What is a hernia and how can it be prevented?

What is a hernia?

Hernia formation after stoma surgery is a very common complication but not everyone with a stoma will develop a hernia. The degree of severity and impact on your stoma care, general health and lifestyle varies from person to person.

A hernia forms as a result of a weakness in the abdominal wall that allows the abnormal protrusion of an organ or part of an organ (usually the bowel). A parastomal hernia forms around a stoma and appears as a bulge on the abdomen. This may cause skin surface irregularities and tension around the stoma, depending on its size and shape.

Hernias may be small in size or they can be quite big, some will even be visible through clothing. The size and shape of your stoma can change depending on your position, for example, becoming less obvious when lying down.

How can I prevent a hernia?

Parastomal hernia is a common complication which affects many people with a stoma and can occur weeks, months or years after stoma surgery. The risk of developing a parastomal hernia increases with age. Other factors include; surgical technique, muscle weakness, having multiple abdominal operations, being overweight, coughing and straining.

You can:

• Perform gentle exercises. These include gentle abdominal stretches or pelvic lifts and walking. Sit ups, crunches or any other exercise directed at the abdominal muscles must be done carefully and in a controlled way. Before beginning any exercise program, always consult with your healthcare professional.
• Avoid heavy lifting and straining – if necessary, use a wheeled trolley to help move heavier items or get someone to help you move them.
• Manage your weight - stay within an appropriate weight range.
• Wear specially designed garments to help support the abdominal muscles and reduce the risk of getting a hernia if doing higher risk activities.
• Do not lift for the first 12 weeks after your surgery.
• Support your stoma and abdomen with your hands whilst coughing, laughing or sneezing.
• Get out of bed by bending your knees and rolling onto your side. Swing your legs over the side and use your hands to push yourself upward into a sitting position.
• If you suspect you have a hernia please contact your Stomal Therapy Nurse.