This topic is about a patient who is considering converting a loop ileostomy to a true end ileostomy due to ongoing issues and concerns about adhesions. Here’s a breakdown of the situation and some advice shared by others with similar experiences:

- The patient, nearly 65 years old, had a loop ileostomy in February 2017 due to colonic inertia and pelvic floor dysfunction. They now wonder why the colon wasn't removed initially to create an end ileostomy.

- The bypassed colon has become inflamed, leading to mucus and stool buildup, especially in the ascending colon. This causes prolonged transit, cramping, and difficulty passing stool. Cortisone enemas provide only temporary relief and aren't a long-term solution.

- Recently, the patient experienced an episode that resembled a full bowel movement, with mostly stool and little mucus.

- The stoma has issues: the functioning limb is recessed, and the non-functioning limb protrudes over it, preventing the peristomal skin from healing. The patient currently uses deep convex flanges.

- The surgical team now recommends a colectomy and conversion to a true end ileostomy. However, the patient has a history of adhesions, and part of the bowel is already fixed by them. The main concern is whether another surgery will worsen these adhesions or create new problems.

- The patient feels somewhat reassured after reading that adhesions may not be excessively disturbed during the conversion procedure but remains uncertain.

- A second surgeon believes that excessive stool is being forced through the inactive limb of the loop, leading to buildup and inflammation, and supports the idea of a colectomy.

- The patient looks forward to having a stoma that sits above skin level but is concerned about the potential waste of several boxes of deep convex flanges they currently own.

Advice and insights from others:

1. A member with a similar experience also has colonic inertia and pelvic floor dysfunction with a loop ileostomy and no plan for reversal. Their surgeon advised removing the colon within a year because an unused colon can deteriorate. They shared that they have not passed mucus after the initial weeks.

2. Coping with partner or family doubt:
- One member suggests openly listing all surgical options, risks, and expected outcomes in advance. This approach helps reduce second-guessing and the "I told you so" dynamic after decisions are made.
- It's helpful to view a partner's comments as attempts to help rather than confront. Maintaining clear communication can keep the focus on the medical decision rather than interpersonal tension.