When someone has an ostomy, it means their stool is rerouted to a stoma and collected in an appliance, bypassing the usual path through the rectum. However, some people still experience rectal pressure and the urge to go to the bathroom, which can be puzzling. Here are some insights and advice on why this might happen and how to manage it:

1. If any part of the rectum or colon is still present, it's normal to have periodic mucus discharge from the rectal stump. This can create a strong urge to have a bowel movement, but usually, only small amounts of mucus, sometimes mixed with gas, are passed.

2. If the rectum has been completely removed, a sensation known as Phantom Rectal Syndrome can occur. This is similar to phantom limb pain, where the brain continues to send signals as if the organ were still there.

3. Gas in the remaining rectal stump can also contribute to feelings of pressure until the intestinal bacteria decrease.

4. Over time, the frequency and intensity of these urges typically decrease. Many people notice significant improvement between 3 to 6 months after surgery, with mucus output eventually reducing to every few days or even less.

5. In the early stages, using protection like adult diapers or extra toilet tissue can be helpful, especially at night, to manage unexpected mucus leakage.

6. These sensations are generally considered normal unless they are accompanied by other warning signs such as bleeding, severe pain, a history of radiation damage, or suspected malignancy, in which case a medical review is necessary.

For more information, you might find it helpful to read the "Feeling Pressure / Mucus After Ostomy" thread on MeetAnOstomate.