What is a Stoma?
A
stoma is a surgically created opening on the abdomen that allows for the discharge of bodily wastes. In neonates, stomas may be required due to various congenital or acquired conditions affecting the gastrointestinal tract. The two most common types of stomas in neonates are
colostomy and
ileostomy.
When is a Stoma Necessary in Neonates?
Stomas are necessary in neonates when there is a need to bypass a diseased or non-functional part of the intestine. Common conditions that may necessitate a stoma include:
How is a Stoma Created?
The surgical creation of a stoma involves bringing a loop of intestine to the surface of the abdomen and suturing it to the skin. The exact procedure depends on whether it is a colostomy or an ileostomy. In a
colostomy, the colon is exteriorized, while in an
ileostomy, it is the ileum.
Infection
Stomal prolapse
Parastomal hernia
Skin irritation
Stomal retraction
Close monitoring and proper care are crucial to minimize these risks.
Regular cleaning and monitoring for signs of infection
Ensuring the stoma appliance fits properly to avoid leaks and skin irritation
Monitoring the output to ensure it is within expected ranges
Parental education on stoma care
How Does a Stoma Affect Nutrition?
Nutritional management is a critical aspect of care for neonates with stomas. Depending on the type and location of the stoma, certain dietary adjustments may be necessary. For example, ileostomies often require more fluid and electrolyte management due to higher output levels.
Can a Stoma be Reversed?
In many cases, stomas can be reversed when the underlying condition is resolved or adequately managed. The timing of stoma reversal depends on the individual clinical scenario and the infant's overall health status. Reversal involves a surgical procedure to rejoin the sections of the intestine.
Education and training from healthcare providers
Support groups and counseling services
Resources from organizations specializing in pediatric stoma care
These resources help families navigate the complexities of stoma care and provide emotional and practical support.
