Topic Explanation:
The original poster (OP) is dealing with severe constipation and obstruction due to rectal conditions that impair their ability to evacuate stool. After conventional treatments and biofeedback failed, they underwent a right-side loop ileostomy to divert waste into a bag on their abdomen, hoping it would improve rectal function. However, after initial success, the symptoms returned, and they are now considering a total proctocolectomy, which involves removing the colon and rectum. The OP is seeking advice on whether this surgery is the right next step.

Advice and Insights:

1. Testing and Diagnosis:
- Before deciding on a total proctocolectomy, it is crucial to undergo specific tests to understand the underlying issue. Tests like anal manometry, defecating tests, and balloon expulsion tests can help diagnose conditions like pelvic floor dysfunction, which may influence the decision to remove the rectum and anus.

2. Pelvic Floor Dysfunction Considerations:
- If diagnosed with pelvic floor dysfunction, it is generally advised not to remove the anus. Removing the anus in such cases can lead to increased pain and pressure, as the pelvic floor dysfunction may prevent proper evacuation even after surgery. This condition can make it difficult to pass stool or even liquid from an enema, leading to further complications.

3. Personal Experiences with Total Proctocolectomy:
- Some individuals who have undergone a total proctocolectomy report satisfaction with the decision, especially if their colon and rectum were severely damaged. However, they emphasize that this surgery is irreversible, and there is no possibility of reversal once the colon and rectum are removed.

4. Mucus and Rectal Issues Post-Ileostomy:
- Mucus buildup in the rectum is a common issue after a loop ileostomy. Some individuals found that even with a loop ileostomy, they still experienced problems with mucus and opted for a total proctocolectomy. However, those with pelvic floor dysfunction may still experience issues even after the surgery.

5. Surgical Decisions:
- If the ileostomy is intended to be permanent, some suggest removing the rectum and anus to avoid ongoing issues with mucus and to simplify life. However, this decision should be carefully considered, especially in the context of pelvic floor dysfunction.

6. Importance of Informed Decision-Making:
- It is important to fully