This topic is about someone who has recently had an ileostomy due to Crohn’s disease and is experiencing some worrying symptoms. They are seeking advice and support from others who might understand what they are going through. Here’s a summary of their situation and some helpful advice:

The person has been experiencing the following symptoms after meals since September 4, 2015:
- Increasing chest pain, nausea, and sharp abdominal pain around the stoma.
- A tender, enlarged bump next to the stoma.
- Near-blackouts with darkened vision upon standing.

Additional events include:
- One morning, the pouch filled with bright-red blood, but the bleeding stopped after emptying.
- Multiple overnight leaks required two appliance changes, and during a 4 a.m. change, they experienced severe chest pain, breathlessness, and intense nausea.
- They had an appointment to establish a new primary-care physician and are seeking advice before seeing someone who may not be familiar with Crohn’s or ostomies.

Additional questions and information:
- An abnormal EKG was found at the PCP visit, leading to an immediate ER visit. Zofran was ineffective, and a CT scan was delayed due to continued nausea.
- There is frustration over frequent ER visits, with staff and family labeling them a “drug seeker,” despite having documented active Crohn’s and ulcers. They are concerned about missing online classes and an SSI disability hearing.
- While hospitalized, they collapsed while emptying the pouch, developed septic shock with bacteremia, and spent several days in ICU. The infection and vital signs have since stabilized, but the effluent is now extremely liquid and empties within 30 minutes of eating.
- They express gratitude for community support.

Advice and insights:
1. Immediate care is critical: go straight to the ER when experiencing severe chest or abdominal pain, bleeding, or possible obstruction; do not “wait and see.”
2. Serious infections such as mesh infections or septic shock can develop quickly; delayed treatment can be life-threatening.
3. Emotional support: many ostomates face skepticism about pain control; rely on knowledgeable peers and advocate firmly with medical staff.
4. Medication note: Zofran (ondansetron) does not relieve everyone’s nausea; ask for alternative anti-emetics if ineffective.
5. Learn and adjust diet individually:
- Drink plenty of water (about 80 oz/day); adding around 1000 mg potassium citrate can reduce urine acidity.
- Limit or avoid fibrous plant foods, processed white flour, high-fat, greasy, or fried foods.
- Emphasize proteins and simple carbohydrates; re-introduce foods one at a time while monitoring output volume, consistency, odor, and peri-stomal skin reaction.
- Common triggers mentioned: cabbage, corn-on-the-cob, certain vegetables, acidic foods/oils.
- Some tolerate cooking with pure virgin cold-pressed coconut oil better than other oils.

Resource links shared:
- Healthline overview of septic shock: http://www.healthline.com/health/septic-shock#Overview1
- WebMD dietary guidance for Crohn’s flares: http://www.webmd.com/ibd-crohns-disease/treat-crohns-15/diet/diet-nutrition
- Basic ileostomy diet tips: www.theamericanostomyclub.com/diet.html