This topic is about dealing with some challenging complications that can arise for someone with an ileostomy, such as hemorrhoids, severe pain, constipation, and blockages. The person sharing their experience is facing intense rectal pain, a constant urge to use the toilet, constipation, and hemorrhoids. They are avoiding prescription pain medication because opioids can worsen constipation, and they are looking for advice from others who have been in similar situations.

Here are some helpful insights and advice:

1. Phantom-rectal sensations are quite common after having an ileostomy for a long time. Sitting and straining on the toilet can trigger pain and contribute to the formation of hemorrhoids.

2. Over-the-counter hemorrhoid suppositories might help temporarily reduce swelling and pain, but they won't solve the underlying problem.

3. While pain medications, especially opioids, don't directly cause hemorrhoids, they can make constipation worse, which in turn can aggravate hemorrhoids.

4. If hemorrhoids are persistent or severe, a laser hemorrhoidectomy performed by a specialist who regularly treats hemorrhoids is recommended. It's best to avoid general surgeons who don't have specific expertise in this area, as poor technique can lead to serious complications, including the need for further surgeries or even the creation of a stoma.