This topic is about the pros and cons of removing the rectal stump after a colectomy, a decision faced by someone who has been dealing with ulcerative colitis and its complications. They are considering whether to wait for potential healing or to opt for a permanent solution by removing the rectal stump and living with an ileostomy. Here are some insights and advice shared by others who have faced similar decisions:

1. Removing the rectal stump can help stop fistulas and reduce cancer risk.
- One person with Crohn’s disease had multiple fistula surgeries before opting for stump removal, which ended the fistulas and relieved rectal pressure.
- Pathology revealed low-grade cancer, suggesting early removal might prevent such issues.
- Despite a postoperative infection, they find life with an ileostomy manageable and preferable.

2. Phantom bowel sensations are common after proctectomy.
- Many people experience urgent "phantom" bowel movements even years after surgery.
- A helpful tip is to sit on the toilet and "push," which usually makes the urge go away quickly.
- Responses to these sensations vary; some can't urinate during these episodes, while others can.

3. Butt burn explained.
- This occurs when frequent, loose, acidic output irritates the sphincter, causing severe discomfort.
- Those who avoided reconnection often cite butt burn and frequent bathroom trips as reasons to stick with an ileostomy.

4. Post-surgical healing experiences.
- One person’s perineal wound took 6–7 months to heal, with occasional leaks, and they wished they had opted for proctectomy sooner.
- Small leaks or wound issues can persist but usually resolve over time.

5. Lifestyle reflections.
- Living with a bag requires adjustments in clothing and activities, but many find it manageable and better than dealing with ongoing disease or surgeries.
- Some mention that holistic or cleaner diets have been helpful for overall healing.

6. General support.
- The value of forums for practical advice and emotional support is emphasized, as hospitals often lack dedicated contacts for stoma-related questions.