This topic is about a person who has had a permanent ileostomy and is experiencing issues with their retained rectal stump. They are concerned about a recent episode of passing a large, impacted mass with blood clots and some bleeding. They are wondering if this is normal and are seeking advice.

Here are some helpful insights and advice:

1. If you experience bleeding, it's important to contact your surgeon or general practitioner promptly. They might recommend a flexible sigmoidoscopy or a full colonoscopy to find the source of the bleeding.

2. It's normal for rectal stumps to produce mucus for lubrication. The amount and frequency can vary greatly, from daily to weekly, or sometimes not at all for extended periods.

3. Temporary bleeding can occur due to:
- Trauma to the stump when thick mucus or stool is expelled after a build-up or impaction.
- Damage from previous radiation or chemotherapy treatments.
- Hemorrhoids or minor tissue tears.

4. Monitoring your haemoglobin levels and maintaining a high-protein diet can help manage minor chronic blood loss.

5. Sitz baths can be soothing, helping to relieve pressure, soften mucus, and ease the passage when there's a build-up causing pain or bleeding.

6. Some surgeons may prescribe rectal corticosteroid irrigations, such as liquid cortisone delivered with a pump, to reduce inflammation in the stump and stop bleeding.

7. If bleeding continues, it's important to rule out strictures, recurrent ulceration, or ongoing radiation injury. Long-term management might involve periodic scopes and using panty liners for any seepage if no correctable cause is found.

8. Experiencing phantom urges and pulsations is common because the colon or stump still receives peristaltic signals even after diversion.

9. For chronic issues with the stump, some patients consider a completion proctectomy (where the anus is sewn closed, often referred to as a "Barbie Butt") or alternative continent procedures like a J-pouch or BCIR. Each option has its own indications and risks.