Home Care of Your Child After an Ostomy

Guidelines for Parents

Home Care of Your Child after an Ostomy

Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Normal Digestion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Types of Ostomies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Ileostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Colostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Stomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 What is a stoma? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Normal appearance of the stoma . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Types of Stomas . . . End ostomy . . . . . . Loop ostomy . . . . . Double-barrel ostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . 7 . 7 . 7 8 . 8 . 8 . 8 . 9

Ostomy Pouches and Skin Care Types of pouches . . . . . . . . . Components of a pouching system One-piece pouching process . . . . Two-piece pouching process . . . .

Pouching Pointers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 The Importance of Pouch and Skin Care . . . . . . . . . . . . . . . . . . 9 Emptying and Cleaning the Ostomy Pouch . . . . . . . . . . . . . . . . . 10 Step-by-step procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Helpful Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Potential Complications . . . Retraction . . . . . . . . . . . Prolapse . . . . . . . . . . . . . Parastomal hernia . . . . . . . . Stenosis . . . . . . . . . . . . . Laceration . . . . . . . . . . . Irritant dermatitis . . . . . . . . Yeast infections . . . . . . . . . Folliculitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 . 12 . 12 . 13 . 13 . 13 . 14 . 14 . 15

Dehydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Risk of dehydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Signs and symptoms of dehydration . . . . . . . . . . . . . . . . . . . . . . . 15 Other Daily Care Tips Activities . . . . . . . Clothing . . . . . . . . Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 . 16 . 16 . 16

Food Lists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Foods that may have various effects on the stool . . . . . . . . . . . . . . . . . . 17 Helpful Tips by Age Group . . . Infants (1 12 months) . . . . . . Toddlers (12 36 months) . . . . Preschoolers (3 5 years) . . . . . School-age children (6 11 years) . Adolescents (12 18 years) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 . 18 . 18 . 18 . 18 . 18

Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Home Care of Your Child after an Ostomy

Introduction
Your childs condition has required an ostomy. An ostomy is an
opening in the abdominal wall created to divert body waste into a pouch. The surgeon creates an ostomy by bringing part of the bowel or urinary tract through the abdominal wall. The visible portion of the ostomy is called a stoma. There are many different conditions or reasons for creating an ostomy. Some of the conditions that would require an ostomy are Hirschsprungs disease, imperforate anus, meconium ileus, necrotizing enterocolitis, and pseudo-membranous enterocolitis. Your doctor will discuss with you why an ostomy was necessary for your child. Ostomies can be permanent, but in infants and children are often created as a temporary solution to a medical problem. This allows time for your childs bowel to heal or grow before corrective surgery may be performed.

How will I learn to care for my child? You may feel frightened
and overwhelmed with your childs need for an ostomy. After the surgery, you may also feel anxious about taking care of the ostomy at home. This is normal; most parents feel this way. To help assure you before you leave the hospital, a specially trained nurse an enterostomal therapist (ET) will teach you the step-by-step procedures for changing and cleaning the ostomy pouch.

What is the purpose of this handbook? This handbook is provided

as a resource for you to use as you learn in the hospital, and for your reference at home. Before going into detail about your childs type of ostomy and home care instructions, we start with an overview of normal digestion. This is so that you can understand a little bit more about how an ostomy works, and why some of the care instructions we provide are important. The instructions in this booklet are intended as guidelines only. Your surgeon may change the recommendations given in this booklet based on the particular needs of your child. Always follow your physicians instructions.

