what is a parastomal hernia

3 min read 05-02-2025

Meta Description: A parastomal hernia is a bulge near your stoma. Learn about causes, symptoms, diagnosis, treatment options (including surgery), and how to manage this common complication of ostomy surgery. This comprehensive guide provides valuable information for ostomy patients and their caregivers.

Understanding Parastomal Hernias

A parastomal hernia is a protrusion or bulge of abdominal tissue through the weakened abdominal wall near your stoma. A stoma is an opening created surgically in your abdomen to allow waste to pass out of your body. This can occur after ostomy surgery, such as a colostomy, ileostomy, or urostomy. It's a relatively common complication, affecting a significant percentage of ostomy patients.

What Causes a Parastomal Hernia?

Several factors can contribute to the development of a parastomal hernia:

Weakened abdominal wall: The surgical procedure itself weakens the abdominal wall muscles. This makes the area around the stoma more susceptible to herniation.
Strain and pressure: Activities like coughing, sneezing, lifting heavy objects, and constipation can increase pressure on the abdominal wall. This pressure can push abdominal contents through the weakened area.
Obesity: Excess weight puts additional strain on the abdominal muscles, increasing the risk of a parastomal hernia.
Inadequate surgical technique: In some cases, the surgical technique used to create the stoma might inadvertently weaken the abdominal wall, increasing the risk.
Infection: Post-operative infections can further weaken the abdominal wall tissues.

Recognizing the Symptoms

Recognizing the symptoms of a parastomal hernia is crucial for timely treatment. Common symptoms include:

A visible bulge: A noticeable lump or protrusion near the stoma is the most obvious sign.
Pain or discomfort: Some patients experience pain or discomfort around the stoma, especially when coughing, sneezing, or lifting heavy objects.
Feeling of pressure: A feeling of fullness or pressure in the abdomen near the stoma.
Stoma dysfunction: In some cases, the hernia might compress the stoma, impacting its function. This can lead to changes in bowel or urine output.

Important Note: Not all bulges near a stoma are hernias. It's vital to consult your healthcare provider for a proper diagnosis.

Diagnosing a Parastomal Hernia

Diagnosis usually involves a physical examination by a surgeon or gastroenterologist. Your doctor will examine the area around your stoma and may order additional imaging tests to confirm the diagnosis and assess the size and severity of the hernia. These tests might include:

Ultrasound: A non-invasive imaging technique used to visualize the abdominal wall and identify the hernia.
CT scan: A more detailed imaging technique that can provide a clearer picture of the hernia and its extent.

Treatment Options for Parastomal Hernias

Treatment options for parastomal hernias vary depending on the size, symptoms, and overall health of the patient. Some patients may not require treatment if the hernia is small and asymptomatic. However, larger or symptomatic hernias may require intervention.

Conservative Management

For small, asymptomatic hernias, conservative management strategies might be recommended:

Stoma support devices: These devices help to support the abdominal wall and reduce strain on the stoma.
Lifestyle modifications: Avoiding activities that increase abdominal pressure, such as heavy lifting and straining during bowel movements.
Weight management: If you're overweight or obese, weight loss can significantly reduce the strain on the abdominal wall.

Surgical Repair

Surgical repair is often the preferred treatment for larger or symptomatic parastomal hernias. There are various surgical techniques available, including:

Open surgery: A traditional surgical approach involving an incision in the abdomen.
Laparoscopic surgery (Minimally Invasive): A less invasive approach involving small incisions and specialized instruments.
Mesh repair: A surgical mesh is often used to reinforce the weakened abdominal wall during the repair.

Choosing the Right Surgical Approach: The best surgical approach depends on several factors, including the size and location of the hernia, the patient's overall health, and the surgeon's expertise. Your surgeon will discuss the options with you and help you make the most informed decision.

Post-Operative Care

After surgery, you’ll need to follow your surgeon's post-operative care instructions carefully. This usually involves:

Pain management: Pain medication will be prescribed to manage post-operative pain.
Wound care: Keeping the incision clean and dry is crucial to prevent infection.
Dietary modifications: Your doctor may recommend a specific diet to promote healing.
Activity restrictions: Avoid strenuous activities until your surgeon clears you.

Living with a Parastomal Hernia

While a parastomal hernia can be a challenging condition, it’s important to remember that effective treatment options are available. By following your healthcare provider's recommendations and taking steps to manage your condition, you can maintain a good quality of life. This includes:

Regular follow-up appointments: Attending regular check-ups with your healthcare provider is crucial for monitoring your condition and ensuring that any complications are addressed promptly.
Maintaining a healthy lifestyle: Maintaining a healthy weight, eating a balanced diet, and engaging in regular physical activity can help to reduce the strain on your abdominal muscles.
Seeking support: Connecting with other ostomy patients through support groups or online forums can provide emotional and practical support.

This information is intended for educational purposes only and does not constitute medical advice. It's essential to consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.