From Stillwater-Ponca City (OK) Ostomy Outlook February 1998:

Hernia and the Ostomate

by Jill Conwell, RNET, Corpus Christi; via Winnipeg (MB) Online Inside-Out

If you've noticed an unusual bulge around or under your stoma, you may have a hernia. A hernia, essentially, is a separation in the muscle through which the bowel was brought when the stoma was created. This separation allows a loop of bowel to slip into the area next to the stoma and puts pressure on the abdominal wall, causing a bulge that can be relatively small, or about the size of a grapefruit or larger.

Why do hernias occur? Usually they form after a person has done heavy lifting or straining, thus putting pressure on the abdominal muscles. Other causes could be coughing excessively without supporting the abdomen, or a weakened abdominal muscle due to previous surgeries. The hernia is not usually repaired unless there are problems resulting from the hernia. The surgeon can either repair the hernia and leave the stoma in the same location, or if the hernia is excessively large, the surgeon may decide to relocate it. In either case, it would be wise to use a support belt to prevent a hernia from reforming.

Another problem with a hernia, especially with colostomates who irrigate, is that the irrigation does not work as well as it used to. It may take longer to run the water in, or maybe it does not enter at all. If you use a catheter, be very careful not to push it too hard if it does not slide in easily. It is probably up against the bowel wall and cannot turn sharply to accommodate the new route of the bowel, and you could perforate the bowel wall. A cone is better to use; however, the sharp curve of the bowel may not allow the water to flow in easily. Sometimes pressing the area around the stoma may open up the kinked area to allow the water to flow. I would recommend holding off on the irrigation procedure and trying to control the colostomy by diet.

There are support belts that are available for ostomates to wear. They are made to accommodate the pouch through a front opening, and they usually have a Velcro closing. They are available in several widths. It is important for all ostomates to be careful in lifting or straining post-operatively, as well as years later. There is always the potential for a hernia to occur due to the opening made in the abdominal muscle for the creation of the stoma. This does not mean that every ostomate should wear a support belt. Just remember that if you lift anything heavier than 5 kg (10 pounds), be sure to use the proper techniques. Use your upper thigh muscles instead of your abdominal muscle. Common sense goes a long way.

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Content last revised 1998-02-16