This topic is about managing excess mucus from a non-defunctional rectal stump, especially when the pelvic floor muscles prevent natural expulsion. This can be a challenging situation, particularly for those who have had an end-sigmoid colostomy and are dealing with pelvic floor dyssynergia. Here are some helpful insights and advice for managing this condition:

1. If you are unable to pass irrigation fluid, it is important to seek urgent medical attention or visit the emergency department. There is a risk of impaction, rupture, or infection.

2. Surgical options that have been reported to help include:
- Completion proctectomy, which involves the removal of the rectum and anus, resulting in a permanent ileostomy. This has relieved mucus problems for some individuals.
- Removal of the rectal stump while leaving the anus intact, which has also ended mucus issues for some with severe pelvic floor dysfunction.

3. For anal or rectal stump irrigation:
- Standard gravity-fed systems might not work if the sphincter is tight. Some have created pressurized systems using a garden sprayer, a Coloplast regulator, and adapted anal catheters.
- Another method involves connecting a handheld shower hose to an anal irrigation catheter while squatting over a bathtub with warm water.
- It is crucial to know the length of the stump before inserting catheters to avoid the risk of colon perforation.

4. Catheter options include anal irrigation catheters provided by hospitals, home-adapted catheters, or a Foley catheter to bypass a clamped puborectalis. It is important to discuss the exact technique with a healthcare professional.

5. Pharmacologic or procedural aids:
- Botox injections into the pelvic floor or anal sphincter may help relax the muscles, though success varies.
- An internal sphincterotomy, which involves cutting the internal anal sphincter, has been suggested to allow mucus to escape more freely. However, it may not address pelvic floor dyssynergia.

6. For conservative symptom control, sitting on ice packs can help reduce spasms. It is also helpful to accept that some mucus production is inevitable and to use absorbent padding.

7. If the stump becomes inflamed or bleeds, using a Mesalamine 1 g suppository nightly for 30 days has helped some individuals. Recurrence may require intermittent dosing.