A hernia occurs when part of an internal organ or tissue, most commonly the bowel or abdominal fat, pushes through a weakened area of muscle or connective tissue that would normally contain it. In people with a stoma, a parastomal hernia may develop around the stoma as a result of weakening of the abdominal wall in that area.

Signs and Symptoms

Symptoms can vary depending on the type and size of the hernia. Common symptoms include:

• A lump or bulge in the abdomen, groin or around the stoma.
• The bulge may become more noticeable when coughing, sneezing, standing up or straining, and may reduce or disappear when lying down.
• A feeling of heaviness, pressure or tightness in the affected area.
• Discomfort or pain, especially during physical activity or exertion.
• With parastomal hernias, there may be difficulties fitting the ostomy appliance, frequent leakage or changes in stoma function.

Risk Factors

Several factors can increase the risk of developing a hernia:

• Overweight and obesity.
• Smoking, which can affect tissue quality and wound healing.
• Chronic cough or respiratory conditions that increase abdominal pressure.
• Constipation and repeated straining during bowel movements.
• Frequent heavy lifting.
• Older age and previous abdominal surgery, particularly surgery involving the creation of a stoma.

How to Reduce the Risk of Developing a Hernia

Although not all hernias can be prevented, the following measures may help reduce the risk:

• Maintain a healthy weight.
• Do not smoke.
• Follow a balanced, fibre-rich diet and stay well hydrated to help prevent constipation.
• Engage in regular physical activity and abdominal strengthening exercises as recommended by healthcare professionals.
• Use correct lifting techniques and avoid excessive strain, particularly after abdominal surgery.
• Manage chronic cough and other conditions that increase pressure within the abdomen.

Treatment

Treatment depends on the type of hernia, its size, the symptoms it causes and the risk of complications.

• Small hernias that do not cause symptoms may be managed with regular monitoring and conservative measures.
• When a hernia causes symptoms, affects quality of life or carries a risk of complications, surgical repair may be recommended. Surgery may be performed using open techniques or minimally invasive approaches (laparoscopic or robotic surgery), depending on the individual patient's circumstances.
• For parastomal hernias, support garments or specialised abdominal belts may help improve comfort and the fit of the ostomy appliance. These should be assessed and fitted by a stoma care nurse or specialist.