Some pediatric gastrointestinal conditions may require an alternative temporary or permanent method of eliminating stools from the body other than through the anal sphincter. The procedure for creating this artificial method of elimination is called an ostomy. The two main types of ostomies are:
- Colostomy – where the large intestine is used to create the outlet (called a stoma)
- Ileostomy – where the small intestine (ileum) is used to create the stoma
A pediatric colostomy may be performed for the following conditions:
- Birth abnormality where the anal opening is missing (imperforate anus)
- Intestinal obstruction
- Necrosis of the colon due to severe infection
- Inflammatory bowel disease (IBD)
Reasons why a child may need an ileostomy:
In most cases this option is taken because the colon cannot be used or it has been removed. Since the colon’s water re-absorption function is missing, stools passed from an ileostomy stoma are much higher in water content than those from a colostomy. Disease conditions that can lead to an ileostomy include:
- Congenital malformations of the intestinal tract
- Necrotizing enterocolitis
- Chron’s disease
- Ulcerative colitis
Concerns about Pediatric Ostomies
It is understandable when parents become concerned about an ostomy procedure on their child. Pediatric ostomies have a life-changing impact on the child and their respective families. Apart from the usual anesthetic and surgical risks, creating an ostomy for a child is a relatively safe operation.
Pediatric ostomy care training begins during hospital stay which usually does not go beyond 7 days unless post-op complications occur. This way, by the time the patient is discharged the care giver is well equipped to take care and manage the child’s stoma.
Post-operative lifestyle for a child with an ostomy
Pediatric ostomates lead a life like that of any other child. They can engage in many sports (except combative ones that risk stoma trauma) and recreational activities and attend regular schools like any other child.
Problems to look out for after a child has had an ostomy
In most cases there are no post-operative complications. However, it is important to know what could happen and what to do in such situations. Common issues include:
- Skin inflammation. This can make the pouch leak. Report to your doctor for early intervention.
- Ostomy hernia
- Constipation. A balanced diet and drinking enough fluids can easily resolve this problem.
- Diarrhea. This can be a simple case of the intestinal tract not agreeing with certain foods or it could be an indicator of a developing problem such as an infection. Contact your doctor if the problem persists or it is accompanied by other worrying symptoms. Meanwhile maintain a good diet and an adequate intake of fluids.
- Obstruction. Signs of obstruction include abdominal pain, abdominal cramps and distension. Vomiting can also be present and the pouch is usually empty. In such circumstances, call your doctor immediately.
Depending on the reason why the stoma was created, your child’s doctor will explain to you whether the ostomy is a permanent one or not. If not a temporary one, a scheduled operation for an ostomy closure is usually planned once the initial issue has been resolved.