Common ostomy types
Depending on your child’s reason for surgery, there may be more than one stoma brought through the surface of his or her abdomen. This is called a double-barrel ostomy. After an ileostomy or a colostomy, one opening will be where the stool leaves the body; the other opening, called a mucous fistula, is where mucus leaves the body. A mucous fistula may be used during a future surgical procedure to connect the bowel when the ostomy is closed1,2. A mucous fistula may not require a pouch and is often covered with gauze. If the surgeon creates it close to the stoma, one pouch may be used to cover both stomas. Your child’s surgeon will fully explain the type of surgery performed.
COLOSTOMY
During surgery, an opening is made somewhere in the large intestine (colon, or large bowel). A part of the colon is brought through the skin’s surface on your child’s abdomen, and secured in place. The stool can now pass from the stoma out of your child’s body. You will be instructed on how to apply an ostomy pouch over the opening to collect stool. Stool output can range from hard and formed to very liquid, depending on the placement of the stoma1.
ILEOSTOMY
In an ileostomy, an opening is made in the small intestine (ileum, or small bowel). An end or loop of the small intestine is brought through the skin’s surface on your child’s abdomen, and the surgeon secures it in place. The stool can now pass from the stoma out of your child’s body3. You will be instructed on how to apply an ostomy pouch over the opening to collect stool.
It is important to have an ostomy pouch that fits properly, to protect the skin surrounding the stoma (called the peristomal skin). The stool from an ileostomy contains enzymes that can irritate the skin around the stoma3. You will be instructed on how to clean this area. The stool of an ileostomy is usually liquid.
UROSTOMY
A urinary diversion is created surgically at almost any place in the urinary system. An opening is made through the skin in the abdomen. This allows the passage of urine, which is made by the kidneys, down the ureters and out through the stoma4. You will be instructed on how to apply an ostomy pouch over the opening to collect urine.
Occasionally, in infants and toddlers, a vesicostomy may be created as a temporary alternative to divert urine from the bladder. An incision is made below the umbilicus (belly button) into the top of the bladder. The opening of the bladder is brought up and sutured to the abdominal skin opening. Urine is often able to empty into the diaper area5.
Medical professionals agree that good fluid intake is important to prevent urinary tract infections. Your child’s doctor and/or nurse will give you guidelines about fluid intake based on your child’s specific medical condition. Routine follow-ups, including urine specimens (“samples”) and radiologic X-ray examinations, are essential.
References [+]
- What is an ostomy? United Ostomy Associations of America Web site. http://www.uoaa.org. Accessed August 27, 2007.
- Minkes RK, McLean SE, Mazziotti MV, Langer JC. Stomas of the small and large intestine. eMedicine Web site. http://www.emedicine.com. Accessed November 29, 2007.
- Information about specific surgical procedures: ileostomy. The Children’s Hospital of Philadelphia Web site. http://www.chop.edu. Accessed November 29, 2007.
- Clark J, DuBois H, reviewers. Urostomy Guide. United Ostomy Association. 2004.
- Vesicostomy care. Cincinnati Children’s Hospital Medical Center Web site. http://www.cincinnatichildrens.org. Accessed November 29, 2007.