This topic is about managing severe mucus build-up in the rectal stump after having a colostomy for a long time. The person sharing their experience has been dealing with this issue since 2009, following multiple abdominal surgeries. The mucus becomes a hard mass, causing significant discomfort and even affecting the bladder, leading to urinary incontinence. Despite trying various methods, the problem persists, and they are seeking advice on how to manage or remove the mucus effectively. Here are some suggestions and insights shared by others:

1. Anal irrigation technique:
- Use small-bore anal irrigation catheters, originally meant for pre-stoma bowel irrigation, and adapt them to a shower hose.
- Employ two catheters: one with the tip cut off for a forward water jet to flush the top of the rectal stump, and another left intact to clean the stump walls with side jets while rotating and withdrawing slowly.
- Perform this while squatting in the bath to manage any mess and to monitor the process visually.
- Measure the remaining rectal length and mark the catheter to avoid inserting it too far, reducing the risk of perforation.
- Continue daily for about 18 months until the mucus becomes consistently clear and watery, then switch to incontinence pads for minor drainage.
- Be cautious, as anal catheters can damage the stump wall if used too forcefully and may be harder to obtain due to these risks.

2. Suppositories:
- Some people find rectal suppositories effective for quickly liquefying and expelling mucus, and they recommend regular use to prevent painful build-up.
- While the effect may be short-lived for some, it is worth trying as a first-line, non-invasive measure.

3. Other resources:
- A forum thread titled "Discharge from Rectum" contains additional firsthand experiences.
- The Colostomy UK information sheet "Rectal Stump Problems" provides medical guidance on managing mucus, available options, and when to consider surgical review. You can find it at http://www.colostomyuk.org/wp-content/uploads/2017/11/Rectal-Stump.pdf.