About the author
My name is Tammy Temple. I’ve been nursing for over 15 years, and a specialist stoma nurse for the past five. I work in Nottinghamshire, and my patients include those with urological stomas. I support them from six months post-surgery onwards, and it’s a role I am extremely passionate about.
The best part is helping patients live their best life and finding out what this means for them. It’s not only about their clinical concerns, such as leakage, soreness and hernia prevention, but also supporting them in getting back to normal, from returning to exercise to socialising and travel. Giving patients confidence helps them have the best quality of life.
Tammy’s advice
You’re probably familiar with the term ‘hernia’, which is when an internal part of the body pushes through a weakness in the muscle or surrounding wall, causing swelling or a bulge.
Urostomates – and people with other types of ostomy – are prone to what is known as a ‘parastomal’ hernia because it appears under, or around, their stoma.
These hernias rarely cause major complications but can sometimes interfere with stoma function and the security of your appliance. So, it’s important to know how to minimise your risk, and when to seek advice from your stoma nurse.
What causes a parastomal hernia?
It’s usually a combination of muscle weakness and strain around the area of your stoma. Following your urostomy surgery, your abdominal wall will have become weakened and is, therefore, more vulnerable than it was before.
A hernia can occur weeks, months, or years after stoma surgery, and the risk of developing one increases with age. Other factors include surgical technique, muscle weakness, and multiple abdominal operations. Being overweight, straining, and even coughing can also increase your likelihood of developing a parastomal hernia.
What to look out for
Parastomal hernias tend to develop slowly, and don’t always cause symptoms or stoma management problems. However, signs include:
- a bulge behind your stoma or swelling around it
- discomfort or pain around your stoma
- issues with keeping your stoma bag in place
- bloating
- pain when lifting things
If you are experiencing symptoms, speak to your stoma nurse.
While parastomal hernias don’t usually require an operation, they don’t go away by themselves and can get worse over time. In rare cases, a hernia can cause twisting in the bowel, which usually requires surgery.
Avoiding hernias
After your surgery, it’s important to avoid lifting anything heavier than 2.2 kg (5 lbs) for up to six weeks. Use a trolley to help move heavier items or get someone to help you.
Your nurse will advise you on the most appropriate exercises for you to do, both before and after your surgery. See below for more about exercise.
Eat a healthy, balanced diet and manage your weight so that you stay within an appropriate range.
If your stoma nurse feels you require some additional abdominal support, they will discuss this with you and provide the appropriate garment to meet your needs.
About exercise
Getting regular exercise can be incredibly beneficial, but get advice from your nurse before embarking on a new regime. No matter what exercise you’re doing, start slowly and gradually build up your stamina.
- Walking and running are fantastic for building fitness. Take things at your own pace and start slowly over shorter distances.
- It’s highly likely you will need to start rebuilding strength in your core and abdominal wall after stoma surgery. Sit-ups may be impractical for ostomates, so try pelvic tilts, hip lifts and knee rolls, which can bring the same results more safely.
- Yoga, tai chi and pilates are perfect for building core strength without any heavy lifting.
- Swimming puts little strain on your stoma and has both strength and cardio benefits.
Getting treatment
Many people who develop a parastomal hernia don’t have any complications. Others find that while their hernia may restrict them from doing certain things, they can still enjoy life.
Gentle exercise, a nutritious diet, a good stoma product system, and a hernia support belt or garment can help you manage your hernia.
As well as providing advice, your stoma nurse can arrange for a support garment to be tailor-made to fit you and provide the support your hernia needs. If your hernia means your usual type of urostomy bag no longer works for you, your nurse will help you find a more suitable one.
It is possible to have repair surgery, depending on your symptoms and their effect on your quality of life, but this will need to be assessed by your surgeon.
I hope this article has been helpful and reassuring. Always make sure you communicate with your stoma nurse as they are there to offer their professional advice.
- This blog appears in the Winter 2024 edition of our magazine, The Journal. The article was sponsored by Hollister Incorporated.
- Learn more about The Journal
Hollister’s disclaimer: We serve people living with an ostomy and those who care for them. We are committed to helping empower those who use our products with the independence to maintain a rewarding, dignified life.
View our comprehensive portfolio of ostomy care products, and access helpful educational resources at www.hollister.co.uk/ostomycare. The testimonials, statements and opinions presented are applicable to the person depicted. These testimonials are representative of that person’s experiences, but the exact results and experience will be unique and individual to each person.
The information provided herein is not medical advice and is not intended to substitute for the advice of your personal physician or other healthcare provider. This information should not be used to seek help in a medical emergency. If you experience a medical emergency, seek medical treatment in person immediately.
Prior to use, be sure to read the Instructions for Use for information regarding intended use, contraindications, warnings, precautions and instructions. Hollister and the Hollister logo are trademarks of Hollister Incorporated. All other trademarks and copyrights are the property of their respective owners. © 2024 Hollister Incorporated