Ostomy

An ostomy is an opening from the inside of the body to the outside, on the abdomen (tummy). It is created during surgery, and 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.

Types of ostomies

Ostomies have different names depending on where they are located.

Ileostomy

An ileostomy creates an opening from the last part of the small intestine (the ileum) to the abdomen.

Colostomy

A colostomy connects the colon to the abdomen. The part you see on the outside of the abdomen is called a stoma and is the end of an ostomy.

The stoma can also look different depending on how your surgeon made it.

End ostomy

An end ostomy is created when the bowel is divided into two separate pieces, and the part of the bowel that is coming from the direction of the mouth is brought outside the abdomen. The other end is sewn closed and left inside the abdomen.

Double-barrel ostomy

A double-barrel ostomy is similar to an end ostomy, but, instead, both ends are brought outside of the abdomen. One stoma will drain stool, and the other will drain mucous.

Loop ostomy

A loop ostomy is made by bringing a loop of bowel through the abdominal wall. A rod or ring is placed under the loop bowel between the skin and the loop. This rod will typically be removed within the first month.

How stool or urine is collected outside the body

Stool or urine is collected in a bag, called an ostomy pouch, that is placed over the stoma. The ostomy pouch protects the skin around your child's stoma and protects their clothing from getting dirty. It can have one or two pieces and come with accessories such as a belt.

Ostomy pouch

After ostomy surgery

• The stoma will be swollen after surgery and may change in shape and size for six to eight weeks after surgery.
• The sutures around the stoma are dissolvable and take about six to eight weeks to fully dissolve.

Taking care of your child at home

Activity

• Have your child rest when they feel tired.
• Your child should avoid swimming for four to six weeks after surgery to allow the sutures around the stoma to heal.
• Your child should avoid heavy lifting for four to six weeks after surgery.
• Most children can return to all other normal activity within two to four weeks after surgery.

Diet

Your child should drink plenty of fluids.

Your child may not want a big meal after surgery. Instead, they may initially eat small, frequent meals. They should have a low-fibre diet for the first few weeks and then slowly progress to a high-fibre diet as tolerated to ease digestion.

Bathing

You can bathe you child with or without the stoma appliance.

It is important to wash gently around the skin and stoma to keep the sutures clean and aid healing. You can get the stoma wet. Water will not get inside the abdomen. The stoma is a one-way valve, so only stool can come out; no water can get in.

When to seek medical attention

Call your child's stoma nurse if:

• There is persistent skin irritation such as redness, itchiness or rash on the skin around the stoma.
• You are having trouble with keeping the pouch on (i.e., there is leakage).
• You have questions or concerns about products, skin integrity or the functioning of the stoma.
• Your child's stoma sticks out higher above the skin or has sunk below the skin.

Call your child's surgeon and go to the nearest Emergency Department if:

• Your child has a fever higher than 102°F (38.3°C).
• There is bleeding from the stoma or blood in the pouch.
• There is new redness, swelling, pain, pus or foul smell from the stoma or incision.
• Your child has abdominal pain or distention (swollen belly), or they are vomiting or have diarrhea.
• There is a considerable increase or decrease in the amount of stool in the bag over a few hours.
• The stoma has changed colour—it is black, dark purple, dark blue.