This topic explores why people who have had their colon removed and now have an ileostomy might experience more blockages in their small intestine. Even though food still enters the small intestine first, the absence of the colon seems to make blockages more common. Here are some reasons and tips to help manage this situation:

- The stoma outlet is smaller: When an ileostomy is created, a loop of the small intestine is brought through the abdominal wall and stitched to the skin. This process makes the opening narrower than the original intestine, so foods that are not well-chewed, like corn, nuts, or high-fiber foods, can get stuck and cause blockages.

- The body tries to close the abdominal opening: Over time, natural healing can cause the opening to shrink, sometimes requiring surgery to move the stoma. This can make the exit even smaller.

- Route changes and sharp bends: The small intestine is rerouted to reach the surface, creating new curves or bends that weren't there before. These angles can trap food that hasn't been chewed well.

- Post-operative adhesions: Any abdominal surgery can lead to the formation of fibrous adhesions around the bowel. These adhesions can restrict normal movement and increase the risk of blockages.

- Early adjustment period: Right after surgery, the gut is still getting used to the changes, and its movements might be slower, making blockages more likely.

- Pre-existing slow transit: Some people already had slow bowel movements or constipation before surgery. With a shorter bowel, the same slow movement now has less space to work with, so blockages are noticed more quickly.

To help manage these challenges, consider the following strategies:

1. Chew every mouthful thoroughly to help prevent blockages.
2. In the early months after surgery, purée or liquidize foods to make them easier to digest.
3. Consider taking Metamucil (psyllium husk) after meals to keep the output soft and moving smoothly.
4. If possible, irrigation can help clear out any leftover contents and reduce the frequency of blockages.