Mucus from Rectal Stump

Hello. I'm reaching out with the hope of finding a solution(s) to a daunting issue I am faced with. I had an end sigmoid colostomy 14 months ago for stool to bypass my dysfunctional pelvic floor muscles. I could not expel stool via my ano-rectal canal because of "paradoxical contraction" of my puborectalis muscle. It closed tight when it's supposed to open to allow stool to come out. Anyway, the surgeon for some reason left quite a bit of colon and my rectum and anus intact. This is causing me a serious problem with all the mucus that the stump still produces. Unlike most ostomates who produce a good amount of mucus from their rectal stump, I cannot expel the mucus by sitting on the toilet and bearing down as if having a bowel movement. I have to take a small water enema to dilute the mucus and then force the mucus out with the water by straining hard because of my paradoxical contraction. But, today I haven't even been able to do that because my pelvic floor muscles have become too weak. I can't generate enough pressure to force out the water and mucus mixture. This is driving me insane. The pain and discomfort is indescribable.

Has anyone else experienced this? How did you deal with it? What was your solution?

Any guidance on what I can do to get some relief would be deeply appreciated. I have read that if I cannot expel the mucus it will build up to a hard mass that has to be surgically removed. Thanks for patiently reading through my narrative.

Oh dear! This sounds like an awful situation. Unfortunately, I don't think mucus can be avoided—I experienced it too, even though my reason for ileostomy was extreme pain when passing things. In my case, I essentially had to suck it up and pretend it didn't feel like acid on my skin, but your case sounds significantly more serious than mine, so I would suggest calling your doctor right away or going to the emergency room.

Trust me, I know that going back to the emergency room after a stoma surgery is the last thing anyone wants to do, but sometimes it's necessary for your safety.

Good luck! o7

Hello markmd1112

Thank you for posting your predicament on here as it doesn’t often come up as a subject, which makes me think that those who ‘suffer’ from it might be a bit more isolated in their predicament than they ought to be.
Prior to having a stoma, I had similar problems with passing faeces and used to anally irrigate. The hospital provided me with anal irrigation catheters (alongside dire warnings of what can happen if I was not ultra-careful in doing this procedure!)
After my stoma, I had similar problems with excessive mucus, so it seemed the obvious thing for me to do was to irrigate as I had done in the past.  However, it did not work with a gravity-fed water system, so I made my own pressurised system.
This consisted of finding out how much colon made up my rectal stump so that I knew how much leeway I had to insert the catheter(s). 
The first catheter I made so that the jet came out directly from the end, which flushed the far reaches of the anus
The second catheter had jets directing the water to the sides which, when twisted would clean and flush the mucus from the sides of the anus,. I would begin the process of twisting and pulling the catheter out from the inside outwards so that it flushed everything out from tom to ‘bottom’ as it were.
These catheters were rigged up to my shower unit in the bath,which is where I squatted, so that any output would land in the bottom of the bath and be visible for inspection.
This worked very well for a year or so until the problem eased and I felt I no longer needed to undertake this procedure anymore.
I would say that if I needed to do it again, I would probably use the same irrigation set-up that I use on my stoma. This involves a pressurised garden sprayer with a Coloplast regulator and an adapted anal catheter on the end.  This works very well in the stoma,  so I don’t see any reason why it would not work anally. 
I do hope you manage to find a way to resolve your own problems, but, if you try the anal catheter method, please take the warnings seriously as ruptured colons can be even more difficult to deal with than mucus.
Best wishes

Bill

Hi Mark, sounds like you need your rectum and anus removed and having a complete ileostomy, which I had done. Life for you will be much better, I'm sure. Regards, IGGIE

Hi there,

I have. I actually have my ileostomy for very severe pelvic floor dysfunction. I actually couldn't even use any water to try and get mucus out, and before my ileostomy I wouldn't go to the bathroom for 3 weeks. My muscles are so severely tight they don't let anything out. I ended up having my rectum removed but left my anus.

My Ostomy Journey: Keyla | Hollister

You should definitely return to the hospital. You don't want any ruptures. Iggie has good advice and experience.

Good luck and hope you can get this resolved ASAP.

Hello markmd1112

I am in the same situation right now. It's so tight the water is not going in or out. I am using pressurized water with anal irrigation catheters. My seat is close to my shower, so I connect the catheter to the hose I use with my handheld shower and get some warm water. But like I said, it's really tight today, and I am still going through pain issues from my last surgery. I am not ready for another surgery of any kind after my last back surgery (see my pics). Even after replacing the broken rod, I still have problems with my left leg. I have done Botox injections, and they have worked in the past. I just had one a few weeks ago, but not much relief this time. Going to sit on some ice and see if I get a reaction.

Hi Papabioo,

Can you provide me info on anal irrigation catheters? What are they? How do you use them? Where do you get them?

