The topic is about preparing for stoma reversal surgery, specifically focusing on diet and bowel preparation. A person who had a colostomy due to a perforated bowel in 2016 is considering a five-day fast before their upcoming reversal surgery. They are curious if this will help create a "clean, empty colon" for the surgeon, as they often fast for detox purposes. They are trying to determine if this is beneficial or if they are overthinking it.

Here are some insights and advice shared on the topic:

- The person stopped eating three days before their surgery and only consumed Smartwater. They completed the standard surgical bowel flush the night before, which resulted in minimal output. The reversal was successful, and they left the hospital without pain medication on the fifth day. They encourage others to proceed with the surgery and wish they had done it sooner.

- Typically, normal surgical bowel preparation is sufficient. Most surgeons require:
1. A 24-hour clear-liquid diet and no food or drink after midnight.
2. A full oral lavage, which usually involves drinking eight glasses of a prescription solution or a Miralax and Gatorade mix (avoiding red dye).
3. Some surgeons may add a pre-op enema or an oral protein drink on the morning of the surgery.
4. In some cases, a surgeon might require two days of thorough cleansing.

- Long fasts, such as five days, are generally discouraged unless specifically approved by the surgeon. It's important to have enough calories, protein, vitamins, and electrolytes to heal and start moving around after surgery. Extended fasting might lower micronutrient levels that need to be normal for surgery. Since you'll already be on clear liquids post-op, it's best to arrive well-nourished.

- Always discuss any dietary or cleansing plans with your surgical team and follow their protocol exactly.

- For post-reversal recovery, expect fatigue, frequent stools (5-10 times a day is common), and changes in appetite for several weeks. Loperamide (Imodium) is often prescribed to slow down bowel movements. Eating small, frequent meals and taking short walks can aid recovery. Bowel frequency usually improves over 3-6 months. Maintaining a sense of humor and a positive outlook can help manage pre-op nerves and post-op adjustments.