Stoma (Parastomal) Hernias
A hernia is a weakness or split in the muscle wall of the abdomen which allows the abdominal contents (usually some part of the intestine) to bulge out. The bulge is particularly noticeable upon tensing the abdominal wall muscles - such as occurs when coughing, sneezing, straining or simply standing.
When a stoma is brought out to the surface of the abdomen it must pass through the muscles of the abdominal wall, thus a potential site of weakness is immediately created. In the ideal situation the abdominal wall muscles form a snug fit around the stoma opening. However, sometimes the muscles come away from the edges of the stoma thus creating a hernia - in this case, an area of the abdominal wall adjacent to the stoma where there is no muscle.
Factors that can contribute to causing a stoma hernia to occur include coughing, lifting heavy objects, being overweight or having developed an infection in the wound at the time the stoma was made. The development of a stoma hernia is often a gradual process, with the area next to the stoma stretching and becoming weaker with the passage of time. This weakness, or gap, means that every time one strains, coughs, sneezes or lifts heavy objects the area of the abdomen next to the stoma bulges, or the whole stoma itself protrudes as it is pushed forwards by the rest of the abdominal contents behind it.
Stoma hernias are rarely painful, but are usually uncomfortable. They may make it more difficult to apply a bag securely and sometimes their size causes a problem as they can be seen beneath clothes.
Although a rare complication, the intestine can sometimes become trapped or kinked within the hernia and become obstructed. Even more seriously the intestine may then lose its blood supply, known as strangulation. This is very painful and requires emergency surgery to untwist the intestine and prevent the strangulated part of the bowel from being irreversibly damaged.
There are surgeons who believe that stoma hernias that are not causing any symptoms do not need any surgical intervention. In the first instance the use of an abdominal support can prevent further swelling. A consultation with your surgeon will clarify the benefits to your individual needs as to whether surgery would be required.
A full range of support products are available on prescription through Moorland.