I've been able to adapt somewhat and mostly avoid full obstructions over the past 6 months by managing my diet. I've had obstructive symptoms, but been able to pull myself back from the edge (meaning either just a partial obstruction, or a full that lasted less than 4hrs or so). Im constantly thinking about what might get me into trouble and reacting to it. Hope it's more than luck. Going to keep trying. Surgery for me last resort. I just hiked the grand canyon, going on 33 years with pouch.