This topic is about someone who has been living with a colostomy for five months but is still struggling with severe constipation, needing laxatives to produce any output. Their surgeon has suggested switching to an ileostomy to address the issue. They are reaching out to see if others have had similar experiences and to gather advice.

Here are some helpful insights and advice:

1. Seek a clear medical explanation and possibly a second opinion.
- It's important to understand why the colon isn't functioning properly and how an ileostomy might help. Ask your surgeon for details about any tests on colon function, the expected benefits, risks, and possible alternatives before making a decision.

2. If colonic inertia (a non-functioning colon) is confirmed, switching to an ileostomy can be life-changing.
- Some people have experienced significant improvements after moving to an ileostomy, especially if they had chronic constipation and blockages with a colostomy.

3. Be prepared for changes in fluid and salt management if the colon is removed.
- Without a colon, the small bowel takes on more responsibility for absorbing water. Some patients may need to take salt tablets and monitor their electrolytes carefully.

4. Be aware of the long-term risks of daily laxative use.
- Continuous use of laxatives can lead to organ damage, dehydration, and electrolyte imbalances, which can worsen constipation.

5. Optimize non-surgical measures while considering your options.
- Some people find success with osmotic laxatives like Miralax (polyethylene glycol 3350) or its generic versions. Others benefit from insoluble fiber supplements such as psyllium (Metamucil) combined with increased fluid intake.

6. Prepare a comprehensive list of questions for your surgeon.
- Ask about how the surgery will correct the issue, any dietary changes, medication adjustments, the impact on your lifestyle, and other treatments to try before opting for surgery.

7. Consider the cost of laxatives.
- When choosing generic laxatives, compare prices per ounce, as store brands like Kirkland may not always be cheaper in every region.