This topic is about dealing with the discomfort and challenges of managing painful mucus discharge and tenesmus from a rectal stump. The person experiencing this issue finds that mucus builds up in the rectal stump and cannot be expelled through normal means. They have been using small tap-water enemas to clear the mucus, but this leads to severe and prolonged pain, spasms, and a sensation of needing to pass stool (tenesmus) that can last for days. They are looking for alternative ways to manage the mucus and alleviate the pain.

Here are some suggestions and insights that might help:

1. **Consultation and Suppositories**:
- Talk to your surgeon or stoma nurse about using glycerin suppositories to help evacuate mucus. Many people with ostomies use them regularly. If the standard size is too irritating, consider trying pediatric-sized suppositories, which are the same formulation but at half the dose.

2. **Continence Products**:
- Use incontinence pads to manage ongoing discharge.
- Place a folded tissue or gauze between the buttocks to help absorb mucus when the output is heavy.

3. **Pelvic Floor Assessment**:
- Request formal testing, such as "bun" muscle manometry or EMG, to confirm any dysfunction.
- Pelvic floor physical therapy can be beneficial, especially if the muscles are weak or lax.

4. **Botulinum Toxin (Botox) Injections**:
- These injections can help relax an overly tight pelvic floor. However, results can vary, sessions can be expensive, and access might be limited.

5. **Specialized Care**:
- Consider seeking care at a specialized center, such as the Cleveland Clinic, which is recognized for excellence in treating pelvic floor dysfunction.

6. **Information Sources**:
- The NHS website provides additional guidance and mentions the use of glycerin suppositories for managing rectal mucus.