Introduction
A common side effect of a stoma procedure is a parastomal hernia. The surgery can weaken the abdominal wall, and extended pressure on the abdomen can lead to abdominal contents bulging through the wall in a visible mass known as a parastomal hernia.
Causes
Stoma surgery can cause the abdominal wall to become weak leaving it lacking enough strength to hold abdominal contents. While specific causes are hard to determine, the following groups may be more at risk of a parastomal hernia:
- Smokers.
- Those who are overweight or obese.
- Those with persistent constipation.
- Elderly.
- Those with high blood pressure.
- Those who don't eat a balanced, nutritious diet.
Symptoms
The most obvious sign of a parastomal hernia is a prominent bulge near the stoma site. This will usually get worse with bending, lifting or coughing.
Some parastomal hernias cause pain and discomfort in the abdomen area and around the stoma. In some cases, and colostomies or ileostomies may loosen.
Diagnosis
Diagnosis is made after a physical examination. A CT scan or ultrasound may be required for a more thorough look at the abdomen and stoma site.
Tests
If the hernia can be manipulated back into place and symptoms don't cause pain or impact lifestyle, no treatment is required.
Symptoms can develop gradually over time and if pain and discomfort surgery may be required.
Surgical options involve closing the stoma, treating the hernia, or repairing the wall of the abdomen.
Surgery won't guarantee that another parastomal hernia won't form in a different area of the abdomen, so it's a last resort if symptoms became hard to manage or affect the quality of life.
Prognosis
The patient can often live with a parastomal hernia by making some simple adjustments including losing weight or using an abdominal support belt.
If a hernia causes ongoing pain and discomfort or is at risk of developing into an incarcerated or strangulated hernia, surgery will be recommended with a full recovery being possible.