An ileostomy is a surgically created opening of the small bowel (or ileum) through the abdominal wall. This opening on the abdomen is called a stoma. An ileostomy is needed when the large intestine (colon) can not be used and must be bypassed or removed. The work of the colon is to absorb water and store stool (poop or feces). Stool coming from the colon is firm. Stool coming from the ileostomy is thin or thick liquid, so careful attention must be paid to the care of the skin around the stoma.
How should an ileostomy be cared for?
As soon as possible, involve your child in caring for his or her own ileostomy. Children as young as three may offer help by handing you supplies or actually doing some of the care. By age six or seven most children should be able to assume full responsibility of routine care of their ostomies.
Ileostomy drainage is continuous and watery, so your child will need to wear a bag at all times. The ileostomy pouch must be changed when leaking or every three days. Since everyone's ostomy is managed differently, while you and your child are in the hospital, we will work with you to tailor the care to your child's special needs and developmental stage.
Videos, developed by pediatric surgery nurses at UCSF Benioff Children's Hospital, explain the different types of ostomies and stomas and their location on the abdomen. Some ostomies are permanent and others temporary. The videos also demonstrate how to care for a stoma, including how to empty, remove and apply a pouch.
- Caring for Your Child's Stoma
This video offers an introduction and overview of stoma management in children with a demonstration of stoma pouch application on a manikin.
- Ostomy Pouching for Infants
Learn how a mother feels about caring for her infant's colostomy and watch while she shows viewers how to apply, empty and remove a pouch.
- Ostomy Pouching for Children
Listen to a mother and her school-age daughter explain what it means to live with an ileostomy. Watch this video for tips when applying, emptying and removing a pouch.
- Ostomy Pouching for Teens
Learn how this teen feels about having an ileostomy and watch while she shows viewers how to apply, empty and remove a pouch.
Ileostomy pouch changing instructions
The pouch should be emptied when 1/3 to 1/2 full of stool or gas. Full pouches and/or gas will cause pouch to come off sooner. If the pouch is leaking it should be changed as soon as possible. At minimum, the pouch should be changed every three days.
- Appropriate size pouch/bag with barrier
- STOMAHESIVE® paste and 5cc syringe
- Scissors (fingernail scissors work best)
- Indelible marking pen
- Tail closure
- Optional: STOMAHESIVE® powder
Step by Step Instructions
- Remove old pouch and cleanse the skin with warm water. A tub bath will be soothing to the skin and not harm the stoma. Observe the stoma for color changes, change in appearance (bulging or sunken), and condition of surrounding skin.
- Trace stoma onto a piece of paper or plastic to make pattern. Cut out pattern and lay over stoma to check fit. The opening should be close to but not touching stoma.
- Place pattern on skin barrier, trace and cut out. Smooth edges with your fingers.
- If barrier is separate from pouch, place pattern on barrier and trace then cut out. Attach barrier and pouch together.
- Prior to applying, hold barrier in your hands for several minutes to warm and soften.
- Remove the barrier backing and center pouch and barrier over stoma.
- If your child has a stoma that is at skin level, below skin level, or has uneven surrounding skin, apply a thin ribbon of paste around the opening of the barrier or around the base of the stoma where it joins the skin.
- Place your hand over pouch and barrier for several minutes since heat will help seal the barrier and paste to the skin.
- Fan fold the bottom of the bag; secure with tail closure or rubberband.