Are you familiar with using a Foley catheter to get past a tightly shut puborectalis muscle? Can you point me to info sources where I can learn more?

Thanks in advance for your help.

Hello Bill,

Thanks for your reply. I admire your creativity and ingenuity. Unfortunately, I don't have the manual dexterity to create and use devices like yours. Do you have any suggestions for where I can get a rectal stump irrigation device that can get past my tightly shut puborectalis muscle and can be used to liquefy and draw out the mucus without me having to strain?

If only they made something like that. Mucus hurts when it hardens and stays in there.

Hope you are able to resolve this issue soon. This is not a solution now, but maybe in the future. I have a colostomy in my lower intestines too due to Crohn's disease in my anus/rectum. The surgeon did not remove these areas, and I had a lot of pushing/pain and mucus coming out of my anus. My anus was always painful. Also, I could not get pregnant after trying for 5 years. A new surgeon went in and tried to do a repair to quiet the area. He removed polyps and cut the muscles in my anus so the terrible contractions would stop. So now the mucus just drains out some days very little and other days a little more, and I just wear padding. I can feel the mucus come out, but the contractions are very mild. But the disease did quiet in that area (it has moved to other parts of my body). My question is, in the future, can they cut the muscles in your anus so you no longer have this pain and the mucus just flows out? Also, my disease went into remission for quite a while after this surgery. I was also able to give birth to 2 children. It's been over 30 years.

Married from someone who suffers from extreme pelvic floor dyssynergia (dysfunction) and the muscles being so overly tight, that would be great, but they would be cutting your pelvic floor, the muscle that controls the anus. All potty and bowel movements are controlled by the pelvic floor muscle, and those muscles stretch from the front where your potty is and go all the way back to your bottom.

I was thinking of just sphincterotomy: In this procedure, your surgeon cuts into your internal sphincter muscle to reduce tension in your anus. Possibly, this would allow a free flow of the mucus.

Married is a good idea, but the problem is that the muscle that controls the anus and all of your back end and your front end is your pelvic floor muscle, so it wouldn't help someone with pelvic floor dyssynergia (dysfunction) being overly tight. It will still be tightened; it will still hurt because the muscle that controls all of it is your pelvic floor. That muscle sits like a swing, reaching from the front and going all the way to the back, and it controls both ends. And they can't do anything for pelvic floor dysfunction. The only thing he could try is to see if the doctor would try Botox injections, but that's not a proven theory. It didn't work for me. But I have absolute zero movement of my pelvic floor. So factors would be how bad his is, and he might be the one that has success, but I'm not sure if they will do it post-ostomy.

Rectal stump. Its kind of a funny term. Only makes sense to us Ostomates who have one.

Consider yourself lucky if your stump only produces occasional mucus.

My rectal stump produced a little mucus every once in a while, for a year. Then it became inflamed. Inflammation caused bleeding. So instead of a little mucus... I'm now pooping out brownish liquid mixed with blood, 3 to 5 times daily. I can "hold" it during the day, but not when I sleep. It leaks out.

Visited my most excellent Gastroenterologist. He performed the usual checks and declared: Inflammation. Prescribed me a suppository medication called Mesalamine, 1000 mg. For 30 days, I inserted one before bedtime.

After the first one... bleeding stopped. I thought: "How cool is that!" Had no bleeding or liquid at all for the next 29 days I used this medication. Had no side effects.

After completing medication, I wondered, "Are my bleeding days over?" 2 weeks later, I got the answer: NO, started bleeding again.

So what to do? Live with it and wear a pad? Try another medication? Get Barbie Butt surgery?

Maybe take the medication 1 suppository at a time. Take 1, bleeding stops. Wait a week or 2, take another suppository. I'm unsure if that would work or cause other unforeseen trouble.

Hi Beth,

I was scheduled for completion proctectomy (ken butt) surgery that has been postponed because of the UTIs I keep getting. Hopefully, my infection can be cleared up soon, and I can be rescheduled. I have a few questions:

1. How long ago did you have your surgery?
2. How difficult was it for you right after the surgery? What were the main issues, and how did you manage them?
3. How long was the recovery period? How did you manage? Any tips?
4. Did the surgery resolve all your issues?

Markmd, which surgery are you talking about? I didn't have a full Barbie butt surgery; I had my rectum removed and left my anus. With pelvic floor dysfunction and being overly tight, it's not an option for me to have my anus removed, as it will cause way more issues and much more pain. If you're asking if the mucus has resolved from getting the rectum removal, yes, but no surgery will stop pelvic floor pain or spasms. If you would like to get into further details about the pelvic floor and the muscles, I can message you. Let me know.

So... can the rectal stump be removed, leaving the anus? Does the anus retain sealing capability?

Yes, the rectal stump can be removed and leave the anus intact. And you get sewn on the side above the anus.