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Normal Digestion
Before discussing how to care for your child after an ostomy, let us review the normal digestion process . Knowing how normal digestion occurs will help you understand why stool consistency, skin care, and other daily care instructions are so important for your child . Digestion is the breakdown of food into very small pieces for the body to use as energy . Digestion starts in the mouth with the chewing action of the teeth . Food particles are then swallowed down the esophagus into the stomach . In the stomach, food particles mix with enzymes (digestive juices) . Next, the food empties into the small intestine (also called the small bowel) where further breakdown of food occurs . It is in the small intestine that your body begins to absorb nutrients . At the end of the small bowel, water and stool (waste material) pass through the colon (large intestine) . Mucous is produced throughout the bowel to help the stool move through the bowel . The colon is where water is absorbed and the stool is stored until it is eliminated through the rectum and anus (the opening to the outside of the body) .

Home Care of Your Child after an Ostomy

Types of Ostomies
There are two basic types of ostomies: Ileostomy

Ileostomy Colostomy
Ileostomy

An ileostomy is an ostomy located in the small intestine (small bowel) area . Stool here will be loose and watery . There is minimal odor and gas may or may not be present .
Ileostomy

Colostomy

A colostomy is an ostomy located in the large intestine or colon . A colostomy is called ascending, transverse, or sigmoid, depending on the area of the large intestine in which it is located .
Ascending Colostomy

Colostomy

An ascending colostomy is located in the ascending section of the large intestine or colon area . Stool here will be loose to watery . Gas and odor are present .
Transverse Colostomy

A transverse colostomy is located in the transverse section of the large intestine or colon area . Stool here will be loose . Gas and odor will be present .
Sigmoid Colostomy

Transverse Colostomy Ascending Colostomy Sigmoid Colostomy

A sigmoid colostomy is located in the sigmoid section of the large intestine or colon area . Stool here will be formed and soft . Gas and odor will be present .

Ostomy with a pouch

The location of the ostomy and the type of pouching system used vary from child to child.

Home Care of Your Child after an Ostomy

Stomas
What is a stoma?

The stoma is the visible opening of the ostomy . It is the portion of the intestine that was surgically brought out to the skin through the opening in the abdominal wall that was made during your childs ostomy surgery . It is important to learn and recognize what the normal appearance of the stoma is, especially for the type of stoma your child has .
Normal appearance of the stoma

The stoma should be a pink/red color and should be moist . Touching the stoma will not be painful for your child . You might notice that the stoma has some motion . This is the normal motion of the bowel, called peristalsis, that moves the stool through the bowel . The stoma will be swollen for six to eight weeks after the operation . Over time, its size will decrease . The stoma may bleed easily if it is handled roughly . If the stoma has a large amount of bleeding, gently apply pressure to the area with your clean finger . If it does not stop within five minutes, call your doctor or surgeon . Shortly after surgery, you may notice dark black tissue around the stoma . This is necrotic (dead) tissue . (The Loop Ostomy picture on the following page shows some necrotic tissue .) Once the necrotic tissue has sloughed off (shed), the stoma will be shaped differently . Generally, the sloughing is completed before your child goes home . Once you are home, if the stoma becomes dark in color, call your surgeon .

Normal stoma

Stoma slightly swollen

Types of Stomas
End ostomy

An end ostomy has one stoma . This picture shows a normal, healthy, pink end stoma .

End ostomy

Loop ostomy

Loop ostomy

The loop ostomy has two openings in one stoma . In this picture, the dark area around the base of the stoma is necrotic (dead) tissue . A supportive device called a rod or a bridge is placed to hold the bowel above skin level until the abdominal wall has healed . The rod will be in place for five days to two weeks .

Double-barrel ostomy

Double-barrel ostomy

In a double-barrel ostomy, there are two stomas . When the bowel is divided, both ends are brought to the skin surface . One end permits passage of stool; the other is an outlet for mucous . A mucous fistula (nonfunctioning stoma) may be created to allow mucous to drain from a nonfunctioning bowel part .

