This topic is about a person who is considering changing their type of ostomy to relieve severe bloating, odor, and pain. They currently have a sigmoid colostomy but are thinking about switching to either an ascending colostomy or an ileostomy. Here’s a bit more about their situation and some advice they’ve received:

- The person was diagnosed with a neurological disorder at 20, which affects their internal sphincter and causes frequent bowel movements and constant fecal odor. They had a sigmoid colostomy in 2013 but still experience stool odor, severe bloating, and intense pain. They irrigate twice daily to relieve pressure and are unhappy with the solid output and 24-hour transit time.

- An X-ray showed no torsion or obstruction, and gut motility appears normal. Their surgeon suggests the issues are due to "typical sigmoid constipation," although they never experienced constipation before the ostomy. They are seeking a second opinion and considering switching to an ascending colostomy or ileostomy.

Here are some insights and advice shared by others:

1. **Seek a Second Opinion**: It's important to get another medical opinion to rule out any surgical errors or hidden obstructions, especially since persistent pain and odor are not typical.

2. **Ileostomy vs. Colostomy**:
- Long-term ileostomates report a quicker transit time, liquid consistency output, and minimal gas or odor. They also mention smaller stomas and no need for daily irrigation.
- Colostomates who irrigate find it gives them odor-free periods and an almost empty pouch, which some prefer over frequent emptying with an ileostomy.
- An ascending colostomy produces more liquid output than a sigmoid or descending colostomy and is less prone to obstruction than an ileostomy, but it can still produce gas and odor.

3. **Gas & Odor Control**:
- Chew food thoroughly and avoid swallowing air while eating or drinking.
- Identify and avoid personal trigger foods like garlic, asparagus, and certain fish.
- For deodorizing the pouch, try placing a scored aspirin tablet inside or dissolving it in a bit of water for thicker output.

4. **Appliance & Skin-Care Techniques**:
- Clean skin with plain water and use stoma powder to protect the skin.
- Apply a secure seal with products like Stomahesive wafers and paste.
- Consider using a support belt for hernia protection, but be cautious with belts that have a circular cut-out around the stoma as they can promote hernias.

5. **Supplies & Brands**:
- Some recommended products include Convatec Natura systems, Hollister systems, and various stoma care accessories like adhesive-remover wipes and skin-barrier wipes.

6. **Diet Tips for Ileostomates**:
- If you want to eat salads, try small, well-chewed portions with starches or cooked foods to avoid loosening output, and introduce them gradually.

Overall, it's crucial to get a thorough evaluation for unexplained bloating and consider an ileostomy if gas and solid stool are the main issues. However, successful colostomy irrigation can also provide odor-free periods if the gas problem is addressed.