The topic at hand is about exploring non-surgical options for managing diversion proctitis, a condition that can occur after a permanent colostomy. The person sharing their experience is looking for alternatives to surgery, as they wish to avoid procedures like reversal or proctectomy, often referred to as "Barbie-Butt" surgery. They had some success with mesalamine suppositories for a while, but these have since stopped being effective. They are curious if others have tried any of the following methods:

1. Warm virgin coconut-oil enemas
2. Homemade virgin coconut-oil suppositories
3. Short-chain fatty-acid (SCFA) enemas prepared by a compounding pharmacy
4. Autologous fecal microbial transplant (aFMT)

Some additional context includes:

- The colostomy was performed three years ago.
- The individual was not informed by their colorectal surgeon that diversion proctitis was almost inevitable, even though inflammation occurs in nearly all patients with a diverted rectal stump, though only about 30% show symptoms.
- They are determined to avoid further surgery.

In terms of advice and insights shared by others:

- One person mentioned that a combination of one of the listed alternatives, along with mesalamine/mesalazine, provided them with relief. However, they noted that this might not work for everyone.