This topic is about someone who has been living with a permanent loop ileostomy for over a year. Recently, they have started experiencing daily mucus discharge accompanied by significant internal pain. They are unsure if this is a common issue for ostomy patients or if they should reach out to their gastrointestinal (GI) surgeon.

Here are some helpful insights and advice:

1. It's normal to produce mucus if the rectum and anus are still intact. Removing them would stop mucus production and reduce the risk of future rectal cancer, but it's a major surgery that can affect fertility.

2. Pain is not a normal symptom, so it's recommended to see a GI specialist promptly. A sigmoidoscopy or colonoscopy might be needed to check for colitis, irritation, infection, or other issues.

3. For managing symptoms at home, consider:
- Using glycerin suppositories once a day or as needed.
- Trying a Fleet Enema once a week to clear out mucus plugs.
- Using medicinal enemas or anti-inflammatory suppositories if inflammation is diagnosed.

4. If the irritation is external, treat it like a diaper rash. If it's internal and causing pain, prescription medications might be necessary.

5. A stoma or enterostomal therapy (ET) nurse can offer quick advice. Sending photos or messages can help them assess the situation.

6. Endoscopic procedures are still possible:
- A colonoscopy or flexible sigmoidoscopy can be done through the anus if the rectum is intact.
- An ileoscopy can be performed through the stoma, with a modified bowel prep that will drain into the pouch.

7. A sudden increase in mucus or painful discharge after a period of calm is a good reason to contact healthcare providers. It's better to get checked than to assume it's normal.

8. Some people have chosen to have their rectum completely removed when faced with persistent painful mucus and complications, resulting in a permanent end ileostomy.