Intestinal Ostomy

INTRODUCTION
PATIENT/FAMILY INSTRUCTIONS FOR:
CARE OF THE CHILD WITH AN INTESTINAL OSTOMY
An intestinal ostomy is an opening into the intestinal system. A surgery is necessary to change the
way stool is passed. Taking care of the ostomy is not difficult. You will be given instructions in the
care of the ostomy. You will be given time to practice your child’s care. The following are some
of the words you may hear your surgeon or nurse use:
a) Stoma: the opening on the abdomen that is made from the intestine. It is normally a rosy red
color.
b) Colostomy: a stoma created in the large intestine. Stool (poop) is usually pasty-tothick
in consistency.
c) Ileostomy: a stoma created in the small intestine. Stool is loose-to-pasty in consistency.
d) Mucous fistula: another stoma that leads to the unused piece of intestine. Mucous drains from
this stoma.
POUCH CHANGE PROCEDURE
The basic change procedure is described here. You will be surprised at how easy changing the
pouch really is. Plan to change the pouch every 1-4 days. Wear time varies. This is related to the
type of stoma your child has and how active he/she is. You will quickly find for yourself the best
change schedule for your child.
1. Gather needed supplies:
• new pouch,
• stoma pattern or measuring guide found in pouch box,
• scissors,
• pen or pencil, wet washcloth or paper towel, dry towel.
2. Remove the old pouch. Use the wet washcloth. This helps loosen the adhesive.
Gently push the skin away from the sticky part of the pouch.
3. Wash the skin around the stoma with warm water. Soap may be used. It will not hurt the
stoma. You may see some blood on the cloth as you clean. This is normal. The bleeding is
minor and stops immediately.
4. Dry the area.
5. Use the measuring guide to determine the best size hole to cut in the pouch. You want about
1/8 th
inch of skin showing between the stoma and the pouch edge. Once you have a good fit
save that backing paper as a ‘stoma pattern.’
6. Peel off backing paper.
7. Apply the pouch around stoma. Press securely to stomach.
8. Apply the clamp.
Page 1 February 2008

