Stoma
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Stoma (Ostomy)
A stoma (in this context) is where the intestine is brought out to the surface of the skin so that it can be drained or flushed. The rectum is essentially the body's natural "stoma", and a surgical stoma creates a new opening for discharge of waste from the intestine. Typically in short gut this is the small intestine, and because the large intestine is responsible for absorbing most fluids, the waste is very liquid.
Types of Stomas
- Typical Stoma where the small intestine is detached from the large intestine and brought to the surface. The large intestine is left unattached to anything and allowed to go dormant.
- Diversion Stoma where the connection between the small and large intestine is cut and the small intestine is brought to the surface. Then the large intestine is reattached at the bottom edge of the small bowel right near to where the bowel goes through the abdominal to make the stoma. This allows the food to go out the stoma very easily, but it can also go down the large intestine. So the child will still have a large amount of output through the stoma but will also have bowel movements in their diaper.(sometimes a few times a day to a few times a week) The end result is all the benefits of a stoma without letting the large intestine go dormant.
Pros and Cons
- Pros
- There is very little back pressure as food travels out of the ostomy so it moves very easily. It so the bowels don't have to work as hard to do their job. This allows sick or injured bowel to heal more easily
- The fact that the food moves so easily gives any dilation that has occurred in the bowel the chance to return back to normal size.
- Makes it so that doctors can easily monitor the health of a newly transplanted set of small bowel.
- Cons
- Because most of the fluid that the patient takes in and that the stomach and small intestine make leaves the body through the stoma, the patient is very susceptible to dehydration and electrolyte imbalance.
- Stomas can be messy and it is very hard to find a bag that will stay attached to the skin, especially in children. Bad fit can result in skin deterioration and leaks. But see StomaCare.
- Because in some instances the colon is unattached it will become dormant and therefore very thin. Sometimes this can be an issue when the bowels are reattached if the size between the bowels is significant.
- In rare cases the stoma can prolapse on it's self. The intestine pushes out of the body through the stoma. This can be a few cm or many inches.
