Topic Explanation:

The discussion centers around living with a rectal stump post-surgery, specifically dealing with issues like bleeding and inflammation due to diversion proctitis. The original poster shares their experience of managing these symptoms with mesalamine suppositories and explores the challenges and options available for those with a rectal stump, such as reversal surgery or ongoing medication. The importance of regular medical surveillance to monitor for potential complications like dysplasia or cancer is also highlighted.

Advice and Insights:

1. Mesalamine Suppositories:
- Mesalamine suppositories can effectively manage inflammation and bleeding in the rectal stump.
- Long-term use of mesalamine suppositories is possible, with some individuals using them for many years without issues.
- Regular blood tests are necessary to monitor kidney function when using mesalamine.

2. Medication Usage:
- Some individuals use a 1000 mg suppository every other day or cut the suppository in half for morning and evening use.
- Adjusting the frequency of suppository use can help manage symptoms and reduce costs.

3. Surgical Options:
- Reversal surgery or "Barbie butt" surgery can eliminate the rectal stump and associated issues, but not everyone opts for this due to personal or medical reasons.

4. Monitoring and Surveillance:
- Regular endoscopic surveillance, such as colonoscopies, is recommended to monitor for dysplasia or cancer in the rectal stump.
- Blood levels of C-reactive protein should be monitored as persistent inflammation can increase cardiovascular risks.

5. Personal Experiences and Considerations:
- Individuals with a rectal stump should consult with their gastroenterologist to tailor a treatment plan that suits their specific needs and conditions.
- The decision to undergo surgery or continue with medication is influenced by personal health history and tolerance for symptoms.

6. Support and Education:
- There is a need for better education and support for ostomy patients, as many feel unprepared for the challenges post-surgery.
- Some hospitals offer pre-op clinics to educate patients on ostomy care, but more support is needed for those who unexpectedly receive an ostomy.