This topic revolves around a young person dealing with a rare pelvic-floor nerve disorder that causes frequent and unpredictable bowel movements. This condition has confined them to their home, affecting their work, social life, and mental health. They are considering an elective sigmoid colostomy, which is a surgical procedure that could potentially improve their quality of life. Here are some insights and advice shared by others who have faced similar decisions:

1. Quality of Life Improvements
- Many people with long-term colostomies or ileostomies report significant improvements in their ability to travel, work, socialize, and engage in activities like yoga and swimming. They often describe the procedure as life-changing and would not choose to go back to their previous condition.
- The surgery could eliminate the current daily loss of 3-6 hours to bowel movements and improve sleep quality.

2. Decision-Making Considerations
- Consider the surgery as a reversible, elective procedure aimed at enhancing quality of life. A positive mindset and therapy can help address any emotional concerns beforehand.
- Discuss with the surgeon whether the colostomy can remain reversible and when irrigation can safely begin.

3. Ostomy Irrigation
- Those who irrigate typically spend about an hour each evening on the process, resulting in minimal output between sessions. They often wear only a stoma cap or mini-pouch during the day.
- Proper instruction can prevent complications, and irrigation should start once post-operative healing is complete.

4. Stoma Placement and Hernia Prevention
- It is recommended to place the stoma below the pant or waistline to reduce rubbing, aid concealment, and allow for fashionable clothing choices.
- Core-strength exercises and proper lifting techniques can help reduce the risk of hernias.

5. Pouching Systems, Supplies, and Accessories
- The ConvaTec SUR-FIT Natura Two-Piece system is highly recommended for its comfort and discretion.
- Options like closed-end and mini pouches are available for added discretion and intimacy.
- Check with your insurance provider, such as Aetna, to understand coverage for supplies.

6. Swimming and Sports
- Many people swim for hours without leaks, though some prefer to change the flange after a long day at the beach.
- Standard pouches adhere well without the need for special belts, and swimwear like tankinis or swim-dress one-pieces can offer additional comfort and confidence.

7. Daily Living Tips
- Empty the pouch 3-4 times a day and roll it up to prevent it from resting on the thigh.
- Avoid foods that can cause blockages, like corn and celery, and gassy drinks before outings.
- While adult diapers were mentioned as a temporary travel solution, many find a colostomy offers a better long-term quality of life.

8. Resources
- An article on elective colostomy is available at ostomy.org.
- A supportive forum community is available for ongoing questions and answers.