Parastomal hernia

Parastomal hernias affect people who have had a stoma made on their abdomen during surgery. Common symptoms include:

• a bulge or lump in the area around the stoma
• a dull ache around the hernia, which often worsens when you are active
• constipation and diarrhoea as a result of the stoma not functioning properly
• the stoma becoming smaller (retracting) as the bulge develops

If you are using a colostomy pouch, the hernia may make it more difficult to change and even cause it to leak.

In rare circumstances, parts of the intestine may become trapped in the hernia, causing obstruction or strangulation which will require emergency surgery.

Your GP or consultant will examine the lump and affected area, which is often enough to identify a hernia. In some cases it may be necessary to carry out an ultrasound scan. This is a painless and non-invasive procedure, but it will help to confirm the diagnosis and assess how severe it is.

Parastomal hernias are usually more uncomfortable than painful, and therefore generally do not require surgery. Your consultant may consider surgery if the hernia is causing severe pain, but they will discuss the risks involved and determine the best approach for you.

Patients are often advised to wear a stoma support garment, such as a belt, girdle, pants or boxer shorts.

Many people also find that it helps to do pilates, or other exercises which help to strengthen the core muscles.

If surgery is required, treatment options include:

• open or laparoscopic (keyhole) surgery
• repairing the tissue around the hernia - this is relatively straightforward, but carries a higher risk of the hernia recurring
• re-siting the stoma to another location – this is a bigger operation, but carries a lower risk of the hernia recurring
• a special mesh may be used to strengthen the area and prevent the hernia returning