251 Impact of presence, level and closure of a stoma on growth in young children Chapter 11 Conclusions A weighted decision on the creation of a stoma and timely stoma closure is important, considering the negative impact that a stoma has on growth in the majority of children. This impact might be decreased by preventing small bowel stomas when possible, specifically those more proximal than 50 centimeters before Treitz, and limiting small bowel resection. Moreover, most young children with a stoma do receive sodium supplementation, but there is no guidance on optimal supplementation and in a large proportion the supplementation seems to be inadequate. Since stoma closure seems essential in reversing the negative effect seen in most patients with a stoma, we opt that early closure, especially in children treated by small bowel stomas, result in an early shift to catch-up growth. Since there are currently no guidelines focusing on the moment of stoma reversal as well as sodium supplementation and monitoring in these patients, this demands future attention.
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