Managing Pain and Complications with Mucus and Stool After Ostomy

Hi all,

I'm new to this forum and looking forward to chatting.
I have had a loop ileostomy since October last year. A few times, I've had mucus and stool surprises, but they have not been easy. I can experience intense pelvic pain, spasms, and cramping in advance; one instance landed me in A&E as I couldn't manage the pain at home.
I know (now) mucus and stool is a ‘normal' part of life after surgery with a stoma, but I am curious as to why these episodes cause me so much pain.
Does anyone else experience this pain on passing of either? I've had other passings where I have brief pain, but today another big one, and a bit of blood too.
The other question is, should I be using an enema once a month or more to ensure no buildup? Today I passed a small stool that felt like glass. 🙊🙉🙈

edit : 12/11/24- apologies all - the first time I had this mucus episode I ended up in hospital with the pain. They performed a scope and it showed radiation proctitis, which is why they think I’m experiencing such pain when passing. I find this difficult to believe since a year ago, before my surgery, I was passing stool without such difficulty. I had radiation in 2014 and have had nothing but problems since which has led to my surgeries. Thank you all so much for your comments. X

As we are all different it difficult to say if what you experienced would be considered normal…I too have a loop ileostomy as a result of a cyst on my colon (4 years ago now).  Once in a while I will pass mucus, fartlettes, and occasionally very tiny turdlettes but never any pain nor blood…only the feeling my colon wants it’s old job back which then passes….blood is always a bit concerning….not sure why you would do an enema…perhaps this is the reason for blood?  jb

Hello and welcome.  

I have a permanent colostomy, had it for 19 months.  Mucus.  At first I was confused.  With some research, discovered passing it is normal, even with a little blood.

Here's why:  Lining of the rectum still produces mucus which can build up and become difficult to pass, sometimes drying into a ball irritating rectal tissue.  This causes discomfort and pain when attempting to evacuate it; especially true if the mucus is not regularly expelled and accumulates.  

This exactly happens to me.  For several months, I'll pass "drops" of mucus.  They cause a little discomfort, but no real pain.  Then months will go by with nothing coming out.  Then one day I'll get discomfort, some pain.. and pass ALOT of mucus.  Sometimes it's dried up and not liquidly.  After that, I'll start passing little mucus drops for a month or two... then nothing for awhile.  So.. that's how it goes for me.

First time the mucus stopped, I visited my surgeon.  He checked my rectum, the same way you get a regular prostate check.  It did hurt and was very uncomfortable.  But needs to be done at least once a year.  He said everything looked good.  After that visit, the next day mucus began passing again for about 4 months non stop.  Then the start/stop cycle began again.

Consult with your colorectal doctor or specialist about using an enema.  They should be able to provide advice about mitigating your pain and cramping.  Good luck.

Hi Foxglove, welcome to the site. With the kind of pain you describe and some blood, it would seem to be time for a talk with your doctor and maybe have a scope done to see what's going on inside. Good luck.

Hello, I have a colostomy and a serious issue with mucus. I also have serious spine issues as seen in my pics. I need to use a small glycerin enema at times. My spinal cord injury caused my pelvic floor problems, mainly a "nonrelaxing puborectalis muscle," which feels like I am sitting on a golf ball and won't allow the mucus to pass. I require regular Botox injections into the muscle to get it to relax and relieve some pain. But more to your point, the mucus can collect and cause inflammation. Regular glycerin enemas and "Short Chain Fatty Acid" enemas help. The SCFA enemas are by prescription and not covered by my insurance, and are expensive. I hope you get some relief.

How to Get Back to Fitness After Ostomy Surgery with Ryan | Hollister

Why did you get your ostomy? I get pelvic spasms and pain all the time, but I have severe pelvic floor dysfunction (dyssynergia). When you pass mucus, does it come out easily, or is it hard to pass?

Doctors suggested the enema if I feel pressure to pass something. Am I supposed to help things out before it builds up?
I recently felt similar pressures, so I did the enema. There were a whole lot of spasms and pain across my colon, and I passed quite a bit of stool, then a small bit of blood. I was so tired for 24 hours after. I think the blood is likely due to the radiation proctitis. I'm just confused about why the pain is so intense.

Bowel obstruction due to complete scarring over of previous anastomoses where a previous stoma was reversed. I ain't going to do that again, so I'd really like to understand what's going on. Original ostomy due to radiation damage.

I seem to be in a similar rhythm ☹️

Though I did pass something yesterday without too much pain or blood, so that's good. I don't mind the passing if it's something I have to live with, but the pain that accompanied it the first couple of times put me in the hospital.

Hi, I had a scope - apologies , I edited the post - and it showed radiation proctitis active at that time. Drs think that’s the reason for the blood, but I still don’t understand the intense pain. 

Thank you for this. I'm sorry to hear of your spinal injuries. Thank you for the enema suggestions. The glycerin deposit might be more gentle. I have a lot of pain in my rectum, and a fissure was diagnosed a couple of years ago. Botox was mentioned as a solution to the pain then, and after reading your post, I wonder if there are spasms causing difficulty in passing. Thank you, these are issues I will raise with my colorectal team.

Thank you for this. I’m sorry to hear of your spinal injuries. Thank you for the enema suggestions. The glycerin deposit might be more gentle. I have a lot of pain in my rectum and a fissure was diagnosed a couple of years ago. Botox was mentioned as a solution to the pain then, and after reading your post i wonder if there are spasms causing difficulty in passing. Thank you, these are issues I will raise with my colorectal team. I could very well have pelvic floor issues too after pelvic radiation. 

Ostomy due to bowel obstruction- more details in my edited post. I find it very hard to pass, like things are not working at all 

Have you seen your surgeon, a colon and rectal doctor? Normally, they say to do an enema or get a glove and try manually to get it out, or sit in a warm bath to help relax the muscles to see if it will pass. I know the pain with mucus being stuck and not wanting to come out. It is very painful. When was the last time you passed any mucus, or have you been able to at all? I ask because sometimes the mucus can end up hardening if it's been stuck in there for too long.

I did a phosphate enema over two weeks ago (prescription given by my colorectal team) - a lot came out and there was a lot of cramping and spasms that came with it. Note to self: take painkiller before the enema next time. 
Strangely, about 3 days ago  I had some cramping and felt need to run to the loo - lots of wind passed and then another run 15 mins later with passing of a small stool. No drama this time though, once it passed all settled. That’s a positive, I guess. 

You shouldn't be passing any stool. Mucus, yes... sometimes it can be a darker color that has hardened, but you shouldn't have stool. Sounds like you had mucus stuck up there.