This topic is about the experiences and benefits of removing the rectal stump, often referred to as "Barbie Butt," after having a permanent ileostomy. Initially, some people might have their rectal stump left in place in case a reversal of the ileostomy becomes possible. However, if a reversal is not an option, the stump can cause issues like leakage and discharge. Here are some insights and advice from those who have gone through this process:

- Many individuals who started with a rectal stump and later had it removed reported significant relief.

- Common issues before removal included:
- Persistent ulcerative colitis or inflammation in the stump
- Chronic pain, recurrent infections, unpleasant odors, bleeding, and constant leakage that required wearing pads

- Benefits after removal:
- Pain and infections often disappeared quickly
- No more leakage or odors, allowing people to stop using pads
- No need for routine cancer surveillance of the rectal stump, which many found painful and stressful

- Surgical experiences and considerations:
- The surgery to remove the stump, known as Barbie/Ken-butt surgery, was often easier than expected, with post-operative pain being milder than the symptoms experienced before surgery
- Some surgeons initially leave the stump to simplify the first surgery, with removal being an option once the patient is stronger
- In some cases, the rectum is removed while leaving the sphincter intact, resulting in minimal fluid discharge
- Suppository pain medication can still be absorbed through any remaining mucosa, though not everyone chooses this option

- Overall, for those with inflammatory bowel disease and permanent ileostomies, removing the rectal stump can prevent ongoing disease activity, leakage, and the need for future surgeries.