This topic is about dealing with the challenges of a bowel obstruction, particularly for someone who has experienced a frightening episode due to a parastomal hernia and scar tissue. The person is seeking advice on how to predict and prevent future obstructions without surgery. Here are some helpful insights and advice shared by others:

1. Seek Specialist Care Early
- At the first sign of trouble, consult a colorectal or GI surgeon rather than going to the ER. Look for centers with expertise in ostomy care.
- Have an advocate with you and arrange for home-health support or friends to monitor your condition. Call emergency services sooner rather than later if needed.

2. Dietary Management & Hydration
- Maintain two lists in your refrigerator: one for foods that thicken stool and another for those that thin it. Adjust your diet at the first sign of change in output.
- Consider "thin/flush" options like hot liquids, apple juice, V8, prune juice, clear juices, Ensure, watered baby food, and yogurt.
- Be cautious with high-fiber or "membrane" foods that can clump together, such as peanuts, seeds, cabbage, oranges, raw pineapple, mushrooms, and certain noodles.
- Many find success with small, soft, "white" meals or even liquid diets.
- Keep products like Benefiber, Imodium, Bentyl, Modulon, stool softeners, or mild vegetable laxatives on hand, especially when taking narcotic pain medication.

3. Mechanical & Positional Tricks When Output Slows
- Drink 3–4 cups of very hot fluid in quick succession.
- Use a warm bath or heating pad on your abdomen and try gentle abdominal massage.
- Perform knee-to-chest "rolling" exercises by elevating your buttocks and pulling your belly up, repeating until output resumes.
- Engage in light exercise or walking if you can tolerate it.
- Relax your gut with Ativan (lorazepam) or a prescribed anti-spasmodic.

4. NG-Tube Tips If Unavoidable
- Insist on a pediatric-size or small-bore tube.
- Request 1–2 mg of IV Ativan (or equivalent) and adequate pain relief beforehand.
- Ask for lidocaine spray to numb your nose and throat, and have the tube chilled in ice water to stiffen it. Request pauses if your gag reflex is triggered.
- Use throat-numbing lozenges afterward.

5. Surgical Perspectives
- Some have found permanent relief from recurrent obstructions through adhesiolysis, hernia repair, or stoma relocation, depending on the surgeon's experience.
- Others manage chronic strictures with daily colostomy irrigation; consult a WOCN (ostomy nurse) to see if this is an option for you.
- Understand that large parastomal hernias rarely improve on their own and may eventually require repair.

6. Product / Supply Notes
- Convatec one-piece and two-piece systems are praised for their reliability.
- Medicare typically provides 20 flanges per month, but frequent leaks with flush stomas may require an appeal for additional supplies.
- Useful resources include ostomy.org for diet and blockage handouts, txcolorectal.com, and articles on digestion.

7. Emotional & Practical Support
- Keep emergency contacts, medical history, and "blockage instructions" card visible.
- Arrange pet-care and family backup plans in advance.
- Don't hesitate to call for a welfare check on isolated ostomates, as community action can be life-saving.