Identifying and Managing A Parastomal Hernia

A doctor discusses parastomal hernias with patient

Cheryl Hutton, a wound, ostomy and continence nurse (WOC nurse) with CHC Solutions, Inc., informs us of what a parastomal hernia is and how to identify it and reduce the chances of it happening.

What’s a Parastomal Hernia?

Those who undergo an ostomy surgery can be at risk of getting a parastomal hernia. As a result of surgery, the muscles around the stomal wall can become weakened making it easier for an injury to occur.

A parastomal hernia is a bulge under the parastomal skin. This bulge is caused by the intestines pressing outward on the stoma.

Preventative Measures

Your doctor can discuss with you various options to help prevent this from happening:

  • Modification of your pouching system
  • Cautious use of tape to avoid skin damage
  • Cautious use of convex barriers to avoid pressure areas around the stoma
  • Adjustment of the size and shape of the opening in the skin barrier/wafer
  • Measuring you for a hernia support belt
  • Attaining or maintaining a waistline of less than 39.4 inches or 100cm
  • Avoiding lifting over 5 pounds for 6 to 8 weeks after surgery

Also, you can use abdominal support belts and garments when doing heavy lifting or heavy work. Along with this, you should abstain from active abdominal exercises or lifting heavy objects for at least 3 months following surgery and maintain adequate nutrition to support wound healing.

Identification of Parastomal Hernia

A bulge is noticeable around the stoma. The bulge can vary in size. For instance, it may partially or completely surround the stoma. The bulge may reduce in size when you lie down and increase in size when you stand, sit or exert yourself.

The stoma may also change in size or shape. A hernia often has no symptoms, but it can be symptomatic with pain or cause your pouch to fit poorly.

If you think you have a parastomal hernia, you can assess for the following symptoms or problems:

  • Abdominal pain
  • Change in bowel habits
  • Difficulty with the colostomy care that was not present prior to the hernia
  • Bluish discoloration of the stoma
  • Pressure areas around the stoma from existing pouch
  • Less wear time of the existing pouching system
  • Leakage and parastomal skin irritation

Management of Parastomal Hernia

If you believe you may have a parastomal hernia, please contact your ostomy nurse or physician for further evaluation.

Finally, to learn more, visit our ostomy blogs page at or visit the WOCN Stoma Clinical Practice Guidelines at January/February 2018 – Volume 45 – Issue 1 – p 50-58.

*Disclaimer: Any health and wellness content presented is for general informational purposes only. Such content is not intended to replace or serve as a substitute for professional medical advice, diagnosis or treatment.