This topic is about dealing with bowel obstructions when you have a colostomy. It covers the causes, ways to prevent them, and strategies for relief at home. Here's a breakdown of the advice and insights shared by others who have experienced similar situations:

1. **Diet & Chewing**
- Many people have experienced blockages after eating oranges (especially the membranes) and nuts. It's often recommended to avoid these foods or chew them very well and drink plenty of fluids. Some find tangerines or mandarins easier to tolerate.
- Other foods that might cause issues include popcorn, raw fibrous vegetables, fruit skins, seeds, quinoa, spaghetti squash, shirataki noodles, and thick fries. These are safer when cooked until soft, minced, sliced thinly, or pureed.
- For those with an ileostomy, the mantra is "CHEW-CHEW-CHEW and DRINK-DRINK-DRINK," with many choosing to eliminate nuts, seeds, and peels entirely.

2. **Hydration & Medications**
- Dehydration and oral decongestants can lead to blockages, so it's important to stay well-hydrated and consider avoiding decongestants.
- Some have used morphine, Demerol, or Percocet in hospitals to relax spasms and ease pain, but these should be used under medical supervision as they can slow bowel movements. Anti-nausea medications like Gravol did not cause constipation for them.
- Miralax (polyethylene-glycol) is used by some at the first signs of a blockage.

3. **At-Home Warm-Water Irrigation (Colostomy Only)**
- The technique involves kneeling over the toilet and gently injecting 50 ml of warm water into the stoma with a thick-tipped syringe, then attaching a large drainable pouch and waiting about 30 minutes for the blockage to pass.
- It's helpful to keep 50 ml irrigation syringes at home, which can be obtained from suppliers or hospitals.
- Some use a pediatric enema bottle filled with warm saline, while others use a Coloplast Sensura irrigation set for routine irrigation.
- It's crucial never to irrigate an ileostomy; only a physician should handle this.

4. **Early-Warning & ER Tips**
- Early signs of a blockage include sharp gut pain, reduced or no output, stomach ache after a risky meal, or vomiting dark green/black bile.
- If these symptoms appear, stop eating solid food, drink very warm water, lie down, and roll side-to-side. If not resolved within 12 hours, go to the ER.
- In the ER, request rapid IV fluids to prevent dehydration and ask for a CT scan. Some people self-irrigate once on IV fluids.
- Walking and hospital-administered enemas have helped some people clear the blockage and avoid needing an NG tube.
- Some request an NG tube voluntarily if vomiting bile and severe pain persist.

5. **Surgery & Adhesions**
- Repeat obstructions can occur due to adhesions. Some advise against further surgery as it can lead to more adhesions, preferring conservative measures unless the situation is life-threatening.

6. **Emotional & Practical Considerations**
- It's wise to keep various pouch sizes and irrigation gear at home.
- Families also feel the stress of these situations, and clear education from stoma nurses and surgeons is often lacking.
- New ileostomy patients who initially eat without issues are cautioned that the risk of blockages can increase over time, so monitoring diet and chewing habits is important.