This topic is about someone who has been living with an ileostomy for 35 years without major issues until recently. They are now experiencing severe intermittent pain, minimal stoma output, gas build-up, and episodes that feel like an "adrenaline rush." They are seeking advice and insights from others who might have faced similar challenges. Here are some key points and advice shared by the community:

- The person has been dealing with intense abdominal pain, nausea, and vomiting, leading to frequent hospital visits. Once the stoma output resumes, they are discharged with opioids.
- They are currently taking Oramorph (oral morphine), Ondansetron, and Lyrica. Despite normal blood tests and X-rays, the symptoms persist.
- During these episodes, the stoma output decreases, the stoma itself shrinks and then re-expands, and there are loud bowel noises. Bloating occurs, but little gas is released. They also experience a significant "adrenaline rush" or feel faint after eating small meals, along with chronic sleep loss and weight loss.
- Hydration and salt intake are carefully managed due to a history of POTS, but food trials have not identified any triggers. Opioids might be affecting gut motility.
- A new gastroenterologist has ordered an MR-enterography (MRE), but there is a 12-week wait.
- They are asking the community if anyone else has experienced similar symptoms or suspected a sub-acute obstruction with a functioning ileostomy.

Additional information from later posts:

- They have been re-admitted multiple times and discharged after receiving IV morphine, with normal lab results.
- A consultant mentioned a "possible sub-acute obstruction."
- They report dizziness or feeling faint after small meals, with normal capillary glucose levels.
- An MRI showed extensive adhesions and a parastomal hernia, leading to surgery where the stoma was re-sited.
- Post-surgery, the major pain is gone, but cramping, bloating, and "head-spin" after eating persist, along with continued weight loss.
- They are now on a lower opioid dose, intermittent Flagyl, and prescribed nutritionally-complete drinks, awaiting further CT and dietetic review.
- The new stoma is almost flush, causing leaks, and they are learning to use new appliances.
- They are curious if a mid-line stoma placement offers advantages over the traditional right-lower-quadrant site and if others have issues with low-residue diets causing leaks.

Advice and insights from the community:

1. Obstruction and Imaging:
- Normal X-rays can miss adhesions, strictures, or hernias. Push for cross-sectional imaging like CT with contrast or MRE, or seek a surgical review.
- Using the Emergency Department for an urgent CT can speed up diagnosis.

2. Opioid Caution:
- Repeated use of morphine or Oramorph may worsen motility and mask obstructions. Consider alternatives or limit use to short-term.
- Some find low-dose Diazepam or NSAIDs helpful for muscular cramping.

3. Bowel Motility Aids:
- Miralax or polyethylene glycol can provide rapid relief for partial blockages, but use only with medical approval.
- Ultra Flora for Seniors probiotic helped one member with output and blockage issues.

4. Diet and Hydration:
- Frequent small meals and constant fluid intake can prevent dehydration, especially with high-volume ileostomy output.
- Japanese-style noodle soup with well-cooked vegetables and small protein portions is gentle on output.
- Avoid relying solely on protein shakes, as excess protein can harm kidneys.
- A pinch of baking soda in water can quickly reduce gas and heartburn.

5. Appliance and Stoma Care:
- For a flush or new stoma, use filler strips around the aperture to prevent leaks. Modern one-piece pouches with integrated filters can eliminate the need for external clips.

6. Surgical Perspective:
- Adhesiolysis and hernia repair can be beneficial when pain and functional loss are severe, but be prepared for possible recurrence.
- Re-siting the stoma is common if the existing site is compromised. It can move the stoma away from scarred areas and accommodate clothing waistbands, though adapting to a new site takes time.

7. Shared Symptoms:
- Several people report dizziness, adrenaline-type surges, and "phantom BMs" after eating. These sensations are real and may relate to rapid glucose shifts or autonomic responses.

8. Self-Advocacy:
- Persistence with healthcare providers and seeking second opinions are crucial. Trust your instincts and push for appropriate imaging and surgical assessments.

9. Psychological Well-being:
- Chronic pain and isolation can lead to depression. Engage with family, seek counseling, and find online support. Celebrate small milestones like getting off the sofa or going on short outings.

Products and drugs mentioned include Oramorph, Ondansetron, Lyrica, Miralax, Ultra Flora for Seniors probiotic, Flagyl, PPIs, Valium, Ibuprofen, and Convatec products.