Diagrams above show cross sections of bowel and stoma

Home Care of Your Child after an Ostomy

Ostomy Pouches and Skin Care

Types of pouches One-piece pouching process

There are many types and sizes of pouches available. They fall into two basic categories: One-piece pouch (skin barrier and pouch are attached) Two-piece pouch (skin barrier and pouch are separate) Many of these systems require cutting the skin barrier to fit the stoma
Components of a pouching system

Make sure the skin around the stoma is

01. Clean the stoma

Cut the shape being careful not to

08 cut one-piece puncture the pouch

clean and dry (Do not use lotion, soap, or oils that will interfere with adhesion)

Skin barrier (also called a wafer): attaches to the pouch and protects the skin Pouch: collects output and captures odor
Optional items:

Prepare the pouch by doing the following:

Apply the pouch by peeling the backing from the skin barrier
09 Peel one-piece

Use Measure stomameasure the stoma guide to 02

Tape: secures the pouch to the skin Stoma paste: caulking for gaps and creases on the skin
One-piece pouching system

6 3
Trace measured shape on to the skinTrace two-piece barrier 03

Gently press to ensure good contact with the skin

10 Press down one-piece

ce Ostomy bag Two-piece pouching system One- Piece Ostomy bag

Two- Piece Ostomy bag

One- Piece Ostomy bag

Two-piece pouching process

Make sure the skin around the stoma is

01. Clean the stoma

POuching POinTerS
Clean the surrounding skin with warm water and a washcloth. It is not necessary to use soap but if soap is used it should be very mild. Avoid cleansers or moisturizers that contain oils deodorants or perfumes. This may cause skin problems and prevent the barrier from sticking. Warm the skin barrier before and after application for better adhesion.

04 Cut two-piece

Cut out the shape

clean and dry (Do not use lotion, soap, or oils that will interfere with adhesion)

5
Prepare the skin barrier (also called a wafer) by doing the following:

Do not use stoma paste as an adhesive. It will not adhere and may cause skin irritation. Use only as a caulking next to the stoma to fill the creases in the skin.

Apply the skin barrier by peeling the backing 05 Peel two-piece barrier and gently pressfrom the skin ing to ensure good contact with the skin.

Use Measure stomameasure the stoma guide to 02

The iMPOrTance Of POuch and Skin care

Proper pouch and skin care help you

6 3
Trace measured shape on to the skin barrier 03 Trace two-piece

meet the goals of caring for a child with an ostomy, which are to: maintain normal bowel function protect the skin from waste material ontrol odor and maintain cleanlic ness by collecting waste material. Good skin care around the stoma includes keeping the skin around the stoma clean and dry. Ill-fitting pouches that allow stool to leak onto the skin can cause skin problems. It is important to keep a good seal on the pouch so stool will not leak onto the skin.

Apply pouch to the skin barrier by placing the lower edge of the pouch flange against the lower two-piece of the skin barrier. 06 stick on portion

Press both pieces together while moving upward and then back down. Gently tug downward on the pouch to assure it is properly attached.

Home Care of Your Child after an Ostomy

Emptying and Cleaning the Ostomy Pouch

Step-by-step procedure

empty the pouch when it is full of air or stool, or earlier if the pouch begins pulling away from the skin. if stool or air is allowed to build up, the pouch will balloon and break the seal or pull away from the skin. Odor should not be a problem if the end of the pouch and the clamp are kept clean. Odor should be noticeable only when changing and emptying the pouch, or if the pouch is leaking. if odor is a problem, odor reducers are available to put in the pouch.

To empty and clean the pouch, use a container, diaper, or catheter-tipped syringe. You will also need a bottle of mild soap or water.

1.
Pour the stool into the container or diaper, or withdraw stool into the syringe.

2.
Use room temperature tap water (1-2 ounces) and a small amount of mild soap (1-2 sprays) to clean the pouch. Pour water into the pouch, swish the water around, and then remove water by using a container, diaper, or syringe.
Step 2 is optional

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3.
Use toilet paper or paper towel to dry the last 2-3 inches of the inside and outside of the pouch.
To help th e pouch-e mptying place the process, bag on yo ur child so off to the it drapes side of yo ur childs Once you body. r child is toilet tra ined, put the bag o n so it ha ngs down childs leg your . The pou ch can th into the to en drain ilet.

