Noticing a new bulge, swelling, or an unexpected change around your stoma can feel concerning, especially if you’re not sure what’s causing it. One possible cause is a parastomal hernia, sometimes called a stoma hernia or ostomy hernia.
Parastomal hernias are a common ostomy complication, and thankfully, they’re not always painful. However, an ostomy hernia can still impact your daily activities, comfort, and overall quality of life.
Below, we’ll explain what a parastomal hernia is, possible symptoms, and risk factors. Plus, we’ll go over what to do if you think you have a hernia and when to seek medical help.
What is a Parastomal Hernia?
A parastomal hernia, also called a stoma hernia or ostomy hernia, is a type of hernia that develops near or around a stoma.
You may be able to quickly spot this type of hernia. It will likely appear as an abnormal bulge or a swelling area under the skin near the stoma. It’s caused by a portion of the intestine pushing outward through a weakened area of the abdominal wall.
Parastomal hernias aren’t always painful, although they can be. Also, it may be more noticeable if you’re straining, laughing, coughing, or standing.
Other symptoms may include tired abdominal muscles, a pulling or dragging sensation in the affected area, ostomy leakage if it affects your pouch fit, and difficulty attaching an ostomy bag.
For some, it may even cause ostomy leakage if it affects how their pouching system fits.
What Causes Stoma Hernias?
Anyone with an ostomy, whether it’s an ileostomy, colostomy, or urostomy, may develop a parastomal hernia.
Now that you know what a parastomal hernia is, you might wonder if you’re at risk, especially if you live with a urostomy, colostomy, or ileostomy. So what causes this ostomy complication?
During ostomy surgery, the surgeon takes a section of bowel to create a passage that diverts waste through an opening in the abdomen. That opening is called a stoma.
Because this process involves abdominal surgery, it may contribute to a weakened area of abdominal muscle around the stoma. Over time, tissue or part of the intestine may push through that weakened area, which creates a hernia.
What are the Risk Factors for Developing a Parastomal Hernia
While not everyone living with an ostomy will develop a parastomal hernia, several factors may increase the risk.
Potential parastomal hernia risk factors may include:
- Having a stoma
- Recent ostomy surgery or abdominal surgery
- Heavy lifting or straining, especially during recovery
- Chronic coughing
- Weight gain
- Changes in activity level or abdominal strength
Some risk factors may not be within your control. That’s why it’s important to talk to your doctor, surgeon, or ostomy nurse. They can discuss what may be right for you.
Tips to Help Reduce the Risk of Parastomal Hernias
So what can you do to help reduce your risk of this common ostomy complication? Keep in mind that your best source for any medical advice is your doctor, an ostomy nurse, or another qualified healthcare provider.
However, here are a few tips that may help reduce strain around your stoma and support your abdominal area.
1. Build and maintain your ab strength.
One common tip for reducing the risk of stoma hernias is to build and maintain abdominal strength. This is because weak abdominal muscles and a weak abdominal wall may make a hernia more likely.
Of course, always check in with your healthcare provider before beginning any new exercise routine, especially if you’re still recovering from ostomy surgery. But many people with ostomies exercise regularly, so don’t let yourself think it’s not possible for you.
Once you’ve got the okay to start physical activity, start out slow. Your doctor or ostomy nurse may have suggestions for gentle core exercises to strengthen your core while living with an ostomy.
2. Ask about hernia support garments or an ostomy belt.
Ostomy belts, wraps, and hernia support garments may help provide additional support for your core. Some may help you feel more secure during your daily activities.
As an ostomy bag fills throughout the day, the pouch’s weight can cause skin barrier lifts and even leaks. Plus, it can irritate your skin by pulling or dragging it down.
If you already have a parastomal hernia, a properly fitted support garment may help with comfort and pouch support.
However, like all ostomy supplies, support garments are not one-size-fits-all. Talk to your healthcare provider or your ostomy nurse about whether an ostomy belt or another support garment is right for you.
Our Ostomy Specialists at 180 Medical can also go over your ostomy accessory options that may help improve fit or reduce pouch leakage, based on your individual prescription, needs, and insurance coverage.
3. Manage your weight (if recommended by your healthcare provider).
Managing weight may help reduce pressure around the stoma. For some people, excess pressure on the abdominal wall may increase the risk of developing or worsening a parastomal hernia.
Talk to your healthcare provider. If they recommend weight management, they may suggest gentle exercise, dietary changes, or other steps tailored to your needs.
4. Avoid straining or heavy lifting.
Anything that causes excessive strain may increase the risk of developing an ostomy hernia.
If you’re lifting or carrying anything, do it safely with good form. That means you’ll want to bend from your knees, not your waist, and keep your back straight while lifting with your legs.
Sudden pain or excessive strain is your body telling you to stop. If what you need to lift is too heavy, don’t be afraid to ask for help.
Also, if you’re living with an ostomy and your job involves regular heavy lifting, you may want to talk to your employer. You may be able to ask about workplace accommodations to reduce your risk of ostomy-related issues, such as hernias.
5. Talk to your doctor about smoking or chronic coughing.
Chronic coughing can repeatedly strain the abdominal wall, which can be a concern for people with an ostomy. Smoking can sometimes cause a chronic cough, and smoking may affect wound healing and overall health.
If you smoke or have a chronic cough due to COPD, asthma, or another condition, talk to your healthcare provider about what you can do to potentially reduce coughing, quit smoking, or reduce strain on your abdomen.
When Should I Get Medical Help for a Stoma Hernia?
If you think you have a hernia, it’s not always an emergency. However, you still need it properly evaluated by a healthcare provider. Contact your doctor or ostomy nurse if you notice a new or growing bulge near your stoma, pain or discomfort, pouch leakage, changes in how your pouching system fits, unexpected changes to your output, or changes to your stoma or the skin around it.
Seek medical care right away if you have:
- Severe or ongoing pain
- Bleeding
- Fever or other signs of an infection
- Nausea or vomiting
- A stoma that’s changing color
- No output when you normally have output
- Signs that your hernia may be causing a blockage
What Do I Do If I Think I Have an Ostomy Hernia?
So, if you have symptoms of a parastomal hernia, what do you do? First, don’t panic. Stoma hernias are pretty common.
However, you do need to contact your doctor or a certified ostomy nurse. They need to evaluate the stoma and the surrounding area and determine the next steps for you. Surgery may be a possibility in severe cases.
They’ll be able to assess your stoma and the surrounding area to determine what’s happening and which treatment is appropriate for your needs. Surgery is a possibility in severe cases.
If you prefer a phone chat, 180 Medical can connect our customers to a team of certified ostomy nurses for any medical questions or concerns you may have.
Also, if your hernia is affecting how your ostomy pouch fits, our Ostomy Specialists are knowledgeable and highly trained in all ostomy product offerings. We’ll gladly help you find the right ostomy supplies to fit your changing needs. Contact us today!
Disclaimer: This article is for informational purposes only and is not intended as medical advice. Information provided on 180medical.com should not be used as a substitute for medical advice, diagnosis, or treatment from a qualified healthcare professional. Please consult your healthcare provider with any questions about your condition, treatment, or medical supply needs.
