Advice and insights for managing the situation include:

- Increase oral fluids as tolerated, as dehydration can worsen an ileus or obstruction.
- If symptoms can be endured safely, wait for the CT scan, which will help differentiate between an ileus, fecal impaction, and true obstruction.
- At the imaging center, inform the technologist about the degree of pain and distension, provide a written surgical and medical history, and ask when the radiologist will read the scan. Request that they contact the treating colorectal surgeon immediately with preliminary results.
- Call the family physician’s office while still at the radiology department to obtain guidance once preliminary findings are known.