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Solving problems associated with Paediatric stomas

Although it is alot to cope with at first, when you and your child develop a routine it will become easier.

Paediatric stoma care

A stoma will not prevent a child from being healthy and active and fulfilling his or her potential in life. All children develop at a different pace and having a stoma will not affect this development in any way. For help and guidance, your Stoma Care Nurse as well as other medical advisers will be on hand.

Problems that you may encounter

Surface bleeding: Sometimes the stoma may bleed a little, for instance if brushed by a towel or dressing or if the child falls. This is entirely normal as stomas have a lot of blood vessels and the bleeding usually stops very quickly.

Bleeding from inside the stoma: This is not normal and should be reported to the doctor immediately.

Wind and flatulence (Colostomates & Ileostomates): Gas/wind can be a common problem causing the pouch to ‘balloon’. Although some pouches contain filters to remove gas, you may want to try to avoid it in the first instance. The following are considered common foods for causing gas:

  • Vegetables such as broccoli, cauliflower, cabbage, spinach and brussel sprouts
  • Baked beans
  • Onions and garlic
  • Fizzy drinks
  • Eggs
  • Fish
  • Spicy foods.

Yoghurt and yoghurt drinks may be beneficial in preventing wind.

Constipation (Colostomates): Constipation may occur as a result of medication or perhaps not drinking enough fluids. If your child is suffering from constipation it may be advisable to try the following:

  • Drink plenty of fluids a- water is best
  • Eat more fruit and vegetables
  • Increase the amount of wholegrain and/or bran in your child’s diet
  • Try drinking fruit juice or more fruit purees.

Diarrhoea (Ileostomates & Colostomates): Diarrhoea can be an indication that your child is having trouble digesting food. If this is the case you should try to remove fibre from their diet and instead eat foods that thicken the stool.  Foods that may lead to diarrhoea include:

  • Cabbage and other green vegetables
  • Spicy foods
  • Fruit (except bananas)
  • Prunes or prune juice
  • Citrus fruit juices.

Foods that might help to alleviate this problem:

  • Very ripe bananas
  • Marshmallows
  • Cheese
  • Rice/ Noodles/ Pasta
  • Yoghurt
  • Jelly/ Jelly babies
  • Boiled milk.

Diarrhoea can cause considerable loss of water so plenty of fluids should be taken to replace this. Certain medication may also cause constipation or diarrhoea in some children. If you are worried about this please consult your doctor.

Discoloured urine (Urostomates)

•Foods such as radishes, fish, beetroot, spinach and spices may cause your child’s urine to have an unusual odour and colour but this isn’t anything to worry about. Some medications may also affect the urine colour and odour.

•Foods that can help reduce urinary odours include yoghurt and buttermilk.

•Generally if the urine is dark, this is an indication that your child is dehydrated and needs to drink more fluids.

Blockages (Ileostomates): As the ileum is quite narrow, foods which are high in fibre can cause blockages after surgery. As a result the output will lessen or even stop and your child may experience pain and nausea. If your child chews their food well and drinks lots of fluids this should help to avoid this risk. Foods that may cause blockages include:

  • Celery
  • Popcorn
  • Coconut
  • Nuts
  • Coleslaw
  • Dried fruits
  • Peas
  • Vegetable skins.

Skin soreness: Skin soreness can be caused by a number of factors including an ill-fitting appliance where leakage may occur, a change in body size, a change in output, too frequent pouch changes or skin allergies. Eakin Cohesive® is the ideal treatment for sore skin as it absorbs moisture and blocks irritants from reaching the skin. You can find more information on skin care and the benefits of using Eakin Cohesive® in our ‘Skin Care’ booklet.

Odour: If your child’s stoma pouch is applied correctly then you should not experience any odour until you come to empty the pouch. Certain foods can cause increased odour:

  • Eggs
  • Baked beans
  • Spicy foods
  • Onions and garlic
  • Fish
  • Asparagus
  • Broccoli & brussel sprouts
  • Some cheeses.

Foods such as yoghurt and buttermilk might help to solve this problem.

If you do experience odour when you are not changing the pouch, then this could indicate pouch leakage. If this is the case then change the pouch immediately.

Change in stoma colour: Your child’s stoma may change colour slightly from time to time. However, if the colour change is quite sudden eg. becoming dark or blue in colour, check to see that it is not being restricted in any way. Consult with your doctor if you are worried.

Prolapse: When the muscles holding the stoma weaken and allow the bowel to slide out, therefore increasing the length of the stoma, this is known as a prolapse. This can be frightening for the child as some can be quite large but it does not usually cause any pain or affect the way the stoma functions. Prolapsed stomas can cause the pouch to leak and the hole of the pouch should be checked for the correct fit. If you are at all worried you should seek advice from your Stoma Care Nurse.

Although it is alot to cope with at first, when you and your child develop a routine it will become easier. A stoma will not prevent a child from being healthy and active and fulfilling his or her potential in life. All children develop at a different pace and having a stoma will not affect this development in any way.

For help and guidance, your Stoma Care Nurse as well as other medical advisers will be on hand.