This topic is about a person who has been experiencing persistent abdominal swelling after having an ileostomy. They are trying to figure out if Small-Intestinal Bacterial Overgrowth (SIBO) might be the cause of their discomfort. Here's a bit more about their situation and some advice that might help:

- The person had emergency colorectal surgery back in 2014. Initially, they had a colostomy, but due to complications like a twisted small bowel, adhesions, and severe weight loss, it was changed to an ileostomy.

- Currently, they notice that their abdomen is flat when they wake up, but it starts to swell after their first meal. By the evening, the swelling becomes painful and puts pressure on their healing abdominal wound.

- They had a hydrogen breath test for SIBO, which came back negative. However, they are skeptical about the results because the test drink reached their ostomy pouch in about 45 minutes, and breath samples were collected for three hours, which might not be accurate without a colon to slow down transit.

- A specialist suggested trying a low-FODMAP diet and returning in three months. The person is unsure about this advice, especially since they didn't have any food intolerances before surgery.

- They noticed that when they empty their pouch into a sealed pot, the effluent hisses, ferments, and bubbles when opened. This makes them suspect that similar gas production might be happening in their small intestine, causing the swelling.

Here are some helpful insights and advice:

1. Consider getting laboratory tests done on the pouch output or urine to check for signs of infection or fermentation by-products. This could provide more diagnostic information.

2. The hissing or bubbling output might be related to certain foods. Some people experience this when they eat foods with skins or other hard-to-digest parts.

3. During episodes of bloating or if you suspect a blockage, try a low-residue diet or switch to full liquids temporarily.

4. Keep a detailed diary of your food intake and symptoms. Note every meal, the level of abdominal pain, and the total ostomy output. A normal ileostomy volume is about 700–1200 cc per 24 hours.

5. Tracking these patterns might help identify specific food combinations or triggers. This information can be very useful for future consultations with gastroenterology or dietetics specialists.