Rectal Discharge After Ostomy Surgery
You may be under the impression that once you have a stoma bag you will stop passing anything through your back passage but what most of us are not told is that you could still have a discharge from your rectum and when it happens it comes as shock, it is quite normal and you should not worry unduly.
What is rectal discharge?
Rectal discharge is common after colon and rectal surgery with an ostomy. This discharge is usually caused by mucus. The colon and rectum produce mucus for protection and to help with the passage of stools. In some ostomy operations the colon and/or rectum are left in place. The remaining parts of the colon and rectum continue to make mucus, even though it no longer serves any purpose, which is then passed through the rectum.
How much discharge will I have?
The mucus can build up, and either leak from the rectum or dry up into a ball which may cause discomfort. Some people have rectal discharge every few weeks, while others have several episodes a day and others never experience it. The length of colon that remains will vary and the longer the colon that remains, the more mucus there is likely to be. The mucus varies from clear to brown in colour and can be a sticky, glue-like consistency. It may be liquid or formed.
Contact your GP if there's blood or pus in the discharge – it may be a sign of infection or tissue damage.
What can I do to manage the discharge?
One way to manage the discharge is to sit on the toilet and gently push down as if having a bowel movement. This may remove any mucus in the rectum and keep it from forming into a ball.
But some people find this difficult because surgery can reduce the sensation in the rectum. Contact your GP if this is the case, as you may need further treatment.
Glycerine suppositories that you insert into your bottom can often help. When the capsules dissolve, they make the mucus more watery, so it's easier to get rid of.
Pelvic strengthening exercises can help strengthen muscles that control the leakage of mucus.
You may want to use pads to protect your clothing.
It is possible the mucus will irritate or cause itching around the anus. Using a barrier skin cream should help (Sudacrem or E45 dermatology for example.) You may need to try a few different creams before you find one that works for you. Ask your pharmacist for advice.
Wash the area gently with plain water or use a moist wipe made for sensitive skin (baby sensitive wipes or water wipes) Do not use wipes with fragrance since these usually have alcohol which can irritate skin. Pat your skin dry to avoid irritation. Reapply your barrier cream after the skin has dried if you need to. Contact your doctor if you have rectal bleeding and pain. This may be a sign of infection or tissue damage.
Also consult with your GP if you have itching that lasts a few weeks as this may be an indication that something else is not right and quick simple examination of your rectum will eliminate other likely causes. Your doctor can prescribe a short course of a mild steroid cream.
Will my diet cause rectal discharge
Some people find that eating certain foods increases mucus production. While there's no scientific evidence to support this, you may want to try keeping a food diary for a few weeks to see whether certain foods could be linked to an increase in mucus production.
About Ian the Bodach
In August 2013 I had my Ileostomy formed. February 2016 (2½ years) I had rectal discharge which lasted for 30 hours and was like having diarrhoea.
July 2018 I had my Ileostomy replaced due to parastomal hernia. March 2019 I experienced rectal discharge which lasted for 6 hours.
I notice daily white chalky drops when I am washing my bottom.
I have a new parastomal hernia growing.
For information only.
Not to replace the advice of your GP or stoma care nurse
Hi Sam61,
Rant all you want. And don't let the stoma nurse or the surgeon bully you into seeking a further opinion if you have a concern. After my resection op last year I was getting concerned about the redness around the main incision and that it might be an infection (albeit a low grade one). Two - TWO - different GP's told me that I definitely did NOT have an infection. The day after I saw the second GP the abscess in the wound burst. Since it left a rather large hole I had to go back to hospital to have it cleaned out and they swabbed it to be tested for infection. Hospital phoned me a couple of days later with the exact name of the infection and with instructions to go back to the GP to request specific antibiotics!
Moral of the story, stick to your guns if you think something is wrong.
By the way, I also had lots of rectal discharge while I had my colostomy last year. But it was most certainly not foul smelling.
All the best,
Yolande
Hi Sam61. It’s so frustrating isn’t it? Once you leave the hospital they seem very reluctant to see you outside of their pre-arranged appointments. The colorectal nurses are great but I think they sometimes think people are over-reacting - and sometimes they are - I remember ringing them because my output was really dark, almost black, and they said it was ok and to give it 24 hours to settle down- which it did. However you also have to trust your gut feeling if something isn’t right.
Could you go see your normal doctor and ask for the discharge to be tested? Explain that you’ve been given antibiotics and then told to stop them and maybe you could have a blood test to check your CRP marker is ok and not creeping up again - I think it should be under 10 and mine was 120 when re-admitted.
Hope things start to get better for you
Take care
Karen x
Hi Kareno62 and @itsybitsy
Thanks for your concern and suggestions.
Nurse called back later - surgical team are still not concerned. Agreed that I would finish course of antibiotics and call back next week if I still felt bad. If so they will have me in and assess me.
I am feeling better today - and friends have said I look better - so going to see how it goes for a couple of days. I probably couldn’t get an appointment with my own GP before next week anyway.
Thanks and best wishes.
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