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4.
Press air out of the pouch and replace the clamp.

Cut at lea st one ex tra pouch middle-o for the f-the-nig ht pouch change. Always k eep supp lies for on change w e pouch ith the ch ild. There wil l be more stool outp your child ut after has eaten . If possib change th le, do no e pouch a t t that tim e. Occupy y our infan ts attenti hands) w on (and ith toys d uring a p change. T ouch ry hangin g a mobil changing e over th area. e Be aware that prod ucts conta alcohol w ining ill sting w hen appli irritated ed to skin. Rea d the lab el of any unfamilia r product .

5.
If stool is on the clamp, wash it before reusing it.

Home Care of Your Child after an Ostomy

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Potential Complications
Retraction

With retraction, the stoma retracts (is drawn back) into the body. It does not protrude from the abdomen. This makes it very difficult to keep a pouch in place. Good skin care is a must. Please contact your ET nurse for possible treatment options.
Retraction

Prolapse

With prolapse, the stoma becomes elongated (longer) and swollen. If the stoma color changes to dark red or blue, notify your surgeon. Your surgeon may teach you to reduce the size of the stoma by putting it back inside the skin. It is fairly common for stomas to prolapse in children. This is because children have poorly developed abdominal muscles, and crying causes an increase in pressure inside the abdomen. A prolapsed stoma may need to be corrected with surgery. A onepiece pouch is recommended to prevent pinching the stoma in the flange.

Prolapse

Diagrams above show cross sections of bowel and stoma

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Peristomal hernia

With peristomal hernia, there is bulging at the base of the stoma. This may be completely around the stoma, or just on part of the stoma base. This bulging may come and go, depending on the pressure inside the abdomen. The pouch might need to be changed more often.
Peristomal hernia

Stenosis

Stenosis occurs when the stoma opening narrows either at skin level or deeper in the abdomens muscular wall. If this happens, notify your surgeon. Stool will be pencil-thin when it comes out of the stoma. If no stool is produced, call your surgeon.
Stenosis

Diagrams above show cross sections of bowel and stoma Laceration

A laceration is a cut on the stoma. This occurs mostly when the pouch hole is too small or when the pouch is centered too close to the stoma. Your child should feel no pain, but there may be some bleeding from the stoma.

Home Care of Your Child after an Ostomy

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Potential Complications
There are three common infections that may be seen around the stoma:

continued

To cArE For A YEAST InFEcTIon

Irritant dermatitis Yeast infections Folliculitis

1.
stoma paste

Clean the skin, rinse it, and pat dry.

2.
Yeast infections

Apply a very small amount of the prescribed anti-fungal powder on the red areas.

Yeast infections are generally caused by candida albicans. It looks like a red, raised, bumpy rash which can appear anywhere from the base of the stoma to under the skin barrier or pouch. If your child has a yeast infection, your doctor will prescribe an antifungal powder.
Irritant dermatitis

3.

Lightly rub in the anti-fungal powder, and then brush off excess powder.

4. 5.

Place pouch as usual.

Irritant dermatitis is an irritation of the skin caused by stool that has leaked out of the pouch onto the skin. The leaking is often due to a pouch hole that is too large or a pouch that has not been changed often enough. The stool then leaks under the wafer and causes skin breakdown. Irritant dermatitis will make the skin look red and broken.

Note: Be sure to ask your physician for a prescription for anti-fungal powder, not cream. Pouches will not stick to the cream.

Change the pouch every day until there is no more rash.

To cArE For IrrITAnT dErmATITIS

1.

Clean the skin, rinse it, and pat dry.

4.

Place pouch as usual. This procedure will need to be done with each pouch change until the skin is healed. If the skin still looks irritated after five days, call the enterostomal therapy nurse.

