Parastomal hernia is a condition that can occur in people with stomas. A stoma is a surgically created opening in the abdomen to allow the removal of intestinal wastes, bypassing the lower intestinal tract. A patient is a candidate for stoma surgery if he is unable to have normal bowel movements due to an underlying bowel health condition.
According to a survey, about 78% of people with stomas develop parastomal hernias. This complication occurs within two years of surgery.
Symptoms of parastomal hernia
Parastomal hernias develop and grow gradually but consistently. You may notice the following conditions as the hernia develops.
- Discomfort and pain around your stoma
- Bulging around the stoma
- Trouble keeping the ostomy pouch in place
Reasons for parastomal hernia
Having a stoma could mean a weakness in your abdominal muscles. This muscle-weakening allows the formation of this hernia. Factors that can contribute to the formation of parastomal hernia may include the following.
- Smoking
- Malnutrition
- Chronic constipation
- Chronic coughing
- Infection after stoma surgery
- Obesity
People who get these hernias
Some people are generally at a higher risk of developing a parastomal hernia. Common risk factors in this regard may include the following.
- Obesity
- Older age
- Diabetes
- Cancer
- Respiratory issues
- High blood pressure
Repairing parastomal hernia
In many cases, this problem is treatable through lifestyle changes such as quitting smoking and losing weight. Wearing an ostomy belt can also contribute to the reduction of the symptoms.
In some cases, parastomal hernias can be severe enough to need surgical intervention. Surgical options in this regard may include the following.
- Closing the stoma: If you have a parastomal hernia, your surgeon will see if you are fit enough to undergo stoma reversal surgery. He will check if your bowel has recovered enough to perform after the bowel reconnection. It is, by far, the best option to treat a parastomal hernia.
- Repairing the hernia: During this procedure, the surgeon opens the abdominal wall over the hernia and secures the weakened muscle by stitching it.
- Relocating the stoma: In some cases, the surgeon may find it more appropriate to close a stoma site and create a new stoma at a new site on the abdomen.
- Mesh: Another very common treatment for a parastomal hernia is the use of mesh inserts. While this option can be more expensive, it is more comfortable than other forms of parastomal hernia treatments. The surgeon generally places this mesh under the abdominal wall. It then incorporates into the surrounding tissues, creating a strong barrier that keeps the bowel from pushing through the abdominal muscles.
Complications
Parastomal hernias can result in a lot of complications. For instance, it can cause the intestine to become twisted or trapped in the hernia. It can result in intestinal blockage. It can also cause the loss of blood supply. The twisting of the bowel often results in its strangulation, which becomes a medical emergency. Surgical intervention may be required to untwist this troubled part of the bowel.
Living with a parastomal hernia
A parastomal hernia is not always painful. You may not even require any medical intervention if you manage it properly. You can discuss with your nurse the types of products and supplies needed to facilitate stoma care when there is a parastomal hernia.
