This topic is about someone who has been experiencing severe cramping, bloating, and vomiting after meals. They have a permanent ostomy due to previous surgery complications, and they are worried that these symptoms might be caused by adhesions (scar tissue) or a twisted intestine. Here are some insights and advice that might be helpful:

1. It's important to get a quick evaluation from an experienced gastroenterologist or colorectal surgeon. If there's a suspicion of an obstruction, exploratory surgery might be necessary.

2. Adhesions, which are external scar tissues, can cause the intestines to stick together, leading to cramping after eating. These might not show up on a CT scan, so direct visualization or surgery might be needed to confirm their presence.

3. A twisted or kinked section of the intestine can cause bloating and pain that might not always be visible on imaging. It's a good idea to discuss this possibility with your gastrointestinal team.

4. If symptoms are severe and recurring, consider hospital admission for continuous monitoring, comprehensive blood tests, and imaging. These tests can help identify infections or other complications.

5. Try to eat small, frequent meals instead of large ones, as big meals can trigger cramping and bloating.

6. Sometimes, a nasogastric tube (a tube through the nose) is used to relieve vomiting and reduce pressure while waiting for a surgical decision.

7. Bring someone with you to medical appointments. Pain and medication can affect your memory, so having someone to take notes can be very helpful.

8. If you suspect medical negligence, such as an intestine being improperly tied off, consult a malpractice attorney early and keep all your medical records.

9. It's crucial to act quickly if symptoms worsen, rather than waiting for many months.