2. 3.
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Apply a very small amount of Stomahesive powder on the irritated, red areas.

Lightly rub in the powder and brush off excess.

Dehydration
Risk of dehydration Signs and symptoms of dehydration

Folliculitis

Folliculitis is an infection at the base of the hair shaft (the follicle) and may cause itching or pain. It occurs when hair has been removed traumatically, such as being pulled out or attached to tape. The infection is generally caused by Staphylococcus aureus. It looks like a pustule or a pimple. To prevent folliculitis, remove the hair around the stoma and under the skin barrier. This can be done by clipping the hair with scissors or by using an electric razor. Be sure to keep the razor away from the stoma.

children who have had an ostomy can become dehydrated more quickly than other children. children and adults perspire (sweat) even when not physically active. It is difficult to know how much fluid is lost to perspiration, chiefly in dry areas such as the Intermountain West and during the summer. This is especially a concern for children with ileostomies. If you suspect dehydration, call your physician.
careful attention to stool output is necessary. You will become familiar with the amount of stool your child normally puts out each day. When this output increases, you need to be alert for dehydration. dehydration might also occur when your child has diarrhea or vomits.

decrease in number of wet diapers. Tired, listless, lethargic; child seems more sleepy, less active, and unable to hold head up. Urine is darker in color and has a stronger smell. Increased temperature or fever. dry mucous membranes; no tears, dry mouth. Foul-smelling stools. Vomiting along with diarrhea. Sunken fontanel (soft spot on top of babys head).

Sign of dehydration is an increase in your childs temperature

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Home Care of Your Child after an Ostomy

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Other Daily Care Tips

Activities

Dont be afraid to bathe your child with or without the pouch. Your child should have a pouch on when swimming in a pool. Your childs activity should not be limited because of the ostomy. Always consult your doctor before your child engages in contact sports or activities.

Clothing

Children with ostomies should be clothed so that they cannot scratch their stomas or pull off their pouches. One-piece outfits or undershirts pinned to diapers may help. For older children, overalls may help. The belt or waistband should not ride or rub on the stoma. This could injure the stoma.

Nutrition

Your childs doctor will discuss your childs diet with you. For the most part, your childs diet should not be different from that of a child without an ostomy. Certain foods may produce specific changes in your childs stool. This does not mean you need to remove the food from your childs diet, but rather to be aware of the potential effect.

my eosto h an il ir en wit w the Childr to che aught be t cially should is espe . This uch ell oods s food w fiber f n h ich ca or hig n, wh true f opcor p s and toma. as nut f the s age o block cause

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Food Lists
Foods that may have various effects on the stool. Food that may cause stool odor Fish Eggs Foods that may loosen stool Dried or string beans Chocolate Raw fruits Raw vegetables Highly spiced foods Fried foods Greasy foods Prune or grape juice Leafy green vegetables (lettuce, broccoli, spinach) Food that may cause gas Dried and string beans Carbonated beverages Foods that may thicken stool Bananas Rice Bread Potatoes Creamy peanut butter Applesauce Cheese Tapioca Yogurt Pasta Pretzels Marshmallows Foods that may color stool Beets Red Jell-O Some medications Cucumbers Cabbage-family vegetables (onions, cabbage, Brussel sprouts, broccoli, cauliflower) Dairy products Spinach Corn Radishes Asparagus Garlic Some spices Beans Turnips Cabbage-family vegetables (onions, cabbage, Brussel sprouts, broccoli, cauliflower) Food that have high fiber* Corn Raw celery Coconut Legumes (chick peas, kidney beans, chili beans) Chinese vegetables Apples with peels Grapes Raw cabbage (coleslaw) Dried fruits (raisins, figs, apricots) Nuts Popcorn Meat with casings (bologna, sausage, hot dogs) Mushrooms Foods that may cause urine odor Seafood Asparagus

*Remember, high-fiber foods need to be well-chewed.

