This topic is about a person who has been living with a continent ileostomy, specifically a BCIR, for 22 years and has been experiencing recurring bleeding. A continent ileostomy is a type of surgery that allows waste to be stored inside the body until it can be drained, and BCIR stands for Barnett Continent Intestinal Reservoir, a specific type of this procedure. Here’s a summary of the situation and some advice based on similar experiences:

- The individual, who is 76 years old, has noticed visible blood in their output on several occasions. The most recent episode involved significant bleeding that lasted five days and could not be examined immediately.

- In a previous incident in February, the bleeding stopped before any examination could determine the cause.

- Upon follow-up, it was found that there was an ulcer at the surgical junction inside the continent ileostomy. This was treated with cauterization, endoclips, and a blood transfusion in May. Since then, the bleeding has mostly resolved, with only occasional small traces of blood.

Advice and insights from similar experiences include:

1. Severe bleeding can sometimes be traced to an ulcer at the anastomosis, which is the area where two segments of the intestine are joined together.

2. This issue might be due to a compromised blood or oxygen supply at that junction.

3. Treatment can involve multiple applications of endoclips and possibly a blood transfusion. Even if the ulcer persists, the bleeding can stop.

4. It’s important to consider whether there is any associated pain. However, the absence of pain does not necessarily mean there isn’t a bleeding ulcer at the surgical connection.