This topic is about managing persistent rectal mucus after having a loop or end stoma surgery. The person sharing their experience has been dealing with some challenges and is seeking advice on how to handle the situation better. Here's a bit of background and some helpful insights from others who have faced similar issues:

- The person had a long-standing rectal prolapse, likely related to childbirth, which was left untreated for about ten years. Surgery revealed a total loss of the internal anal sphincter, and an attempted reconstruction worsened continence. They agreed to a stoma, and due to hospital policy, a loop stoma was created to allow for possible reversal, although they never wanted a reversal.

- The current issue is continuous, uncontrollable rectal mucus that keeps the perineal area wet. An end stoma with bowel removal was initially planned, but surgeons advised against it due to the small reduction in cancer risk compared to the high risk of the operation.

- The main question is whether people with an end stoma, but retained bowel, experience a significant drop in mucus output or if daily leakage is still likely. The person hopes to avoid a fourth surgery but dislikes the constant "wet butt."

Here are some insights and advice from others:

1. One person, several years after a loop colostomy, found their mucus output became intermittently worse. They manage it by wearing incontinence pads and placing a folded strip of toilet tissue in the anal cleft to absorb secretion before it reaches the pad.

2. Surgeons often discourage a proctectomy, also known as a "Barbie butt" closure, because it is a major procedure with significant risks. Accepting ongoing mucus may be a safer option.

3. Another person with an intact rectum experiences mucus only every few months. When it occurs, they clean carefully and wait for it to pass spontaneously. Understanding that this is normal has reduced their anxiety.

4. An individual with an ileostomy, whose colon was removed but the rectal stump retained, still produces unpredictable mucus five years post-op. They can expel it voluntarily when urinating by tightening pelvic muscles. However, lack of control suggests that stump removal might be the only guaranteed solution.

5. The consensus among those who shared their experiences is that mucus volume varies widely and may not lessen after converting from a loop to an end stoma unless the rectum is fully removed. Conservative management, such as using pads, tissue, and scheduled "expulsions," is a common coping strategy. A proctectomy can eliminate the problem but carries significant surgical risk, so the decision involves balancing quality of life with operative safety.