Home Care of Your Child after an Ostomy

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Helpful Tips by Age Group

Infants (112 months) School-age children (611 years)

In the first year, most infants triple their birth weight. Therefore, it may be necessary to measure the stomas size frequently. You may also need to try different pouches as your child grows. Infants are activerolling, exploring their bodies, and discovering the world. To protect the pouch, keep it concealed in the diaper. Dress your baby in one-piece outfits or overalls.
Toddlers (1236 months)

Children at this age can learn more about changing and emptying the pouch. By age 7 or 8, they should be able to take care of changing the pouch and emptying it on their own. However, parents still need to occasionally look at the skin to make sure there are no problems. When your child starts school, he will need to take an extra pouch and changing supplies with him. Teachers will need written step-by-step instructions. Review these instructions with the teacher and school nurse. This will give your child a support person at school. At some point in this age group, it may be necessary to change to an adult-size pouch.
Adolescents (1218 years)

By age 12 or so, your child is generally able to assume self-care, make appointments, and order equipment. Your role as parent is to offer support. Teenagers do not need to tell everyone about their ostomy. They should tell only the people they want to. To participate in active sports such as wrestling or football, your child should have approval from the surgeon. Ostomy equipment for adolescents is the same as for adults. Selection should be based on what is most effective for your child.

Toddlers are even more active crawling, walking, running. Before you change the pouch, it is helpful to have all supplies ready. You can begin teaching older toddlers how to help empty the pouch and what steps are necessary. To help protect the pouch, dress your toddler in overalls or pants with no tight waistbands that ride over the stoma.
Preschoolers (35 years)

Preschoolers are intensely curious and want to be independent. They can assist with certain parts of ostomy care, such as removing the pouch, emptying the pouch, and cleaning the skin. Keep lessons short because your childs attention span is probably short. Help your preschooler choose clothes without tight-fitting waistbands.

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Notes

Home Care of Your Child after an Ostomy

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Glossary
Colostomy: A surgically created opening of the large bowel, which forms a stoma and diverts body wastes. Enterostomy: Surgical formation of an opening into the digetive tract. Hirschsprungs disease: A disease associated with lack of nerve (ganglion) cells in a part of the intestine. The lack of ganglion cells affects the intestines ability to move stool through the intestine. Ileostomy: A surgically created opening of the small bowel, which forms a stoma and diverts body wastes. Imperforate anus: An anus that is closed by a membrane or tissue such that there is no opening for stool to pass. Meconium ileus: A blockage in the newborn bowel with thick meconium stool. Meconium is the first feces produced by a newborn baby. Necrotizing enterocolitis (NEC): Condition when the blood supply to the intestine slows or is cut off. The intestine becomes infected and dies. Ostomy: A surgically created opening which is made through the abdominal wall to divert body wastes. Peristalsis: The normal motion of the bowel that propels bowel contents forward through the bowel. Peristomal: The area surrounding the stoma. Prolapsed stoma: Stoma that is elongated (lengthened) and sometimes swollen. All layers of the bowel come through the stoma opening. This is common. Pseudo-membranous enterocolitis: Inflammation of the lining of the intestine, which can involve both the small intestine and the colon. Retracted stoma: Stoma that does not protrude (stick out) from the abdomen. Instead, the stoma looks like a hole or pucker in the abdomen. The mucosal surface (moist tissue lining of the intestine) may or may not be visible. Stoma: The visible opening of the portion of the intestine that is surgically brought out to the skin through the opening in the abdominal wall during your childs ostomy surgery.

Primary Childrens Medical Center 100 North Mario Capecchi Drive Salt Lake City, Utah 84113

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2008 INTERMOUNTAIN HEALTHCARE, Primary Childrens Medical Center, Pediatric Education Services. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns. More health information is available at intermountainhealthcare.org. Patient and Provider Publications 801.442.2963 IHCEDPES001 07/08

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