This topic is about the experiences and decisions people face after having a colostomy, particularly when dealing with ongoing pressure, urges, and mucus due to retaining the rectal stump. The original poster has been living with a colostomy for 16 months and is experiencing painful sensations that affect daily activities and sleep. They are curious if others have opted for rectum removal because of similar issues. Here are some insights and advice shared by others:

1. Common medical reasons for removing the rectal stump include:
- Reducing or treating cancer risk in the remaining rectum or anal canal.
- Managing recurrent ulcerative colitis or Crohn’s disease activity in the stump.
- Addressing chronic or repeated infections due to stagnant mucus.
- Alleviating continuous painful pressure, phantom urges, and problematic mucus or blood discharge.

2. Mucus production is normal in a disused rectum, but without regular bowel movements, it can accumulate, potentially leading to infections and discomfort.

3. Signs of infection to watch for include cloudy, bloody, or foul-smelling mucus, similar to a sinus infection. Antibiotics might be necessary while the stump is still present.

4. Surgical experiences vary:
- Some people delayed removal for years, but found significant relief once they underwent surgery due to worsening disease or infections.
- Those in better health at the time of surgery often experienced smoother recoveries, were up and walking within days, and found the surgery manageable.
- One person reported being free of ulcerative colitis after removal and later had a healthy pregnancy.

5. Emotional aspects are important to consider. Fear of surgery is common, but many have noted an improved quality of life afterward with minimal long-term drawbacks. Some even humorously mentioned benefits like no more skid marks or accidental flatulence.

6. A practical tip is to discuss ongoing symptoms with your colorectal surgeon or gastroenterologist. Persistent pressure, frequent infections, or active ulcerative colitis or Crohn’s disease are valid reasons to consider elective rectal stump removal.