Prolapsed ileostomy

My 8yr old son has a recent ileostomy (his surgery was July 9, 07). 2 days ago, it prolapsed and his small intestine is now protruding from the stoma about 3 inches.
His surgeon had me take him to emergency room where they put it back into the stoma, it came back out a short time later. Now, when he lies on his back it recedes back inside, but when he stands it comes out again. I can't keep him lying on the couch forever. I now how to place it back inside, but I don't know how to keep it inside. Also I don't know why this is happening in the first place.

Please, has anyone experienced this? What do we do about it? His surgeon says this is a common problem with ileostomy and that if it gets longer than 6 inches we may need another surgery, but he says it may prolapse again because this is common.

Can anyone give me any advice please, my son needs to live his life.

Thank you
Jsmom

A prolapse is more of an annoyance than a danger.

Imagine a sock rolled back once on itself. This is how a stoma is constructed. What you actually see of the stoma is the inside not the outside of it. Now, imagine you pull the inside of the sock out so the sock gets longer. This is what happens in a prolapse.

To get the stoma to return to it's normal size, there are a couple of things you can do. Try putting ice on it. If that doesn't work, sprinkle some brown sugar on it (yes it does work!).

If it constantly prolapses, surgery may be the answer.

Good luck to both of you.

Thank you both for your advice. My husband and I have been putting a belt on him and it's been working pretty well. In his case, the belt must be tight and cover the stoma completely, otherwise he still prolapses. We were uncomfortable about the pressure and completely blocking his stoma in this way, but his surgeon said it's okay as long as my son periodically raises the belt off the stoma so it can eliminate into the bag. If it were only cosmetic, it wouldn't be a big concern, but he has intense cramping and nausea during prolapse. No cramping or nausea otherwise. His surgeon had him x-rayed and ruled out possible obstruction. Many doctors, incl surgeon, recently checked him and ruled out hernia. His surgeon said that we can consider surgery to adjust the stoma, but there is no guarantee of positive outcome. (must be great to not have to be accountable for results--- there, I vented) It's been a few days now and the belt is preventing prolapse. We're scheduled to see surgeon again to re-evaluate this in 3 weeks. Will keep everyone posted.

Thanks for the ice recommendation also and the brown sugar idea is intriguing. Will try these too! The prolapse retreats slowly on its own when my son lies on his back. But lying on one's back is disruptive during the day. Maybe I'll try an alternate belt fitted with an ice pack that he can change out during the day. When he cannot change ice packs, just tighten the belt over the stoma like before.

Thank you again so much for responding.

Jsmom

Would it be possible to use any type of belt to prevent prolapse in the first place?

I am kind of re posting my question seeing as there seems to be some interest again. My son has prolapses of his ileo all day. We are going to hospital next week, not sure what will have to be done, I am not wanting more surgery as the last one this past summer was so serious and difficult. My son has CP and uses a wheelchair for mobility so is sitting most of the day. Has anyone had surgical correction for a prolapsed ileo on this site please? If so what did the surgery consist of and did it work?
Brenda and Dan
We have a great blog at DansSideCar.blogspot.com

Thank you for responding. We recently had an emergency with the prolapse, on Thursday it would not return. We took Dan to Jefferson Hospital in Phili, traveling on the bed in motor home. This all started at 2pm, we were quite worried as it was getting more swollen and prolapsed as time went by. There was not a surgeon available to see us right away, Dan was very uncomfortable. At around 11.30 it finally started to go back ( I have no idea why) by 12 pm the surgeon came and it was 100% back. They told me that he was no longer an emergency and we had to leave. I was concerned as I knew that it would come out as soon as he sat up, they were not concerned, "just come back" was what they said. Somewhere I remember reading about someone having an ostomy belt made for them, none of the doctors I have talked to have anything other than a revision as a plan, so I decided to put Dan's waist band right over the stoma, and it is a miracle for the first time in over a whole month he has gone a day without a prolapse. we are on the 5th day right now and I am so pleased at how this is working. I am still checking all the time and concerned that it does not effect his out put, but all in all this is OK.
Brenda

no I don't we and they canceled it as there is nothing that can be done that is better than it working with this pressure on it. The medical fix is not a great option. I tried an ACE bandage today but it did not work as well as the sweat pants waist band. I plan to try a pair of boxer undies under his pants. Since the surgery I have not been able to zip his reg pants up as the bag is in the way. Sitting in a wheelchair complicates things though. But like you say the stoma is having good output even with the pressure on. I always have to be very vigilant as the first 4 months after surgery we had many horrible blockages that lasted over a week. Thanks, B and D