Over the past couple of months I developed some swelling behind my stoma, I thought it was due to the heat, the humidity and the amount of activity I was doing whilst we were in Australia. But since we got back, the swelling didn’t really go down. It is worse in the evening and goes up and down, its causing me some discomfort but not really painful.
I spoke to my stoma nurse who thought it was a hernia, but as I was due to see my surgeon she suggested that I refrained from any lifting and saw what Mr Brown said. He confirmed that he thought it was a hernia and that he could repair it surgically but as I am probably planning the pouch surgery it would be worth just trying to deal with it and wait till the takedown surgery when my stoma will be removed anyway.
A hernia is when there is a weakness in muscle tissue that causes the intestine to bulge through. Because a stoma goes through the abdomen it becomes a compromise in the muscles and hernias can be common in people with a stoma. A hernia behind the stoma is called a parastomal hernia. The term parastomal hernia is used to describe a bulge or swelling around or under the stoma that leads to problems with stoma function and appliance security. This usually occurs gradually and the hernia may increase in size over time.
Its probably a good idea for you not to google this term though… Some of the photographs are fairly graphic!
There are many factors that contribute to the development of a parastomal hernia including:
- Coughing and sneezing.
- Straining: this can happen when lifting heavy objects or duringstrenuous activities such as gardening.
- Infection at the site of the stoma or abdominal wound.
- Muscles becoming weaker with age.
- Being overweight.
- Poor siting of the stoma.
- Emergency surgery.
The treatment differs depending on the extent of the hernia, mine appears to be relatively minor and so Im happy to wear a hernia support made for people with stomas.
Exercise or Pilates, aimed at strengthening the core muscles, may help too.
For others the treatment will be surgery;
A tissue repair at the site of the hernia is a relatively simple procedure, but there is a high risk of the hernia recurring.
Repair and re-siting of the stoma to another location on the abdomen is a bigger operation involving a larger incision, but the chance of the hernia recurring is lower.
Repair and reinforcement of the hernia site with mesh carries a very small risk of infection but the chance of the hernia recurring is lower.
This information comes from the Colostomy Association.
As always with this blog, I am not a medical professional and all my thoughts here are entirely my own and in no way replace medical advice. If you are worried you might have a parastomal hernia, then get in touch with your stoma nurse, doctor or clinic.
Love Sam xx