Caring For Intestinal Stoma In Children

Parents of children with stomas have to be very cautious about their stoma and peristomal skin health because it is the area that has to support the weight of an ostomy pouch.

Intestinal stoma care is needed for neonates who suffer from congenital bowel conditions and Necrotising Enterocolitis (NEC). These temporary stomas remain there for up to 12 months. Older children and adolescents will also need intestinal stoma care. These children usually suffer from conditions such as Crohn’s disease and ulcerative colitis.

There are two types of intestinal stomas: colostomy and ileostomy.

• A colostomy brings a part of the colon out through a cut in the belly, creating a stoma.
• An ileostomy also creates a stoma but by bringing a part of the small intestine or ileum.

Referral to the stoma therapist

Parents will need to refer to a stoma therapist as soon as the child is admitted or is already an inpatient, waiting for the stoma surgery day. A stoma therapist will:

• Advise and assist the nursing staff in teaching parents, caregivers, or children how to take care of a stoma
• Provide information on how to contact a local community stoma therapist for ongoing stoma care support

Caring for a new stoma

Parents need to meet a stoma care nurse within the first five days of the occurrence of stoma necrosis. They will observe, assess, and document the stoma status in response to the following conditions.

• Perfusion
• Bleeding
• Skin integrity
• Prolapse
• Problem attaching an ostomy pouch
• Stoma retraction
• Signs of infection in the incision wound

Stoma output

During the first couple of days after surgery, the stoma output will be watery. The colostomy output will tend to be semi-formed.

• You will need to report to the medical staff if the ileostomy output is greater than 20-30mls per kg per day.
• Report to the medical staff if the output is greater than 30-49mls per kg per day.

Removing the ostomy pouch

While removing an ostomy pouch,

• Use warm water and a soft cloth
• Peel the skin barrier downwards
• push down the skin and lift the flange up

After removing the skin barrier, pat the peristomal skin dry.

Applying the ostomy appliance

A stoma therapist will recommend the right ostomy pouch for your child. Be sure to follow a few standard steps while applying a new ostomy pouch.

• Clean the skin with warm water. Pat it dry and use the skin barrier cream if needed.
• Use a flange cutter to create a hole in the ostomy barrier. Make sure that the hole is of the exact shape and size of the stoma.
• Smooth rough edges of the skin barrier’s hole by running a finger through it.
• Use your palms to warm the skin barrier. It will ensure a good seal.
• Place the skin barrier on the peristomal skin and smooth down at the edges.

Skincare

Ensuring skin integrity of the area around the stoma is crucial for comfortable stoma management. Skin complications in the peristomal skin area occur due to contact with fecal materials, moisture, and chemical or biological irritants. Ensuring proper adhesion of the ostomy appliance is the best way to prevent any skin complications. You may need to speak to your stoma therapist to get information on what to do to avoid these complications.

Common Myths about Stoma

According to a survey, about 750,000 Americans live with an ostomy, which is a life-saving surgical treatment done to allow the body waste to pass through an opening in the abdominal area into an ostomy pouch. This procedure sometimes becomes necessary to treat Crohn’s disease, colon or bladder cancer, ulcerative colitis, and injury to the bowel or urinary tract.

Since this treatment affects physical and mental characteristics of an individual, it can result in a change in lifestyle. But then, it is worth remembering that there are many successful people out there living with an ostomy.

There are many misconceptions about this treatment and its aftermaths. So, debunking those prevailing myths is very important. In this article, we are going to debunk some well-known, infamous to be precise, myths.

People get to know about your ostomy pretty quickly

You may wonder if your ostomy bag is noticeable; and it could be one of the bigger concerns. The matter of fact is that people will get to know about your ostomy bag only if you opt to tell them about it. So, whether or not people know about your ostomy is entirely your personal matter.

Since these bags are available in different sizes and types, you can buy one that fits your lifestyle, meaning that you can make sure that people do not know you are carrying an ostomy bag.

All ostomy procedures are permanent

Not all stomas are permanent. Certain conditions, such as inflammatory bowel disease, require the ostomy that is temporary. Such ostomy procedures are done in order to allow certain parts of the excretory tract to heal within a certain period of time. Once that portion is healed, the pouch is removed.

However, there are certain conditions for which the ostomy tends to be permanent. Those conditions mainly involve removal of certain parts of large intestines.

Ostomy bags always smell bad

This problem has been true in the past but not anymore. Modern technologies have helped well in reducing the smell coming out of an ostomy bag to zero. The only time you might feel noticeable odor is when you change or empty the bag.

You will have to be on a special diet for the rest of your life

You might have to make small adjustment in your diet but that doesn’t mean you have to be on a specific diet for the rest of your life. All it takes is the proper healing of your stoma for you to be able to start eating your normal foods. However, there are the food restrictions you need to follow while your stoma is healing.

Traveling with stoma is stressful

Having a stoma doesn’t restrict you from going anywhere in the world. The thought of long journeys is concerning for the people with stomas due to the reason that there is a planning required ahead of time; and it is not something very difficult. The key is to make sure that you have all of the ostomy supplies that you think you will need.