Understanding Phantom Rectum - Causes and Management Tips

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248
Ostomate & woundr
May 25, 2023 10:09 pm

A couple of people have described a sensation of needing to defecate or being constipated or having diarrhea. This is a phenomenon known as phantom rectum. It is similar to phantom pain from amputated limbs. Sometimes the nerves that were once connected to your sigmoid colon, and especially your rectum, do not yet know that they are not connected to anything anymore. So, when you experience pressure from a colon full of fecal matter, your body misinterprets it as a full rectum and makes you feel like you did when you were constipated before you had an ostomy. It can make sitting quite uncomfortable. Some people find that actually sitting on a toilet, as if they were going to defecate the way they did before they lost some guts, releases the sensation temporarily because it tricks the body into thinking that you have dealt with the problem. But if there is significant fecal matter backed up inside, it won't relieve it for long (if you get any relief at all).

I have an ileostomy and even still, with the opiates that I had to take after my surgery until I weaned off of them, I did experience the phenomenon you describe. My heart goes out to you, dear. That is the best advice that I could give you. I even started taking magnesium citrate, which is, as you may know, about prep regularly just to have it be as cleaned out as possible to avoid the sensation. Now, I don't recommend that. Someone with a colostomy can find diarrhea awfully difficult to deal with as well. But even diarrhea can cause that sensation because it is the same sensation as diarrhea you felt before you had your ostomy. The best advice is regulating your stools by trying Metamucil. If you don't like the type you add water to, they make little crackers now too.

After falling and breaking six ribs in my back, I was on some pretty significant opiate pain control and it backed me up pretty significantly. So, I recently have been living this one again. Oh joy! Just so that you're aware, I hope this helps.

Mysterious Mose
May 25, 2023 10:56 pm

Well, I think the thread that prompted this one was about concerns over the changing color of the discharge. Personally, I understand what the discharge is. I just don't have a handle on the changing color. Mostly, it fluctuates between brown and reddish brown. Early on, my surgeon said the discharge should stop after a few months. Being a surgeon, he wouldn't let me pin him down on the definition of "few." I know 5 is less than "few," as it has been 5 months for me. :-)

In my case, I have no colon to get full and I seldom let the discharge accumulate to where there is any urgency. I usually just pass the discharge, if need be, when I empty my bag. In my case, the only part of me missing is the large intestine. The more I read about other folks' experiences, the more I am thankful for that. Even though it did cost me 3 months in the hospital and the ginormous medical bill that came with that.

--Daniel

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IGGIE
May 28, 2023 12:36 pm

After I got my Ken Butt, for a very short time I kept getting the feeling I wanted to have a poo, but it had to be in my head because the nerve that makes that feeling is no more.

Ostomate & woundr
May 28, 2023 2:50 pm
Reply to IGGIE

Hi Iggy, phantom rectum occurs when the part of the nerve that was severed in surgery (or trauma) goes with the removed portion. The still-living end that is attached to your spinal cord and thus to your brain is confused because it doesn't know what signal to send, so sometimes it sends a distress signal like phantom limb pain in amputees or phantom rectum in us ostomates. I have had Barbie butt for 14 years, and I just had to deal with phantom rectum just last week when codeine pain meds backed me up.

Hisbiscus
Jun 02, 2023 3:33 am

I get this phantom rectum from time to time, and it's quite strange.

 

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