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.
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
- 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
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.
- 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?
Options for peristomal hernia support
It is important for a Nurses Specialized in Wound, Ostomy & Continence (NSWOC) 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.