A 50-year-old woman, Amelia from Birmingham, had recently returned to her normal daily routine following stoma surgery. Months later, she discovered a bulge forming beside her stoma.
Like many individuals, uncertainty was felt about whether the change should be ignored or taken seriously. Although pain was not felt, a sense that something was not quite right remained.
Across the UK, this situation is commonly experienced, and such a bulge is often recognised as the first sign of a stoma hernia, also referred to as a parastomal hernia.
What Is a Stoma Hernia?
The word stoma comes from the Greek, meaning “an opening.” A stoma is created surgically to assist the body’s functions of the digestive and urinary systems.
A hernia is a condition in which internal organs of the body protrude through a weakened area in the surrounding muscle wall or tissue. As a result, a soft bulge may be formed.
Hernias develop in several parts of the body, including:
- The abdominal region,
- The groin and lower abdomen
- The midline of the abdomen
- Previous abdominal surgery incision sites
- The lower chest through the diaphragm (in less common cases)
Research by the NHS shows that hernias most commonly develop after surgery, especially in cases involving the abdomen.
What Causes a Stoma Hernia?
A weakness in the abdominal wall around the stoma opening, resulting in a bulge, is known as a stoma hernia or parastomal hernia.
Several contributing factors are commonly identified:
- Natural healing following stoma surgery
- Weakness in abdominal muscles
- Persistent cough and sneezing
- Physical strain (Lifting heavy objects)
- Excessive body weight
- Weakening muscle health as you get older
- Long-term constipation
- Smoking
- Infection around the stoma
- Use of steroids
Even after a perfect surgery, there are still chances of a stoma hernia. Over time, changes in muscle strength and internal pressure can result in the development of a hernia.
Stoma Hernia Symptoms
A stoma hernia develops gradually; its symptoms may not be noticeable and can vary from person to person. Early signs are subtle and are only recognised over time.
The following symptoms are commonly found:
- A soft bulge or swelling around the stoma
- A visible bulge while you stand, cough or strain yourself
- Feeling uncomfortable in your abdomen or experiencing heaviness
- Difficulties with the application of a stoma bag
- Notice changes in your stoma functions
Research has indicated that 75% of people with a stoma hernia experience complications such as pain, leakage, and skin irritation in the abdomen.
People are often more concerned about unpredictability, leakage, and managing the condition in social and daily life, rather than pain itself.
Is a Stoma Hernia Dangerous?
Around 30-50% ostomates (people who have had a stoma surgery) have a stoma hernia within the first two years or later. Stoma hernia grows gradually and differently, and is mostly manageable. If you neglect your condition, complications may arise.
The following warning signs should be carefully monitored:
- Bulge size growth over time
- Increased pain and persistent discomfort
- The stoma stops functioning
- A sudden swelling in the affected area
- Signs of blockage in the stoma
- Vomiting
People with a stoma hernia experience increased anxiety and difficulty with daily activities and independence. Ignoring these risk factors may worsen the situation, and in the worst case, you will need to be admitted to A&E.
Stoma care places a significant demand on NHS resources. Recent UK data suggests that spending on stoma and continence products alone is estimated at around £350 million each year, with additional costs arising from complications and ongoing care needs.
Treatment Options for Stoma Hernia
The treatment approach for stoma hernia differs from person to person, considering how severe the condition is and its effects on daily lifestyle. Most stoma hernias do not require immediate surgery.
Surgical treatment is often not suggested to older people due to the increased risks associated with anaesthesia. Even after surgery, a stoma hernia may recur. Instead, symptom management is recommended.
Non-surgical Management for stoma hernia:
- Support belt designed for a stoma
- Specialised support garments, including boxers, pants, and girdles
- Exercise aimed at strengthening abdominal muscles, such as pilates
- Avoid heavy lifting or strains on the body
- Use of appropriately fitted stoma appliances
- A qualified stoma care nurse can give the most suitable support
If you cannot manage a stoma hernia with non-surgical treatments and the first-line measure fails, or your condition becomes severe, you should consult with your GP.
To repair the stoma hernia, the surgeon will suggest either.
- Incision Surgery: Repair the hernia via an open surgery in the abdomen
- Laparoscopic Surgery: Reposition the stoma through a keyhole in the abdomen
The choice of surgery is proposed by the surgeon after considering the patient’s overall health, age, and severity of the hernia. Surgery does not guarantee permanent resolution, as recurrence of the hernia may still occur.
Stoma Care in Wolverhampton
For people like Amelia, the first moment of noticing a change can feel uncertain, and experiencing symptoms mentioned above, reassurance and support can be provided through specialised stoma care services.
In Wolverhampton, Secure Healthcare Solutions is a healthcare company offering care and support, including dedicated stoma care services, to patients at every stage of their journey.
These services typically include:
- Consultations guided by GPs
- Support from trained stoma care nurses
- Personalised care plans tailored to individual needs
Through professional guidance, individuals are supported in managing their condition effectively and are encouraged to regain control over their daily lives.
