Ateneo De Naga University

Naga City
College of Nursing

Colostomy (SDL)
Renie Serrano

Pediatric Considerations

Do

Always carry extra supplies. This can include pouches, stoma powder and extra clothes in case of a leak.

Empty the pouch when it is 1/3 full (almost halfway) full of stool or gas. Change the pouch if it leaks or if
the skin is red, itchy or burning.

Change the pouch 3-4 times a week. Change it in the morning or before breakfast. The stoma is less
active at that time.

Have the child take a stool softener. This keeps stool soft and moving, especially while taking pain
medication. Ask the child’s surgeon how often the child should take a stool softener.

Check the skin around the stoma for redness or irritation. The skin around the stoma should not be red,
raw, swollen or burning.

Keep in touch with the child’s stoma nurse. The nurse can teach about the stoma and how to change the
pouch. The nurse can also adjust the pouch size as the child grows.

Do not

Do not let the child lift or carry anything heavy after surgery. The surgeon will tell you when the child
can lift or carry things.

Do not let the child soak in the bath or swim until the incision is healed. The incision is where the
surgeon cut into the skin.

Do not rinse the pouch. It can make the seal around the skin weak and cause leaks. It can also bother
the skin.

Do not use baby wipes on the skin around the stoma. They can make it harder for the next pouch to seal
tightly.

Gerontological considerations (as a caregiver to an elderly)

 While applying the pouch, the skin should be wrinkle-free. Failure to do so will cause the pouch
to loosen and the seal to break, whenever the skin stretches.
 Whenever you are changing your pouch, remember to put a date on it. This will help you
remember the last date you changed your pouch.
 The area should be clean and dry. Trim off hairs if there are any.
 Ateneo De Naga University
Naga City
College of Nursing

Colostomy (SDL)
Renie Serrano

 Always remember to wear the pouch in front of the mirror. This will allow you to wear it
properly.
 Clean and empty your pouch when it is one-third full. Don’t wait for the pouch to fill up
completely, as it will cause problems while emptying it. Moreover, the risk of leakage and odor
will also increase.
 After emptying the pouch, you can clean it using Dreft soap and water. This will not only freshen
up the bag but also lubricate it.
 You can also consider applying non–stick cooking oil such as Palm spray inside the pouch. This
will not allow the stool to stick inside the pouch and enable faster and hassle-free cleaning.
 Your elderly can bathe with or without the pouch. However, one must remember that the stoma
will be working during this time.
 The materials that are for washing the stoma, need to be clean enough to prevent any dirt from
irritating it.
 Try and cover a part of the pouch inside the underwear. This will provide better support.
 Humid or hot weather conditions would require your elderly to wear a cover over the pouch.
This is to prevent perspiration from irritating the skin lining.
 The pouch that is available is usually odor proof. They come with an inbuilt carbon filter, which
is to filter off the gas and thereby prevent a buildup of odor. However, if odor seems to bother
your elderly. You can then consider using deodorants that can be inside the pouch.

Home care considerations in colostomy care

 Bathing: Bathing can happen with the pouch on or off. Water will not go into the stoma
and does not harm it. The stoma may produce output while bathing. Avoid oily soaps and
lotions around the stoma. Dry the skin around the stoma after bathing and check the seal
for integrity.
 Swimming: Use the pouch while swimming. An ostomy belt or waterproof tape around
edge of skin barrier can assist security of system. Remove tape as soon as done as this
can irritate skin.
 Sleeping: Empty before naps and before bedtime. Children can sleep on their abdomen;
this will not hurt the stoma. Infants should sleep on their backs for safety.
 Travel: Pack all supplies as carry-on. Avoid placing the seat belt over the stoma. Carry
wet paper towels for clean-up, not wipes.
 Clothing: Avoid clothing that has waistbands that might rub against the stoma or that are
so snug they prevent the pouch from filling. For small kids, onesies work well.