A Parastomal Hernia (Stoma Hernia) is a weakness or protrusion in the muscle wall of the abdomen at the site of a Stoma which allows the abdominal contents to bulge out. The bulge often protrudes more when coughing or undertaking physical activity.
Following your stoma surgery, the abdominal wall will have become weakened and is, therefore, far more vulnerable than it was before. The muscles in the abdominal wall should create a snug fit around the stoma opening, so if the muscles in this area becomes weak, a hernia can form.
A parastomal bulge is a complication that can occur months or years after stoma formation in more than half of the patients. The bulge is a swelling next to the stoma whereby abdominal contents protrude underneath the skin.
We're talking about parastomal (peristomal) hernias. That's when more intestine than planned pushes through your muscles and causes a bulge at your ostomy site. You can tell if you might have a parastomal hernia by a noticeable bulge or by placing your hand over your stoma and seeing if it protrudes out when you cough.
In the case of elective procedures in high-risk patients one should consider local parastomal hernia repair with prosthetic mesh, while laparotomy might be advised if parastomal hernia is associated with a concomitant incisional hernia.
Most parastomal hernias require a surgical procedure at some point in time. The open approach is done from the outside usually through the prior incision. The incision will extend through the skin, subcutaneous fat, and allow the surgeon to get to the level of the defect.
There are two options. One can move the stoma to a new site on the abdomen, i.e. create a new opening elsewhere and repair the hernia at the old site as one would any other hernia, or one can try to repair the hernia around the stoma, leaving the stoma where it is.
Although a parastomal hernia may restrict you from doing certain things, you can still live a 'normal life'. Things like gentle exercise, eating and drinking well, a good stoma product system and a hernia support belt or garment can help you manage your hernia and live a normal life.
Background. Long standing ostomy related complications such as parastomal hernia and stoma prolapse may be at a higher risk of developing spontaneous rupture and evisceration, especially in patients suffering from chronic cough. Such patients may need early refashioning of the stoma to prevent this serious complication ...
While parastomal hernias are a common complication of many ostomy surgeries, they can develop into something more serious. To avoid any long-term problems, always contact your doctor if you notice any signs of pain, discomfort, skin irritation, changes to your stoma, or problems with your pouching system.
It is important that you partake in some form of regular exercise, this could be simply a gentle daily walk. Gentle exercise is important to try and prevent the development of a parastomal hernia. It is necessary to try and strengthen your core muscles, your Stoma Care Nurse is able to advise you on specific exercises.
Parastomal hernias may develop soon after surgery, or may take years to develop. Most people (about 80%) will not experience any difficulties with the hernia and will not require any intervention. The remaining 20%, however, may have symptoms that require some help to manage.
Symptomatic or progressive stoma prolapse requires surgical repair, through laparotomy or laparoscopy approach. Strangulation of the intestine may lead to edema and necrosis and require emergency surgery.
A prolapsed stoma is when the intestine extends to an abnormal length through the ostomy site. This may look like the stoma is longer or more swollen than what you are used to. Two images of prolapsed stomas in the belly.
Avoid heavy lifting, heavy pushing, overstretching/reaching or fully using your abdominal muscles. Support your stoma and abdomen when you cough and sneeze. And then: Avoid gaining weight, or try to lose weight if you need to.
The term parastomal hernia is used to describe a bulge or swelling around/under the stoma that leads to problems with stoma function and appliance security. This usually occurs gradually and the hernia may increase in size over time.
In the first few weeks after surgery, avoid heavy lifting and any activity which causes straining or pressure around your stoma. Then, over a period of weeks and months, you can gradually build back up to your normal activities, while also doing your core and abdominal recovery exercises.
Parastomal hernia is the most frequent complication following the construction of a colostomy or an ileostomy, occurring in up to 50 percent of patients.
Results: Of 14 patients, 12 patients had end-sigmoid stoma, one had end ileostomy following surgery for ulcerative colitis and one had urinary conduit. The size of the defect varied from 4.5 cm to 6 cm in diameter, and the average duration of surgery was 125 min.
Gentle exercises such as chair yoga, walking and swimming are all suitable. Sit-ups, crunches, or any other abdominal muscle exercises must be controlled and done very carefully. In the course of exercising it might be advisable to support your stoma with a stoma belt/speciality underwear or stoma guard.
Although rare, a parastomal hernia may cause the intestine to become trapped or kinked inside the hernia causing intestinal obstruction and loss of blood supply. This is known as a strangulated hernia, a dangerous and life-threatening complication.
Unfortunately, the answer is no. While a hernia cannot heal itself, it can almost always be treated effectively with surgery.
While it may not be causing trouble now, it is very likely that it could lead to more serious complications later if it is not repaired. One of those complications is strangulation. This occurs when the bulging tissue is squeezed by the muscle wall. As a result, the blood supply is cut off and the tissue begins to die.
Skin irritation around your stoma is usually caused by leakage from your ostomy pouch and the output from your stoma getting underneath the adhesive and onto your skin. It is uncomfortable and can stop your pouch from working well. The skin around your stoma should look similar to the skin on the rest of your body.