This topic is about dealing with pain caused by scar tissue around an ileostomy, which is a surgical opening created in the abdomen to allow waste to exit the body. The person experiencing this pain had an ileostomy in 2009 and a proctectomy in 2011. They started feeling sharp pain near the stoma about eight months ago, which worsens with movement but not when sitting or lying down. The pain is tender to touch, and changing the pouch has become difficult. Initially thought to be a muscle strain, it is now suspected to be due to scar tissue or adhesions. Surgery is considered a last resort. The person is seeking advice on confirming scar tissue, ruling out other issues, and finding relief.

Here are some helpful insights and advice shared by others:

1. Vitamin E: Consider taking 1,000 IU/day of natural d-alpha-tocopherol to help soften scar tissue. Be sure to check for any potential drug interactions.

2. Warm bath and self-massage: Taking a hot bath and gently massaging the abdomen can help relieve pain, especially if it's due to intestinal twisting or minor obstructions. Over-the-counter pain relief like acetaminophen (Tylenol) can also be helpful.

3. Hernia and adhesion repair:
- Adhesions might not show up on scans, so a laparoscopy might be needed for confirmation and repair.
- Using mesh during hernia repair can help prevent future hernias.

4. Further diagnostic work-up:
- Request a referral to a GI specialist or surgeon for imaging or an endoscopic inspection through the stoma. This can help rule out strictures, twisting, or mucosal issues.
- Keep an eye on ostomy output; a decrease might indicate an obstruction and should be checked by a GI specialist.
- If GI causes are ruled out, consider a spine assessment, as lumbar spine disorders can cause referred abdominal pain.

5. Nerve-block option: An interventional pain specialist can perform an abdominal wall nerve block, which is a quick outpatient procedure that can relieve pain for 6 to 12 months, though this varies by patient.

6. Adhesion-barrier sheet: If surgery becomes necessary, ask about a new intra-operative barrier material that can be used to reduce future adhesions.