Ostomy Care

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KEY POINTS

• An ostomy is an opening in the belly that creates a new way for bowel movements or urine to leave the body.
• Most hospitals have specially trained staff who will teach you how to change and care for your child’s ostomy.
• Ask your provider about any changes your child will need to make in his normal lifestyle.
• Make sure you know what symptoms or problems you should watch for and what to do if your child has them.

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What are an ostomy and a stoma?

Sometimes all or part of your child’s bowel or bladder needs to be removed to treat a disease. Your child may then need a new way for bowel movements or urine to leave the body. The surgeon can make a new passageway for bowel movements or urine by making an opening in the belly. The opening is called an ostomy. The surgeon uses part of the bowel (intestine) to create the passageway through this opening for emptying bowel movements. A piece of bowel, or part of the ureter, the tube that drains urine from the kidney, may be used to create the opening for emptying urine. The part that surrounds the opening on the skin is called the stoma.

The stoma is protected with an appliance. Many types of ostomy appliances may be used. The appliance may be a cover or cap for the stoma. Or it may be an ostomy bag that collects bowel movements or urine. The type your child has depends on his needs and the type of ostomy he has. Talk with your healthcare provider about this.

Most hospitals have specially trained staff who will teach you how to change and care for your child’s ostomy. You may want to have other family members also learn about ostomy care so they can help you and give you support. Some of the things you will learn include:

• Changing the ostomy appliance. Some appliances may need to be changed every day. Others can be used for as long as 7 days before needing to be changed. You will learn how often you need to change your child’s appliance and how to do it.
• Covering the stoma. You will learn how to measure the size of your child’s stoma to make sure you are using the right size of opening in your child’s appliance to cover the stoma. The wrong size opening may allow bowel movements or urine to leak onto your child’s skin, which can cause redness, swelling, and discomfort.
• Cleaning the stoma. You will need to clean the area around the stoma each time you change your child’s appliance.
• Emptying an ostomy with a pouch. In most cases, children with an ostomy need to wear an ostomy bag, or pouch, over the stoma to collect stool or urine as it drains. Ostomy bags must be emptied regularly so that they do not become too heavy and leak.
• Emptying an ostomy without a pouch. If your child has an ostomy with a pouch inside the body, the pouch must be drained several times a day with a flexible tube called a catheter.

Also ask your provider about any changes your child should make in his normal lifestyle. For example:

• Chewing foods well and drinking plenty of fluids. Your child may need to limit foods that can cause gas and odors, such as cabbage, onions, beans, and fizzy drinks.
• Avoiding heavy lifting and contact sports to prevent injury to the stoma.
• Preventing odor by cleaning the bag well and using a bag deodorant.
• Using a room deodorizer if needed.
• Not wearing tight clothing over the stoma and bag.

You can get more information from:

• The United Ostomy Associations of America
  800-826-0826
  http://www.ostomy.org/Home.html
• Wound, Ostomy, and Continence Nurses Society (WOCN)
  888-224-9626
  http://www.wocn.org