Hernia information

What is a peristomal hernia?

A peristomal hernia is when bowel (usually small intestine) comes through the muscle that makes the abdominal wall. A peristomal hernia looks like a bulge under or around a stoma.

To make your stoma, the surgeon made a hole in the muscles of the abdomen. The bowel that makes the stoma comes through this hole. This is done because it helps to stabilize the stoma.

Making an opening in the muscle will make the muscle weaker. There is a 20-50% chance of developing a peristomal hernia after ostomy surgery.

  • Being overweight
  • Age
  • Nutritional deficits before surgery
  • Steroid therapy

  • A swelling or a bulge of the abdomen around your stoma. It may appear as though your stoma is “sitting on an orange”
  • A dull ache or heavy or “dragging” feeling around your abdomen, particularly when standing
  • The bulge (hernia) may reduce in size when you are lying down and get larger when standing up
  • The size of your stoma may increase over time if the hernia enlarges
In a rare number of cases, the bowel that protrudes though the abdominal muscle wall may become twisted, trapped or kinked. This can affect the blood supply to the bowel or create an intestinal obstruction causing intense pain. If this occurs, immediate medical attention is needed.

A peristomal hernia is more visually distressing than it is a “medical problem”. In fact, peristomal hernias are rarely surgically repaired due to the high rate of recurrence even after hernia surgery.

The incidence of developing a peristomal hernia is highest in the first year after surgery, however it can happen at any time. Many individuals have reported the sudden onset of a “bulge” after a sneeze or similar one-time event.  Unfortunately, once a peristomal hernia is present, it will often enlarge over time. The size of the “bulge” will vary from person to person.

  • Avoid activities that strain or increase “intra-abdominal pressures” such lifting greater than 10lbs, coughing, sneezing, vomiting and bearing down (as with constipation or straining to pass urine)
  • As coughing and sneezing are often unavoidable, try bracing or splinting your abdomen with a pillow or your hands to “hold things in”
  • Maintain a healthy weight
  • Strengthen your abdominal core muscles. It is best to consult a Physiotherapist for an individualized plan of core bracing and stabilization exercises

What does a hernia look like?

hernia

hernia2

Options for peristomal hernia support

It is important for an Enterostomal Therapy (ET) nurse to assess your stoma, abdomen and hernia. A belt that doesn’t fit correctly can cause complications with the hernia and the stoma. Not every peristomal hernia needs a support garment or belt. We take the time to discuss all of your options and select the best supportive option for you.

For some people, good supportive underwear is enough. For women, a type of “shapewear”, such as control-top panties, is a good option and available at many stores like Walmart, Hudson’s Bay, Sears, etc.
For men, Salts and  Comfizz have underwear with a higher rise.
Nu-Hope Belts
We have worked with these belts for over 30 years. We have learned to adjust them to give you the right fit and support.

Carefix
These products can be adjusted to provide the correct fit and support for your comfort.

Valco

These belts do not require customization.