This topic is about a person who has been dealing with complications after receiving an ileostomy due to a Crohn’s-related entero-vaginal fistula. This condition involves stool passing through the vagina, which is understandably distressing. Here’s a breakdown of the situation and some advice shared by others:

- The person was diagnosed with ulcerative colitis at age 11 and underwent a colectomy with rectal removal and a temporary ileostomy, which was later reversed.
- Now at 46, they likely have Crohn’s disease that has been untreated for 35 years, leading to severe inflammation and the development of an entero-vaginal fistula.
- Four weeks ago, they received a diverting ileostomy to allow the fistula to rest before a planned reversal in 4 to 6 months.
- Recently, they have been experiencing pelvic pressure, urinary urgency, and the passage of stool, blood, and mucus through both the vagina and anus more than five times a day.
- The main question is whether it’s possible to have a bowel movement without a colon, rectum, and with an ileostomy.

Additional details include:

- The person confirms passing small amounts of blood and mucus, but also definite stool from both the vagina and anus.
- They are unsure if their stoma is a loop ileostomy.
- They contacted an on-call surgeon, went to the ER, were admitted, and had a pouchoscopy with bowel irrigation. They are now doing self-irrigation at home.
- They were treated for a severe urinary tract infection, had a Foley catheter placed and then removed, and are on oral antibiotics, feeling better now.

Advice and insights shared by others:

1. Many advised an immediate visit to the ER to rule out infection, abscess, or sepsis, stressing that stool in the urinary or reproductive tracts is an emergency.
2. It was explained that true formed bowel movements are impossible once the bowel is completely diverted, but residual mucus and small amounts of old stool may still pass.
3. Ongoing stool suggests either a loop ileostomy, an incompletely diverted segment, or a persistent fistulous connection.
4. Fistulas rarely heal with diversion alone; they often require surgical closure or drainage.
5. Diagnostic follow-up like a CT scan or MR-enterography was suggested to map fistula paths, along with reviewing the operative report to understand the diversion construction.
6. Seeking second or third opinions at high-volume centers such as the Mayo Clinic was recommended.
7. Practical tips included keeping a written log of daily symptoms, questions, and procedure dates, and bringing a companion to consultations for note-taking.
8. Regular irrigation as per the surgeon’s orders was advised to evacuate residual bowel contents and reduce infection risk.
9. Monitoring for signs of a urinary tract infection or systemic infection was emphasized, with a recommendation to return to the hospital if fever, chills, or increased pain develop.
10. A personal experience was shared where a loop ileostomy allowed backflow to the distal limb and out the anus, which was resolved by revising the stoma.
11. Emotional support was offered, with community members encouraging updates and offering ongoing assistance.