POUCH EMPTYING PROCEDURE
1. Supplies needed:
• small basin or soiled diaper,
• irrigation bottle or syringe,
• soap and water,
• toilet paper.
2. Hold end of pouch up and open clamp.
3. Drain stool into small basin or soiled diaper. Older children will drain their pouch directly
into the toilet.
4. Flush pouch with soapy water. See comments below on flushing.
5. Clean end of pouch with toilet paper and close clamp.
6. Dispose of basin contents/diaper.
• Regular attention to the ostomy prevents leaks and frequent pouch changes.
• Empty the pouch when it is about 1/3 full.
• Let out excessive gas as needed even if it is not necessary to empty the pouch
• Mix soap and water solution to use in flushing pouch. 1-2 drops dish soap in a quart of tap
water.
• Flush as desired but be careful to not pull pouch loose.
SKIN CARE
This is the most important part of caring for the stoma. Frequent pouch changes and frequent
leakage can irritate the skin around the stoma. To decrease skin problems:
• Always change the pouch promptly when leaking.
• Ask your nurse for help if leakage is on-going
• Be careful to cut pouch opening the same size as the stoma. Large openings lead to skin
irritation.
BATHING
Your child may bathe (tub or shower) with the pouch on or off. Soap and water will not harm the
stoma. A good washing and airing may be helpful for the skin around the stoma. Your child may
use any bath soap except those containing oils. Rinse area with clear water prior to reapplying the
pouch.
CLOTHING
Your child may wear whatever clothes they like with their ostomy.
• Infants and toddlers benefit from a one-piece garment. This age group often pulls their
pouches off and a one-piece garment helps prevent pulling on the pouch.
• The pouch may be inside or outside the diaper or underwear, whatever seems most
comfortable.
• If the stoma is near your child’s waistline it is important that tight belts or pants not cause
pressure on the stoma.
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DIET
• Your child should eat a diet normal for his/her age. No special precautions are required
because of ostomy surgery.
• It is recommended that your child eat a well-balanced diet of meats, fruits and vegetables.
• However, some foods may cause excessive gas and odor.
• These lists are provided for your information in reducing problems with gas and odor. Do
not routinely exclude these foods from your child’s diet.
apple skins - meats with casings
(sausage, hot dogs)
celery - mushrooms
Chinese vegetables - nuts
coconut - orange rinds
beans - broccoli
carbonated beverages - cabbage
cucumbers – brussel sprouts
asparagus-broccoli
cheese – brussel sprouts
eggs - cabbage
Hard to Chew/Digest Foods
Gas-causing Foods
Odor-causing Foods
coleslaw - popcorn
corn - potato skins
dried fruit - raisins
grapefruit - seeds
dairy products - cauliflower
mushrooms - onions
fish - cauliflower
some spices - onions
ACTIVITIES
Your child will quickly resume their usual activities. As a parent you will worry about allowed
activities. Aside from general home safety precautions, any activity is okay. Children doing
sports may need special protection for their stoma. Discuss this with your nurse or surgeon.
Below are some special considerations:
.
1. Child Care.
Arrange a meeting with the day care staff to discuss the ostomy and to instruct the staff in
care for the ostomy,. Make sure the day care providers have extra ostomy supplies available
2. School Issues.
Inform school staff about your child’s ostomy. Important persons to talk with are your
child’s homeroom teacher, gym teacher, school nurse, and the school principal.
Make arrangements for your child to use the bathroom whenever necessary. Your child will
need extra time or more privacy. Regular bathroom breaks are usually not sufficient,
Keep extra supplies with the school nurse. Older children may keep an emergency kit in
their backpack.
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3. Traveling.
An ostomy does not require special precautions or adaptations for a car seat or booster seat.
Seat belts can be worn by anyone with an ostomy. Always carry the ostomy supplies with
you, in case your luggage is lost. Keep ostomy supplies in the main compartment of the car
or van. Heat and cold can damage supplies. Pack twice as many supplies as you should
need. Carry a reference card with the ostomy supplies. order numbers, brand in the event
you need to purchase something while out of town.
ACCESSORY SUPPLIES
Occasionally children need extra supplies to assist the pouch to remain leak proof or to prevent
skin irritation. Following is a list of some these supplies. Please note your child may or may not
need any of these supplies.
Stomahesive Paste: A paste used to fill in irregular areas on the skin. This is commonly called
caulking for ostomies. This product comes in a tube. It has a small amount of alcohol in it so it may
cause temporary burning on irritated skin. Never use the paste with a urostomy or stoma with large
amounts of liquid output.
Eakin Cohesive Seals: Moldable rings that are helpful when paste cannot be used or when paste
does not work.
Protective Barrier Wipe: A small pad in a foil packet that is applied to dry skin and allowed to dry.
The pad leaves an invisible protective barrier on the skin.
Adhesive Remover Pad: A small pad in a foil packet that is used to loosen the adhesive. It can make
removing ostomy pouches easier. Any adhesive remover leaves an oily film on the skin that must be
washed away before the next pouch is applied.
Stomahesive Powder: A powder designed to be used around ostomies. The powder will heal irritated
skin, but must be ‘sealed’ in place with a protective barrier.
WHO TO CALL
For problems with the surgery site or the stoma, call your surgeon:
Name_______________________ Telephone Number ______________________
For skin care problems and general questions about care, call the Advanced Practice Nurse:
Name _______________________ Telephone Number _______________________
For well baby checks, immunizations, and illnesses, contact your pediatrician or clinic.
Page 4 February 2008

HOME SUPPLIES
Supplies for home use has been arranged through the following company. Please contact
this company for supplies after discharge.
Company Name ____________________________________________________________
Telephone Number _____________________ Contact Person _______________________
Page 5 February 2008