This topic is about dealing with rectal stump bleeding after having an ileostomy. The person sharing their experience has had an ileostomy for three years without any issues until they started noticing bleeding for three days in a row. Here's a breakdown of their experience and some advice from others:

- On the first day, they noticed heavy, bright-red blood while emptying their pouch.
- The second day brought lighter bleeding.
- By the third day, the bleeding turned dark reddish-brown.

They are unsure of the bleeding's source and only have a primary-care doctor who lacks experience with ostomies. They also don't currently have a surgeon or specialist to consult.

Here are some helpful pieces of advice and insights from others:

1. Seek specialist care immediately. It's important to get evaluated by a gastroenterologist or colorectal surgeon as soon as possible if you experience any rectal or stoma-output bleeding.

2. Consider diagnostic procedures:
- An office proctoscopy is a quick procedure that doesn't require anesthesia and can help identify rectal inflammation or disease.
- An endoscopy, colonoscopy, or CT/MRI might be necessary to find the source of internal bleeding.

3. Possible causes of bleeding could include:
- Rectal inflammation, such as colitis or Crohn’s disease.
- Bleeding at a small-bowel anastomosis, which might require endoclips and could lead to severe anemia if not treated.
- Postsurgical complications like adhesions or mesh migration, which can cause hidden bleeding and serious infections if left unchecked.

4. If you can't quickly reach a GI specialist:
- Call a hospital's "dial-a-nurse" or advice line. They might direct you to the Emergency Department or help you get a fast-tracked referral.

5. Navigating insurance in the USA:
- With Original Medicare Part A & B, you can self-refer to any specialist who accepts Medicare.
- Most Medicare Advantage plans require a primary-care referral and pre-authorization for diagnostic tests, so contact your plan promptly.

6. A general warning: Bleeding is never considered "normal" after an ileostomy. Even if the bleeding stops, it's crucial to have a full GI work-up to prevent complications like anemia, sepsis, or permanent organ damage.