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Dec 01, 2011

Ostomy reversal complications - Seeking advice on persistent diarrhea

The topic at hand is about dealing with persistent diarrhea after a colostomy reversal. This can be a challenging situation, especially after undergoing multiple surgeries and hospital stays. Here are some insights and advice that might help:

1. **Strengthen Sphincter and Pelvic-Floor Muscles:**
- After months of not being used, these muscles can weaken. Gradually, continence may improve as muscle strength returns.
- Consider starting or continuing pelvic-floor exercises, like Kegels, to help rebuild muscle tone both before and after surgery.

2. **Manage Symptoms:**
- Over-the-counter anti-diarrhea medications, such as loperamide, can help slow down bowel movements until muscle tone improves.

3. **Check for Inflammation or IBD:**
- Persistent diarrhea might be due to colonic inflammation. It’s a good idea to consult with a gastroenterologist to see if this is the case and to get appropriate treatment.

4. **Consider Dietary Causes:**
- Surgeries can sometimes lead to lactose intolerance, which can cause watery stools. Trying a lactose-free diet for a few days might help firm up stools.

5. **Infection Precautions:**
- Even though current tests are negative, C. diff is common in hospitals. Using an ammonia-based cleaner to wipe down surfaces during future hospital visits can help prevent reinfection.

6. **Additional Postoperative Tips:**
- Regular ostomy pouches can handle bowel prep without needing special high-output bags.
- Nutritional supplements like Ensure and high-protein snack bars can aid in regaining weight lost during hospitalization.
- For pain management, requesting morphine before the removal of a Jackson-Pratt drain can be helpful.
- For constipation, some have found relief with small, frequent sips of lactulose solution, though this is for the opposite issue of diarrhea.

These suggestions aim to provide some comfort and control over the situation while you work towards recovery.
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