Question:
I am a Biomedical Engineering Master’s student and as part of my thesis, I am researching Parastomal Hernias.
I recently read an article on your website titled “Exploring the Debate on Hernia Support Belts: To Hole or Not to Hole” by Yaser Nadeem (Jan 2020). The article mentions that hernia support garments with a hole might actually worsen the progression of parastomal hernias (“The concern is that belts with holes might exacerbate the hernia issue they are meant to address.”).
This is one of the key questions I am trying to answer in my thesis. I was wondering if I could get in touch with the author to learn more about whether there is clinical evidence or scientific research supporting this claim.
Answer:
Parastomal hernia management is a complex topic with limited scientific evidence available. The hole vs. no-hole belt debate has been ongoing for many years.
Here are some key considerations regarding hernia belts:
Belts with a Hole: Potential Concerns
- A prolapse is technically a form of parastomal hernia that occurs through the stoma itself. Some surgeons believe that wearing a belt with an opening may worsen the condition by placing additional pressure on the abdomen, potentially leading to increased bowel prolapse.
- Many hernia belts with openings on the market have soft openings that provide minimal support to the hernia or the abdominal muscles around the stoma. This lack of support could contribute to hernia progression rather than prevention.
- I have personally seen many parastomal hernias develop in individuals using these belts, leading to frustration among patients who believed they were using the correct support device.
Belts Without a Hole: Challenges
- Colostomy patients may experience pancaking and appliance leaks unless output is properly regulated.
- Ileostomy patients may have better success with a no-hole belt, but some still experience leaks or belt rolling at the back.
- There is no single perfect belt, as individual experiences vary.
Lack of Regulation & Standardization
- There are no clear regulations on what defines the elastic support level of hernia belts.
- Companies manufacturing these belts do not disclose their internal guidelines on support classification, making it difficult to evaluate their true effectiveness.
The Best Approach to Parastomal Hernia Prevention
- Belts alone cannot prevent parastomal hernias. Instead, strengthening the core muscles with the guidance of a physiotherapist is essential for long-term management and prevention.
Answered by:
Lauren Wolfe RN, MClSc-WH, CWOCN
laurenwolfeconsulting@gmail.com
Nurse specialized in Wound Ostomy and Continence
2 Responses
I have a parastomal hernia for the past 6 years, and recently had a hernia belt ordered from CONVAL AID in Ottawa. The belt took EIGHT MONTHS to be shipped. I told them specifically that my last belt had been too tight, and specifically asked them to give leeway with the new belt. When it FINALLY arrived, there is no more than 1/2 give for adjustment. They also insisted I get the wider belt, wheras my fist belt that is now worn out was 1.2 inches narrower. I am a curler, so the narrower belt was fine, however it is old, and I needed a new belt. The new belt I finally received is (1) too tight (2) too wide, so it literally digs into my ribs when I get in the curling hack. I simply can’t wear it.
QUESITONS:
(1) Do you feel these belts are helpful?
(2) If so, do you have suggestions other than Conval Aid in Ottawa (or somewhere online) where I can order a belt from that is the proper size, and width, and doesn’t take 8 months for delivery?
THank you
Thank you for sharing your experience.
We can certainly understand your frustration, especially after waiting eight months for a belt that does not meet your needs. For people living with a parastomal hernia, comfort, proper fit, and the ability to continue normal activities such as curling are very important.
Regarding your questions:
1. Are hernia support belts helpful?
Many ostomates with parastomal hernias find support belts helpful for improving comfort, providing abdominal support during physical activity, and helping the pouching system stay secure. However, the effectiveness of a belt depends greatly on obtaining the correct size, width, and opening placement. A belt that is too tight or too wide can cause discomfort and may be difficult to wear for extended periods, as you know.
It is important to note that hernia belts do not repair a hernia, but they may help manage symptoms and provide support during activities such as sports, exercise, and daily tasks.
2. Are there alternatives to Conval Aid?
There are several manufacturers and suppliers that offer custom or semi-custom hernia support garments. Some ostomates have had positive experiences with:
• Nu-Hope Hernia Support Belts
• Comfizz Support Garments
• CUI Wear Support Garments
• Ostomy Resolutions Hernia Belts
• Safe n’ Simple Support Belts
Many ostomy nurses can assist with measuring and selecting the appropriate width and size. If possible, you may wish to consult with a Nurse Specialized in Wound, Ostomy and Continence (NSWOC) before ordering another belt, particularly since your previous narrower belt worked well for curling. The nurse may also be able to recommend suppliers with shorter delivery times.
You may also find the hernia support articles and product reviews on Vegan Ostomy website helpful, as they discuss the advantages and disadvantages of different support garments and belts used by people living with ostomies.
We hope you are able to find a belt that provides the support you need without limiting your ability to enjoy curling.
Sincerely,
Andrea
Medical Lifestyle Advisory Committee
Ostomy Canada Society