Some people who have surgery for inflammatory bowel disease (IBD) or other reasons may have their small or large intestine transferred to the stoma. A stoma is an opening through which waste (feces) leaves the body and is collected in an ostomy bag or pouch.
In some cases, a person will have a stoma, but also a rectum. However, in this case, the rectum is not used to hold stool. Stool leaves the body through the stoma and does not enter the rectum.
Sometimes, even with a stoma, secretions are drained from the bottom where the rectum and anus are located. How often some fluid needs to be drained from the rectum varies from person to person, and why this happens. In many cases, this is normal, expected, and nothing to worry about.
This article explains what an ostomy is, why you may have discharge from the rectum, how to deal with a leak, and when to talk to your healthcare provider.
If the discharge from the bottom is bloody or smells bad, make an appointment with your healthcare provider as soon as possible to discuss the issue.
What is ostomy surgery?
A colostomy is done when part of the large intestine is removed from the body. The remaining part of the rectum is called the rectal stump. The end of the remaining bowel is then connected to the abdomen through a surgically created stoma. Waste leaves the body through the stoma and is collected in appliances worn outside the body.
An ileostomy occurs when the small intestine is attached to the abdominal wall. This is usually after the large bowel has been completely removed. But sometimes, the large intestine is left inside (usually to allow it to heal) and bypassed by using a stoma.
People with a permanent stoma can choose to have their rectum removed or preserved. Those who are at risk of having a reverse ostomy in the future may choose to preserve the rectum. The amount left in the rectum varies from person to person. Much depends on the reason for the ostomy, such as those used to treat IBD, colon cancer, trauma, or other conditions.
Why there may be discharge in the rectum
The rectum is living tissue, and it continues to make mucus even though it’s not “connected” to anything and stool doesn’t pass through it. Mucus is part of normal stool, although it’s usually not present in sufficient amounts to make it visible. Mucus passing through the rectum becomes more noticeable in the absence of stool.
By sitting on the toilet and defecating like a bowel movement, the mucus is expelled from the rectum.
How to deal with leaks
Some people find that mucus sometimes leaks from the rectum, especially if the mucus is watery. Some gauze or sanitary pads worn in your underwear may help prevent accidental leaks.
Sitting on the toilet regularly to try to drain the mucus, even before you feel the urge to pass it, may help.
You may benefit from working with a wound ostomy incontinence nurse or simply an ostomy nurse. This registered nurse cares for and acts as a resource for ostomy patients.
When to see your healthcare provider
If you’re experiencing excess mucus, it’s particularly annoying, it’s foul-smelling, or it’s green or yellow, you may need to be investigated by a healthcare provider. Call your doctor if you experience any pain or symptoms related to rectal or mucus discharge.
If you see blood mixed in the mucus, don’t panic. Chances are, it’s not serious. However, you should still bring this to the attention of your provider.
Colostomy and ileostomy are two types of ostomy. An ostomy is an operation that makes an opening in the skin so that waste can leave the body. Waste is collected in bags outside the body. A colostomy is formed from the large intestine while an ileostomy is formed from the small intestine. Colostomy and ileostomy are most commonly used for diseases related to the digestive tract. As a living tissue, the rectum will continue to produce mucus even though it is not “connected” to anything, so some discharge is abnormal; it should be expected.
It can be confusing to feel like sitting on the toilet when a person has a stoma, but it’s normal. The natural tissue attached to the rectum will continue to produce bacteria and other substances. Usually, these fluids are excreted in the stool, but in the case of transfers such as ostomy, they need to excrete on their own. These fluids may be difficult to control at the time because they do not mix with stool.