This topic is about someone who has been dealing with severe rectal pain and constipation for two years. Despite seeing multiple doctors, the cause remains unknown, and now a permanent ostomy has been suggested as a solution. The person is understandably scared and is seeking advice from others who might have had similar experiences.

Here are some helpful pieces of advice and insights shared by others:

1. Consider getting another medical opinion. It's important to consult at least one more gastroenterologist and, most importantly, a board-certified colorectal surgeon before deciding on surgery.

2. Avoid undergoing a major surgery without a clear diagnosis. Removing the rectum or colon is a significant and irreversible procedure and should not be used as a way to troubleshoot unknown issues.

3. Make sure to ask what conditions have already been tested for or ruled out, such as inflammatory bowel disease, cancer, internal hemorrhoids, pelvic or organ prolapse, chronic ileus, and rectocele.

4. Keep copies of all medical records, including office notes, biopsy reports, imaging results, and lab summaries. Use patient portals like MyChart to access doctors' notes, CT/MRI reports, and blood work to advocate for yourself.

5. If you are female, consider adding a urogynecologist to your healthcare team, as pelvic-organ prolapse can mimic bowel problems. Specialized scans can help check for this condition.

6. One person shared their experience of having a temporary loop ileostomy as a diagnostic test after years of constipation and rectal spasms. Eventually, they had a total proctocolectomy and a permanent end-ileostomy, which resolved their pain and constipation completely.

7. Understand the basics of an ostomy: the pouch is only for external stool storage, and removing the rectum or colon is irreversible and comes with surgical risks, such as post-operative ileus and other complications.

8. Before surgery, use laxative regimens and imaging tests like CT scans and X-rays to document colon function.

9. Be aware that healthcare systems are not perfect, and errors or missed findings can happen. Compare scans over time, question any remarks that dismiss your concerns, and insist that doctors address any discrepancies.

10. A common piece of advice from several people is to "figure out what’s wrong before anyone adds accessories to your waistline.