A pediatric ostomy is a surgical procedure that creates an opening, or stoma, on the abdomen for the purpose of eliminating waste from the body. This procedure is often necessary for children with short bowel syndrome (SBS), a condition in which the small intestine is damaged or missing, making it difficult for the body to absorb nutrients and fluids. Children with SBS may require an ostomy to improve their quality of life and overall health.
There are several types of ostomy procedures that may be performed on children with SBS, including an ileostomy, a colostomy, and a urostomy. An ileostomy is a procedure in which the end of the small intestine, or ileum, is brought through the abdominal wall and the stoma is formed from the ileum. A colostomy is a similar procedure in which the colon, or large intestine, is brought through the abdominal wall to form the stoma. A urostomy is a procedure in which the urinary system is rerouted through the abdominal wall to form the stoma.
The type of ostomy a child with SBS receives will depend on the specific needs of the child and the location and severity of the damage to the small intestine. In some cases, a child may require more than one ostomy procedure, depending on the extent of their condition.
Caring for a pediatric ostomy can be a challenging and time-consuming task for both children and their caregivers. It is important for caregivers to be knowledgeable about ostomy care and to be able to provide the necessary support and assistance to their child.
Here are some key considerations for pediatric ostomy care for patients with SBS.
1. Stoma Care
The stoma is the opening on the abdomen through which waste is eliminated. It is important to keep the stoma clean and free of irritation. This may involve gently cleaning the area around the stoma with warm water and mild soap, as well as applying skin-protectant ointments or creams to prevent irritation.
2. Changing the Ostomy Bag
Children with an ostomy will need to have their ostomy bags changed regularly to prevent leaks and to ensure proper waste elimination. It is important to follow the manufacturer’s instructions for changing the bag and to use the proper type of bag for the specific type of ostomy.
3. Nutrition and Hydration
Children with SBS may have difficulty absorbing nutrients and fluids due to damage to their small intestine. It is important for caregivers to work closely with a healthcare provider and a nutritionist to ensure that their child is receiving the proper nutrients and fluids. This may involve providing supplementary nutrition through tube feedings or intravenous fluids.
Children with SBS may require medications to help manage their condition, including antibiotics to prevent infections and medications to help regulate bowel movements. It is important for caregivers to administer these medications as directed by a healthcare provider.
5. Psychological Support
Caring for a child with an ostomy can be emotionally challenging for both the child and their caregivers. It is important to provide emotional support and to address any concerns or questions that the child or caregivers may have. A healthcare provider or a mental health professional can provide additional support and resources.
6. Ostomy Reversal
In some cases, children with SBS may be candidates for an ostomy reversal procedure, in which the ostomy is closed and the digestive system is restored to its original form. This decision should be made in consultation with a healthcare provider, as it will depend on the specific needs and circumstances of the child.
There are several resources available for parents seeking information about managing a pediatric ostomy site. Here are a few options.
1. Ostomy Organizations
Organizations such as the United Ostomy Associations of America (UOAA) and the Ostomy and Continence Nurses Society (OCNS) offer a variety of resources for people with ostomies, including information about managing a pediatric ostomy site. These organizations often have local chapters and support groups that can provide additional support and information.
2. Online Support Groups
There are several online support groups for parents of children with ostomies, such as the Pediatric Ostomy Support Group on Facebook. These groups can provide a forum for parents to connect with others who are managing a pediatric ostomy site and offer support and information.
3. Healthcare Professionals
Your child’s healthcare team, including their ostomy nurse and gastroenterologist, can provide you with information and guidance about managing your child’s ostomy site. They can also provide you with resources and refer you to additional support services as needed.
4. Ostomy Product Manufacturers
Many ostomy product manufacturers offer educational materials and resources for people with ostomies, including information about managing a pediatric ostomy site. These resources may be available on their websites or through their customer service departments.
It is important to note that managing a pediatric ostomy site can be a complex process and it is important to work closely with your child’s healthcare team to ensure that their ostomy is being properly managed. They can provide you with the most up-to-date and accurate information about your child’s specific needs
Peristomal irritation is a common issue for people with an ostomy, especially in the first few weeks after surgery. It occurs when the skin around the stoma (the opening in the abdomen where waste is eliminated) becomes inflamed or irritated. This can be caused by a variety of factors, such as the use of the wrong type of ostomy appliance, skin irritation from the adhesive, or pressure on the stoma from the appliance.
Peristomal irritation can be uncomfortable and may cause skin redness, itching, or swelling. It is important to address peristomal irritation as soon as possible to prevent further skin damage and ensure that the ostomy is functioning properly.
Here are a few tips for managing peristomal irritation and caring for the skin around the stoma.
1. Choose the Right Ostomy Appliance
It is important to select an ostomy appliance that fits well and does not put pressure on the stoma. The wrong size or type of appliance can cause irritation or leakage, which can lead to skin irritation. Your healthcare team can help you select the right appliance for your needs.
2. Protect the Skin
Use a skin barrier or skin protectant to protect the skin around the stoma from the adhesive on the ostomy appliance. This can help prevent irritation and allow the skin to heal.
3. Keep the Skin Clean
It is important to keep the skin around the stoma clean to prevent irritation and infection. Gently clean the area with mild soap and water, taking care not to scrub or rub the skin too hard.
4. Avoid Using Alcohol-Based Products
Alcohol-based products, such as some types of wipes and skin barrier removers, can be drying and irritating to the skin. Avoid using these products or use them sparingly to prevent further irritation.
5. Use a Gentle Cleanser
Choose a gentle, non-irritating cleanser to wash the skin around the stoma. Avoid using harsh soaps or scented products that can be drying or irritating to the skin.
While there is no “one size fits all” solution for ostomy care or management, there are countless resources available for parents navigating the overwhelming process. It is important to remain patient and remember that your child’s healthcare provider is always accessible should you need additional information.