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An ostomy hernia is a bulge in the area of a stoma, or surgically created opening in the body, caused by the protrusion of the intestine or other parts of the abdomen. It forms as the muscles around the opening weaken, and physical activity causes internal organs to press on the area. Called a parastomal hernia, it is one of the most often seen complications of ostomies by doctors. This occurs more commonly after procedures on the colon than other types of ostomy. The problem can progress gradually over time following the initial surgical procedure, and may or may not require major surgery to fix.
Living with an ostomy comes with certain risks. One is that the muscles around it can weaken over time and cause a hernia. Motion around the defect created by the surgery, infections that damage tissue, and significant gains can cause tissue to herniate. Other causes of an ostomy hernia include heavy lifting, sneezing, and coughing, which add pressure to the area around the stoma. Individual health and behavior can attribute to the problem, or complications from the surgery can trigger it as well, especially if the opening is not well formed or an infection develops afterward.
The site of the stoma creates a muscle weakness, so preventing an ostomy hernia can be challenging. If a small one develops, then a hernia belt can be worn if someone has to do a lot of lifting. Surgery is usually not required initially, but if the hernia grows and becomes painful, an operation may be necessary if the intestine is at risk of becoming strangulated. Surgeons sometimes repair the area around the ostomy, but occasionally the stoma has to be moved to another site and closed at the old one where the hernia formed. A light steel mesh is sometimes implanted into the muscle to prevent any breaks in the tissue from ever forming again.
Treating an ostomy hernia can be major surgery and, depending on the patient’s health, even administering anesthesia and stitching the muscle can be dangerous. A hernia can seriously complicate the management of a stoma and progress to the point that it can be life threatening. When associated with an ostomy, it is usually not painful, and often does not require aggressive treatment when it first occurs. A surgeon assesses the risk of the ostomy hernia before any action is taken, and often monitors the condition over time to determine when surgery is the best option.