Distal Loop WashoutWhat is it?A distal loop washout is a procedurecarried out to clean the lower part ofthe bowel, i.e. the bowel from thestoma down to the bottom (or wherethe bottom should be in children withAnorectal Anomalies (ARM).

Surgeons may ask for this to bedone as a once-only procedure oron a regular basis. It is done:

1. After an operation to form a stoma and started before the child is discharged. It is done in an attempt to clear the lower part of the bowel of meconium or old stool.

2. Before surgery to perform an anoplasty or a pull-through procedure to ensure the bowel is clean for surgery.

3. Or in cases where your baby/child is producing a lot of mucus in the lower bowel which is being passed through the bottom.

Procedure for BabiesA small (rectal) catheter will be passedinto the part of the stoma which leadsto the bottom. Small amounts of warmsaline will then be run through the tubeinto the bowel. If the baby has anopening in the bottom, the saline mayexit the body along with any stool ormucus. If the baby has an ARM, thesaline, stool and mucus will come upand out of the stoma.

The nurse will continue to run smallamounts of saline in until no furtherstool or mucus is present.

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Distal Loop Washout

Procedure for OlderChildrenWith older children the procedure iseasier and quicker if they sit on thetoilet. A (rectal) catheter will be passedinto the part of the stoma leading to thebottom. Warm saline is run into thetube, this can then pass into the toiletwith any stool or mucus. The nurse willcontinue to run saline in until it runsclear from the bottom.

The bowel has no sensory nerves andtherefore this procedure is not a painfulone, however the child may befrightened of a tube being placed intothe stoma. Explanation of theprocedure should be given to the childin a way he/she can understand.Usually, when the procedure is donemore than once, the child's feardiminishes.

With older children theprocedure is easier andquicker if they sit onthe toilet.

This leaflet has been produced by ConvaTec, working in conjunction with Specialist Nurses fromthe Paediatric Stoma Nurse Group (PSNG). ConvaTec is one of the world's leaders in making andsupplying stoma equipment. ©2013 Copyright in the content resides with the members of thePaediatric Stoma Nurse Group (PSNG) as at date of production. ©2013 Copyright in the layoutand other supporting material resides with ConvaTec Inc. AP-010389-GB PAED28

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