A colostomy is a surgical procedure that creates an opening (stoma) on the abdomen to divert the large intestine, causing stool to exit through the stoma into an external pouch. This bypasses the rectum and anus. A common side effect of this surgery is the continued discharge of mucus from the rectum, which is a normal biological process following the diversion of the fecal stream. This article explains why mucus production continues, what to expect, and how to manage the discharge effectively.
The Source of Mucus Production
Mucus discharge after a colostomy results directly from the remaining anatomy. Even though stool is diverted to the stoma, the lower segment of the bowel, often called the rectal stump, remains functional. This section of the intestine is still lined with cells that have a natural, continuous job to perform.
The lining of the large intestine contains specialized cells that continuously secrete mucus. This mucus provides lubrication and protection for the delicate inner lining. Since the remaining bowel tissue is a living organ with a blood supply, it continues this function, producing mucus just as it did before surgery.
Without the normal flow of stool to carry it out, the mucus accumulates in the unused rectal segment and must eventually be passed through the anus. The amount produced varies depending on the length of the colon and rectum left in place.
Timeline and Normal Characteristics of Mucus
Mucus discharge is a permanent function of the remaining bowel, though its frequency changes over time. Immediately after surgery, discharge is often more frequent and may contain small amounts of old, dark blood from healing tissues. This increased frequency usually subsides as the surgical area heals.
Long-term frequency varies significantly; some individuals pass mucus daily, while others do so only every few weeks or months. For most, the frequency reduces over the first year following the colostomy. Normal mucus is clear, white, or pale yellow.
Its consistency ranges from a thin, liquid “egg white” texture to a thicker, sticky substance. Occasionally, mucus dries into a firm ball inside the rectum, causing pressure or discomfort similar to needing a bowel movement. The amount of mucus produced relates directly to how much of the colon remains after the procedure.
Practical Management of Mucus Discharge
Managing the discharge involves proactively emptying the rectum to prevent buildup and leakage. A simple and effective approach is to sit on the toilet regularly, even without a strong urge, and gently bear down as if passing stool. This routine helps expel accumulated mucus and reduces the chance of unexpected leakage throughout the day.
For people who find it difficult to pass mucus naturally due to reduced sensation, a medical professional may recommend a glycerin suppository. This type of suppository helps to thin the mucus, making it easier to pass and reducing the potential for a painful, dried ball to form.
Wearing a thin panty liner or a small absorbent pad offers comfort and protection against minor, unexpected leakage. Pelvic floor exercises are also a helpful technique for those who experience involuntary leakage. Strengthening the muscles around the anus improves control, allowing an individual to hold the discharge until they reach a toilet. If the mucus discharge irritates the skin around the anus, applying a barrier cream can soothe and protect the area from soreness.
Warning Signs Indicating a Problem
While mucus discharge is normal, certain changes in its character or accompanying symptoms can indicate a complication requiring medical attention. Any discharge containing a large amount of fresh, bright red blood should be reported to a doctor immediately. Blood streaks or dark, old blood may be seen shortly after surgery, but persistent or new bleeding needs investigation.
Pus in the discharge, appearing as a thick, yellow or green liquid, suggests a possible infection in the remaining bowel. This is often accompanied by an unusual or foul odor. Other signs of a problem include fever, severe abdominal pain, or a general feeling of being unwell.
These symptoms could indicate inflammation in the unused bowel segment, a condition known as diversion colitis. An increase in the volume of mucus, especially if it is a new change, should also be discussed with a stoma nurse or physician to rule out infection or developing complications.