Hernias develop most often in ostomates around the stoma. A weak spot was created during surgery when a small circle of abdominal muscle was removed to bring the intestine to the surface. Lifting something too heavy or starting strenuous exercise can cause the intestine to protrude through this gap. In some individuals, even sneezing, coughing or standing up can make the bowel bulge through this weak spot. Parastomal hernias are rarely painful but are usually uncomfortable and can become extremely inconvenient. They may make it difficult to attach a bag properly, and sometimes their size is an embarrassment as they can be seen beneath clothes.
Regardless of inconvenience or pain, hernias are defects in the abdominal muscle wall. They should not be ignored simply because they might not hurt. Some surgeons advocate those small stoma hernias that are not causing any symptoms do not need any treatment. Furthermore, if they do need treatment, it should not be by surgery in the first instance but by wearing a wide, firm hernia belt. This is probably true with small hernias, in people who are very elderly and infirm or people for whom an anesthetic would be dangerous (serious heart or breathing problems, for example.) Your Ostomy Nurse can help measure you and show you the different belts available. Operative repair of a stoma hernia may be necessary to improve the quality of life, prevent progressive enlargement of the hernia and make it easier to manage the stoma. Give your muscles time to heal and introduce physical activities slowly and gently.
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