Enterostomal Therapy

Enterostomal [en-ter-oh-STOH-muhl] therapy provides care for people with ostomies, like colostomies or urostomies. An enterostomal therapy nurse, or ET nurse, is a trained professional who can help you and your child use and maintain an ostomy. This nurse might help your child while they are in the hospital, or they could be a home health aide who comes to your home to help take care of your child’s ostomy.

What is an ostomy?

An ostomy [AH-stuh-mee] is an opening on the body to get rid of your child’s stool or urine. It is related to, but not the same as, a stoma [STOH-muh]. “Ostomy” means the opening that is created through a surgical procedure, while “stoma” means the end of the ureter [yoo-REE-ter] or bowel in your child’s body. The stoma often extends through the ostomy so urine or feces can leave the body. Common ostomies include:

• Colostomy [kuh-LAH-stuh-MEE], a hole which is used to connect to your child’s colon, where feces passes through.
• Urostomy [you-RAH-stuh-MEE], a hole which connects to your child’s ureter, where urine comes out.

An ostomy can have a number of risks and challenges, especially with children. Some of these can include:

Hygiene

Your child’s ostomy site needs to be cleaned well to prevent infection, irritation, and to keep it from smelling bad or bothering your child more than it needs to. You might find it hard to keep your child’s ostomy clean, or you might be worried that you are not cleaning it well enough.

An ET nurse can help make sure that your child’s ostomy is kept clean and sanitary, and can show you how to change the ostomy bag in the case of a urostomy or colostomy. They can also adjust the bag and other equipment to make it more comfortable for your child to wear.

Emotional issues

An ostomy can be embarrassing or difficult for anyone, but children can be especially hard hit by these problems. Children with ostomies might not want to spend time with their friends, because they are embarrassed or worried about accidents. This can lead to depression and other mood problems.

While an ET nurse can’t make your child feel better on their own, they can teach you and your child how to care for the ostomy in a way that will minimize accidents and help your child feel less embarrassed.

Side effects of enterostomal therapy

When kept clean and used the right way, ostomies are safe and effective. However, there can be some side effects that you should be aware of. Talk to your child’s doctor or ET nurse if you notice any of these:

• Fever
• Bad smell lasting longer than a week
• Irritation around the stoma that doesn’t go away
• Nausea, vomiting, or pain in the stomach
• No bowel movements

Some symptoms can be a sign of a serious problem. You should go to the emergency room if you notice that your child has:

• Bowel movements that are black or bloody
• Bleeding in the ostomy that won’t stop
• Severe weakness
• Severe abdominal pain

Even though an ostomy can be difficult to use, it is an important medical tool that can help your child live a more normal life if they have diseases, disabilities, or other conditions that stop them from getting rid of waste in a normal way.

Enterostomal therapy helps by giving you and your child support, care, and training for your child’s ostomy. An ET nurse can help by:

• Making your child’s ostomy easier to use.
• Reducing the health risks of a colostomy or urostomy.
• Teaching you and your child what the ostomy does.
• Lowering the chance of accidents or side effects by teaching you and your child how to use, clean, change, and maintain the ostomy.

You and your child can prepare for enterostomal therapy by scheduling an appointment with the ET nurse and knowing what to expect during their visit. If your child’s ostomy is new, you might have questions about how to keep the ostomy clean and comfortable for your child when the nurse is not there.

You have a right to know everything about the medical treatment that your child is receiving, so you should make a list of questions for the ET nurse, and talk about them until you understand fully. If there are questions your ET nurse can’t answer, you should schedule a follow-up appointment with your child’s doctor.

Enterostomal therapy can be different depending on the type of ostomy your child has, your level of knowledge about caring for the ostomy, and other factors. However, your child’s ET nurse will usually do some or all of these steps during their visit:

• Change your child’s ostomy bag.
• Clean the stoma, the hole in your child’s body that the ostomy bag connects to.
• Check your child’s stoma and ostomy for any signs of irritation, infection, or other side effects.
• Talk to you and your child about any problems or challenges with the ostomy, and advise you on how to deal with these issues.

You can check the results of your child’s enterostomal therapy by keeping track of how well they are doing with their ostomy as a result of the ET nurse’s help. If the therapy is working, your child should have fewer complaints about their ostomy, and experience less side effects than they would without the therapy.

If at any time you think that your ET nurse isn’t helping, you should talk to the nurse or your doctor to discuss other ways of improving your child’s results.

If your child is doing well with their ostomy, you might not need any follow-up. However, enterostomal therapy is itself a common follow-up service that can be provided both while your child is in the hospital and once they’ve come home.

In addition to the care your ET nurse provides, your doctor may schedule regular follow-up visits with your child to monitor their progress. Since children usually have ostomies as a result of another underlying disease or condition, your doctor will want to keep track of whether this condition is getting better, getting worse, or staying the same.