Ostomy

Gastrointestinal (GI) tract
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The gastrointestinal tract begins at the mouth and ends at the anus.

What is an ostomy?

An ostomy is an opening from the inside of the body to the outside, on the abdomen (tummy). It can be temporary or permanent.

An ostomy helps your child get rid of stool or urine if their intestine or urinary tract does not work properly. It is created during surgery (an operation).

Ostomies have different names depending on where they are on your child's body. For example, an opening from the intestine to the abdomen is an ileostomy or a colostomy. An opening from the urinary tract to the abdomen is called a urostomy.

What the end of the ostomy looks like

The end of the ostomy - the part you can see - is called a stoma.​ This looks different in every patient, but it is usually:

  • round or oval
  • red, like the inside of your cheek
  • moist and shiny.

The stoma can be small or large. It usually changes size during the first six weeks after surgery but stays the same size from then on.

There are no nerve endings in the stoma. This means that your child will not feel pain when the stoma is touched or when stool comes out of it.

Stomas can sometimes bleed a little during washing or if they are bumped. This is normal. They can sometimes also bleed when they are irritated. You can stop any bleeding by applying gentle pressure to the stoma with a soft cloth.

Ostomy types
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An ileostomy creates an opening from the last part of the small intestine, the ileum, to the abdomen (tummy). A colostomy connects the colon to the abdomen. The end of an ostomy, the part you see on the outside of the abdomen, is called a stoma.

How stool or urine is collected outside the body

A bag, called an ostomy pouch, is placed over the stoma to catch urine or stool. The ostomy pouch protects the skin around your child's stoma and protects their clothing from becoming soiled (dirty). It can have one or two pieces and come with accessories such as a belt.

You can get lots of different ostomy products from many different companies. Your ostomy nurse will tell you where to buy ostomy pouches and accessories before you leave the hospital.

Ostomy pouch
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The stoma does not have any nerve endings and can be washed while your child is having a bath or shower. The ostomy pouch catches any stool and urine that leave the body through the stoma and acts as a barrier to protect the skin.

Emptying and changing your child's ostomy pouch

Your child's pouch needs to be emptied when it is one-third to half full.

If your child has a lot of gas in their pouch, you will need to open the pouch often to let the gas out so that the pouch does not come loose. Depending on the amount of gas, you may need to use an ostomy pouch with a gas filter.

You will normally need to change an ostomy pouch every one to four days. However, your child can wear the same pouch for up to one week if the pouch does not leak and there is no rash or other redness on the skin around the ostomy.

If the pouch does leak, be prepared to change it as soon as possible. This will help make sure your child does not get a rash from the stool touching their skin. Have enough supplies at home and always carry an extra ostomy pouch outside the home just in case.

Before your child leaves hospital, your ostomy nurse will give you more detailed instructions about how to care for, empty and change your child's ostomy pouch.

Will my child still be able to do their normal activities with an ostomy?

Yes. Having an ostomy does not limit your child's activities. They can lie on their stomachs and do all the same activities they did before surgery. Talk to your doctor about this before you leave the hospital.

Your child can have a bath or shower with the pouch on or off, as water will not hurt the stoma or be sucked into it. If you leave the pouch off, though, dry your child's skin carefully afterwards. A new pouch will only stick to dry skin.

When to get medical help

Call your child's nurse if:

  • your child has a rash or other problems with the skin around the stoma
  • the ostomy pouch leaks a lot
  • you have any questions about the ostomy and ostomy pouch.

Call your child's doctor if:

  • your child develops diarrhea
  • a lot more stool than usual collects in the pouch over a few hours
  • your child is unusually sleepy
  • your child is not making urine
  • your child has a fever of 38.5°C (101°F) or higher
  • there is a major change in the stoma's size or colour for more than a few minutes
  • the stoma bleeds more than a small amount or will not stop bleeding
  • your child has less frequent bowel movements
  • your child is crying non-stop or otherwise seems to be in pain​
  • your child's belly becomes firm and bloated
  • your child has green vomit​, even once.

Important phone numbers

My child's surgeon is:           ________________________________

Phone number:                    ________________________________

My child's ostomy nurse is:  ________________________________

Phone number:                    ________________________________

Key points

  • An ostomy is an opening from the inside of the body to the outside, through the abdomen. The end of the ostomy is called the stoma.
  • Stool or urine is collected outside the body in a bag called an ostomy pouch. Always carry a spare pouch in case of leaks.
  • Call your nurse if you have questions about the ostomy, the pouch or any skin irritation around the stoma.
  • Call your doctor if your child has diarrhea, a fever or much longer delays between bowel movements than normal, if their vomit is green or if the stoma does not stop bleeding.​​​
Kimberly Colapinto RN (EC), MN, CETN (C)
Theresa Allan RN, ET​
11/19/2013

​Sour​ces

American Pediatric Surgical Nurses Association, 2006. Teaching Sheet: Ostomy Information​.

Notes: