This topic revolves around a young woman who is facing a significant decision regarding her health. After undergoing an emergency surgery due to cancer in her large bowel, she now has an ileostomy and is considering whether to keep her rectum for a possible future ileo-anal pouch (J-pouch) reconstruction or to have it removed and live permanently with her stoma. Here are some key points and advice shared by others in similar situations:

1. She currently feels healthy and enjoys the freedom from constant toilet urgency, which is a significant relief for her.

2. Re-joining the bowel could potentially lower fertility and might require Caesarean delivery due to pelvic scarring, which is a concern since having children is very important to her and her supportive husband.

3. There is a fear of further cancer if the rectum remains, which is a major factor in her decision-making process.

4. She experiences discomfort from the sensation of rectal urgency when only mucus is passed, which she finds unpleasant.

5. Her surgeon has suggested possibly keeping the rectum until after childbirth, but she is leaning towards immediate removal to "start a new life."

6. She plans to revisit her decision in three months, with surgery potentially scheduled before Christmas.

Additional considerations and advice from others include:

- Some suggest not rushing the decision and allowing time for recovery first. Waiting 5–8 months might help as mucus discharge usually lessens, strength returns, and perspectives may change if there is no immediate cancer threat.

- Many report a good quality of life with a permanent ileostomy, finding freedom from toilet dependency to outweigh any inconveniences.

- Creating an internal pouch can introduce new problems, such as frequent bowel movements, weight loss, and other complications, which might ultimately lead to needing a permanent stoma anyway.

- Fertility considerations are important, and avoiding additional pelvic surgery might protect fertility. It could be worth postponing any re-connection until after childbearing if that is still desired.

- Some have shared positive experiences with rectal removal, reporting improved quality of life and no regrets.

- Emotional support is crucial, and members commend her courage, emphasizing patience and encouraging her to focus on family goals and gradual recovery.