A stoma hernia, or parastomal hernia, may develop following an ileostomy. This happens when part of the intestine protrudes through a weakness in the abdominal wall around the stoma. Surgery can help repair the hernia.
An ileostomy involves making an opening in the wall of the abdomen. The end of the ileum, which is the end of the small intestine, is brought through this opening in the abdomen to create the stoma.
A hernia is a common complication of a stoma. Certain factors, such as doing physical activities, may increase this risk. If a stoma hernia occurs, a doctor may recommend surgery to treat it and help the person find ways to prevent another stoma hernia.
Read on to find out more about stoma hernias. This article discusses causes and symptoms, treatment options, diagnosis, and more.
A stoma hernia can occur after a person undergoes an ileostomy procedure. During an ileostomy, the surgeon will create an opening in the wall of the abdomen and bring the end of the small intestine to it.
This procedure may be necessary if a person’s ileum is not working properly. It allows the digestive contents to leave the body through the stoma and into a pouch the person wears on their body.
The stoma can weaken the part of the abdominal wall it passes through. This makes it easier for part of the stomach, typically part of the bowel, to bulge out.
Stoma hernias are a common occurrence in people with a stoma. Certain factors may increase the risk of a stoma hernia. These
- chronic coughing or severe sneezing
- Crohn’s disease
- smoking tobacco
- infection after surgery
- performing strenuous tasks or physical work
- poor muscle tone as a result of aging
- poor nutrition around the time of the ileostomy
- stoma placed outside of the rectus abdominis, which is a muscle in the abdomen
A person should contact their doctor if they have concerns about any of the risk factors for a stoma hernia.
Symptoms of a stoma hernia can include:
- bulge around the area of a stoma
- discomfort or pain around the stoma
- feeling full or a sense of tightness in the abdomen
- leaking from stoma appliances
- skin irritation around the area of the stoma
Some people may find that the “bulge” the hernia causes is only noticeable when they are in certain positions, such as standing or sitting down. The bulge may not be noticeable when the person lies down. In some cases, the hernia is always noticeable, regardless of the person’s positioning.
A stoma hernia may develop soon after surgery. For some people, it can take several years to develop.
The first treatment a doctor may recommend for a stoma hernia is to wear a stoma support garment. This can include:
Surgery may be necessary in cases where the stoma is painful, if complications develop, or if the stoma is unable to function properly. This can be done either laparoscopically, which is minimally invasive, or through open surgery.
If a doctor recommends surgery for a person with a stoma hernia, they will be able to discuss the type of surgery they recommend and what it will involve.
A stoma hernia is a fairly common occurrence in people with a stoma.
According to the Canadian Society of Intestinal Research, around 3–10% of people who have had an ileostomy will develop a stoma hernia.
Around 80% of people with a stoma hernia will not require intervention. Around 20% of people will experience symptoms that require either management or surgery.
A stoma hernia may cause complications. These can include:
- unpredictable stoma functions, such as alternating between diarrhea and constipation
- changes in the size of the stoma
- increased fragility of the skin surrounding the stoma
- hernia strangulation
Obstruction and hernia strangulation are medical emergencies. A person with symptoms of a stoma hernia should contact their doctor for advice to reduce the risk of serious complications.
After an ileostomy, a person’s doctor will be able to advise on ways to reduce the risk of a stoma hernia.
Steps they may recommend include:
- avoiding any heavy lifting of strenuous exercise for a number of months
- reintroducing exercise slowly and gradually
- wearing a support garment such as a hernia belt
A stoma hernia, or parastomal hernia, can occur in people who have a stoma. They can develop soon after the ileostomy, or they may take a number of years to develop.
As part of the stomach pushes against the weakened abdominal wall, this can appear as a bulge. For some people, the bulge may be visible at all times. Other people may find that changing positions can cause the bulge to disappear.
Treatment is not always necessary for a stoma hernia. If a person experiences a stoma hernia, they should contact their doctor for advice. A doctor may recommend support garments such as belts. If the hernia causes pain or complications, surgery may be necessary to repair the hernia.