Following your stoma surgery, the abdominal wall will have become weakened and is, therefore, far more vulnerable than it was before. The muscles in the abdominal wall should create a snug fit around the stoma opening, so if the muscles in this area becomes weak, a hernia can form.
A stoma (parastomal) hernia is a weakness or protrusion in the muscle wall of the abdomen which allows the abdominal contents to bulge out. The bulge often protrudes more when coughing or undertaking physical activity. A stoma hernia is one of the most common complications following stoma creation.
Bowel blockage or obstruction
Speak to your stoma nurse if you have cramps, feel nauseous or notice swelling around your stoma. They may recommend avoiding solid foods, massaging your tummy or having a hot bath. In more serious cases, your bowel could burst (rupture), and you may need further surgery.
The term parastomal hernia is used to describe a bulge or swelling on or around your stoma. Try not to lift anything heavy within first 6-8 weeks following surgery. If you intend to do any strenuous work when you have fully recovered from your surgery, you should wear a support belt to protect the abdominal muscles.
Parastomal hernia is the most common complication in various types of stomas. It can progress almost asymptomatically, often resulting only in an abdominal deformity in the vicinity of the stoma, but in extreme cases it can lead to bowel incarceration and strangulation, thus necessitating immediate surgery.
A stoma hernia resembles a bulge or a lump. Many people describe it a looking like a “golf ball” or a “grapefruit” behind their stoma. Having a hernia can cause your stoma to look more pronounced and potentially change shape, it may also appear larger or flatter than it did before the hernia.
A parastomal bulge is a complication that can occur months or years after stoma formation in more than half of the patients. The bulge is a swelling next to the stoma whereby abdominal contents protrude underneath the skin.
The first sign of a stoma infection may be a pus-like discharge, unusual swelling, increasing redness, or color changes. Some may notice an abscess or an ulcer. A Wound, Ostomy, and Continence Nurse (WOCN) or your doctor will be the best source for medical advice on this issue.
Depending on the severity of the prolapse, a referral can be made to the Surgeon for review, but is often not deemed as urgent, unless the prolapsed stoma changes to a very dark/dusky colour, stops functioning or causes pain. Pain may suggest bowel strangulation which is treated as an emergency.
Contact your provider if: The abdominal swelling is getting worse and does not go away. The swelling occurs with other unexplained symptoms. Your abdomen is tender to the touch.
As long as your symptoms eventually go away, they probably aren't serious. But if your bloated stomach doesn't go away or gets worse, or if you have other symptoms of serious illness, such as fever or vomiting, you should seek medical attention to rule out other medical causes.
When the skin becomes infected it can start to look inflamed and the infection tends to cause some swelling around your stoma. The skin colour often changes from a healthy pink/reddish colour, to pale, bluish purple or even black. If there is any discharge of blood or pus this is often a definitive sign of infection.
Skin irritation around your stoma is usually caused by leakage from your ostomy pouch and the output from your stoma getting underneath the adhesive and onto your skin. It is uncomfortable and can stop your pouch from working well. The skin around your stoma should look similar to the skin on the rest of your body.
Get medical help right away if: Your stoma has turned purple, brown, black, or dark red. Your stoma won't stop bleeding. You haven't pooped into the pouch for several hours and you have nausea, belly pain, or you're vomiting.
Some common complications of stoma include poor siting, parastomal hernia (PH), prolapse, retraction, ischemia/necrosis, peristomal dermatologic problems, mucocutaneous separation, and pyoderma gangrenosum. Each will be discussed separately in further detail.
You will know when you have a blockage as your bag will be empty when usually it is filling up. Another symptom of a blocked stoma, in addition to your output slowing down, is stomach-ache. You may start to feel waves of cramping and abdominal pain, which may worsen if the symptoms you experience are unresolved.
Severe, continuous pain, redness, and tenderness are signs that the incisional hernia may be entrapped or strangulated. These symptoms are cause for concern and immediate contact of your physician or surgeon.
We're talking about parastomal (peristomal) hernias. That's when more intestine than planned pushes through your muscles and causes a bulge at your ostomy site. You can tell if you might have a parastomal hernia by a noticeable bulge or by placing your hand over your stoma and seeing if it protrudes out when you cough.
Background. Long standing ostomy related complications such as parastomal hernia and stoma prolapse may be at a higher risk of developing spontaneous rupture and evisceration, especially in patients suffering from chronic cough. Such patients may need early refashioning of the stoma to prevent this serious complication ...
There are two options. One can move the stoma to a new site on the abdomen, i.e. create a new opening elsewhere and repair the hernia at the old site as one would any other hernia, or one can try to repair the hernia around the stoma, leaving the stoma where it is.
Although a parastomal hernia may restrict you from doing certain things, you can still live a 'normal life'. Things like gentle exercise, eating and drinking well, a good stoma product system and a hernia support belt or garment can help you manage your hernia and live a normal life.
It is important that you partake in some form of regular exercise, this could be simply a gentle daily walk. Gentle exercise is important to try and prevent the development of a parastomal hernia. It is necessary to try and strengthen your core muscles, your Stoma Care Nurse is able to advise you on specific exercises.