This topic is about experiencing bleeding and mucus discharge from the rectal stump after having a total colectomy with an ileostomy, which was done to treat ulcerative colitis. The person who shared their experience is noticing small amounts of mucus, which is common, but is also seeing fresh, light-red blood every few days. They are concerned that the remaining rectum or small colon segment might still be inflamed with colitis and are seeking advice since their follow-up appointment isn't until August.

Here are some helpful insights and advice:

1. Don't wait until August for your follow-up. Reach out to your general practitioner, stoma or IBD nurse, or the surgeon's secretary to see if you can get an earlier review or referral.

2. Fresh red blood and mucus are often due to residual ulcerative colitis in the rectal stump. This part is left by surgeons in case a future reversal or J-pouch is desired. The mucosal lining can still ulcerate and bleed.

3. Others have had similar experiences after a subtotal colectomy. Symptoms often improve with rectal medications such as:
- Salofalk (mesalazine) suppositories, 1000 mg, used nightly or every other night.
- Cortifoam Rectal Foam for flare-ups.
- Other mesalazine or steroid suppositories or enemas—consult your doctor for advice.

4. If the bleeding worsens, is accompanied by pain, or becomes heavy, seek urgent medical assessment to rule out hemorrhage, infection, or other issues.

5. Wearing a pad can help manage ongoing mucus or blood loss. Be aware that exercise, like walking or hiking, might increase spotting.

6. Some people have opted for a complete proctectomy, also known as "Barbie butt," and a permanent ileostomy to eliminate persistent ulcerative colitis, urgency, and leakage. This is a more complex operation with specific risks, especially for women, so thorough research is essential before making a decision.

7. The quality and experience of the surgical center are important. Check hospital rankings, seek second opinions, and ensure your rectum is medically quiet before any further surgery. Aggressive medical therapy first is advisable.

8. There is a gastro-surgeon in Augusta, GA, who reportedly offers a rectal "ring" procedure to improve continence after reversal. This might be worth investigating if you're considering restorative surgery.

9. Some people report a better quality of life with a permanent ileostomy compared to dealing with ongoing stump problems or challenging J-pouch function.