This topic is about someone who has had an ileostomy for two and a half years and is experiencing something unexpected. They have noticed passing what seems like normal stool, even though their stoma is working as it should. Along with this, they are feeling abdominal cramps and backache. They are concerned because they thought their surgery had left no way for stool to exit through the rectum.

Here are some helpful insights and advice:

1. The material passed is likely not actual stool but a mix of mucus, shed intestinal cells, and possibly some blood from the remaining rectal stump or colon. This can sometimes form a brown, smelly paste that looks like stool.

2. If any part of the colon or rectum was left during surgery, it can still secrete and expel contents. This is common with end or loop ileostomies, and the pain often eases after the discharge.

3. Conditions like ulcerative colitis or Crohn’s disease can continue in the rectal stump, leading to more mucus and blood. If symptoms persist or worsen, it’s important to see a doctor.

4. For those with loop ileostomies or both bowel ends brought to the surface, back-pressure might allow some output to pass the old way when the pouch is full. Removing the remaining bowel can prevent this.

5. Constipation in the retained colon can cause occasional semi-formed stool. Keeping regular bowel movements or using bowel prep under medical advice can help.

6. If the entire colon, rectum, and anus were removed, passing true stool through the rectum is abnormal and should be treated urgently. Contact your surgeon or stoma nurse right away.

7. In rare cases, an anastomosis or fistula might allow fecal flow. It’s safest to get checked by a colorectal surgeon who knows about stoma surgery.

8. Long-term ileostomy patients often reassure that occasional rectal discharge is common and usually harmless, but it’s always best to confirm with your doctor for peace of mind.

9. A practical tip from another person: Avoiding solid food after mid-afternoon and having only light snacks at night can reduce stoma output and discomfort during the night.