Life after an ostomy reversal can be a challenging journey, especially when dealing with ongoing issues like constipation and the fear of eating. A wife is seeking advice for her husband, who has struggled with severe chronic constipation for 20 years. After undergoing a partial colectomy and a diverting colostomy, he recently had an ostomy reversal. While his surgical incision is healing well and pain is minimal, his bowel function is still not optimal. He is only able to have a bowel movement every four days, and only with the help of Miralax and Dulcolax. This has led to a fear of eating, causing depression and anxiety. The new gastroenterologist has advised him to eat anything and continue with daily Miralax. They have a follow-up appointment with the surgeon soon, and she is reaching out to the community for practical advice and emotional support.

Here are some helpful insights and advice:

1. Clarify the root cause of the original constipation. Surgery and laxatives address symptoms, but it's important to ask the gastroenterologist to investigate potential motility problems, nerve function, and other underlying issues.

2. Recognize the mind-gut connection. Chronic worry, fear, and stress can further slow bowel movements through the autonomic nervous system. Engaging in stress-reduction practices like writing, gardening, walking, hobbies, meditation, or counseling may help improve motility.

3. Re-introduce food slowly and track responses. Start with easy-to-digest, cooked, low-fiber foods such as peeled cooked carrots and soft fruits without skins. Keeping a food diary can help identify which foods move through well and which cause problems.

4. Join support resources. Local ostomy or take-down support groups and online forums can help reduce fear and provide practical tips from people who have already gone through a reversal.

5. Be patient with the healing timeline. Many people report that bowel patterns gradually normalize over weeks to months after a reversal. Setting realistic expectations can help reduce anxiety.

6. Consider probiotics and adequate hydration. Daily probiotic supplements and increased water intake can promote healthier gut flora and softer stools.

7. Continue bowel aids as needed, under medical guidance. Miralax and Dulcolax are safe short-term tools. It's important to adjust doses with the guidance of a gastroenterologist or surgeon rather than stopping abruptly.

8. Encourage open communication with the care team. Share the food log, express fears openly, and ask for an evaluation by a colorectal motility specialist if constipation persists.