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.

Tips To Live With a Colostomy Bag

An ostomy is a small opening which is made through a surgery when a person’s bowel or bladder stops functioning normally. The stoma created as a result of surgery allows the wastes to be removed from the body. The types of ostomy include urostomy, ileostomy, and colostomy. Each of these different types is made to perform on the opening of a particular organ.

Colostomy Bags and Supplies

Colostomy bags are made to collect the bodily wastes which are passed out through the stoma. The colostomy bags are used to collect stool, which is firm in most of the cases. In such cases, the colostomy bags that are used are the closed pouches. However, if the stoma output is more liquid, the preferable colostomy bags are the drainable ostomy pouches.

Ostomy bags are easy to carry, and you don’t need to wear special clothes to adjust those bags. Those bags are designed to lie flat against the abdomen, and so they remain undetected. If adjustment and management of your stoma is difficult to you, you can consult your doctor.

Traveling with a colostomy bag

There shouldn’t be any problem in traveling after a colostomy surgery. However, some planning is suggested.

First of all, think about the number of appliance changes that you will need while you are away. And make sure that you have all of the ostomy supplies that you are going to need while traveling. Having some extra supplies will ensure peace of mind. And you are going to be careful about the food intake. Be careful while putting on seat belts, as your stoma needs to be prevented from the pressure which is caused by seat belt.

If you have to take flight, make sure that all of your colostomy bag supplies are in the hand-carry bag. You need to be fully prepared to manage the colostomy bag during flight.

Going back to work

Going back to your office with a colostomy bag is not going to be quite challenging. But you have to make sure that you are recovered enough to return to your office.

You can talk to your employer about gradually building your working hours. Moreover, you will have to inform your employer about your inability to carry heavy items for a while. Since carrying a colostomy bag is not going to change your appearance, you don’t need to tell your colleagues about it unless it is absolutely necessary.

Odor management with a colostomy

Individuals carrying colostomy bags worry a lot about the possibility of emitting the smells which people can notice. This odor can be managed by limiting the intake of foods that can produce odor. You can also use certain products to reduce the odor coming out of the ostomy pouch.