Parastomal Hernia: Around a Stoma - What to Know
Published on: 10/Oct/2025
Posted By: Arka Health
Introduction: Navigating Life After Stoma Surgery
Life after an ostomy surgery, a procedure that creates an opening, or stoma, for waste to leave the body – is a journey of adaptation. For many in Bengaluru and around the world, a stoma is a life-saving intervention that allows them to return to the activities they love. However, a common challenge that can arise is the development of a bulge around the stoma site. This is known as a parastomal hernia.
A parastomal hernia is a type of incisional hernia that occurs when abdominal contents, like the intestine, push through the muscle opening created for the stoma.1 It is one of the most frequent long-term complications of stoma surgery, affecting up to 50% of patients, often within the first few years.3 While not always dangerous, a stoma hernia can cause discomfort, interfere with the fit of your ostomy appliance, and impact your quality of life.
This guide will explain why a parastomal hernia happens, explore the options for parastomal hernia management – from supportive garments to surgery and clarify when a surgical repair can help. At ARKA Anugraha Hospital, a designated ‘Centre of Excellence in Hernia Surgery’ in Bengaluru, we provide expert, compassionate care to help you manage this condition and live comfortably and confidently.
Why It Happens: The Root Causes of a Parastomal Hernia
A parastomal hernia is essentially an incisional hernia that forms at a very specific, surgically created weak point in the abdominal wall. The stoma itself is a “controlled hernia,” an intentional opening that allows the intestine to pass through the core muscles. This necessary opening creates a natural point of weakness.
The Mechanics of a Stoma Hernia
A parastomal hernia develops when the normal pressure inside your abdomen pushes tissue through the weakened area around the stoma. Several factors can increase this internal pressure and contribute to the formation of a stoma hernia:
- Strenuous Activity: Heavy lifting or intense physical exertion puts significant strain on the abdominal muscles.
- Chronic Coughing: A persistent cough, often linked to smoking or pulmonary diseases like COPD, repeatedly increases abdominal pressure.
- Chronic Constipation: Straining during bowel movements is a major risk factor.
- Obesity: Excess body weight increases the constant pressure on the abdominal wall and is a strong independent risk factor for hernia formation.
Other Contributing Risk Factors
Beyond increased pressure, other patient- and surgery-related factors can influence the likelihood of developing a parastomal hernia:
- Age: As we get older, our abdominal muscles naturally weaken, making them more susceptible to herniation.
- Surgical Technique: The size of the opening created for the stoma and whether it passes through the rectus abdominis muscle can impact hernia risk.
Poor Wound Healing: Conditions like malnutrition, infection at the surgical site, or the use of corticosteroids can impair the healing of the abdominal wall.
Support Garments vs. Surgery: A Look at Parastomal Hernia Management
Not every parastomal hernia requires immediate surgery. The approach to parastomal hernia management depends on the size of the hernia, the severity of symptoms, and its impact on your daily life.
Conservative Management: Support and Lifestyle Adjustments
For many people with a small or asymptomatic stoma hernia, a non-surgical approach is the first line of management. The goal is to provide support, alleviate discomfort, and prevent the hernia from getting larger.
- Hernia Support Garments: Specially designed belts, girdles, or support underwear are highly effective tools for parastomal hernia management. These garments work by providing external compression and support to the abdominal wall around the stoma. This can help:
- Reduce the heavy or dragging sensation caused by the hernia.
- Provide a smoother profile under clothing, improving cosmetic appearance.
- Create a more stable surface, making it easier to achieve a secure seal with your ostomy appliance and prevent leaks.
- Support the abdomen during physical activity to prevent the hernia from worsening.
It is important to be assessed by a stoma care nurse to ensure you get the right type and fit for your body shape and needs.
- Lifestyle Modifications: Simple changes can also make a big difference in managing a parastomal hernia:
- Avoid Heavy Lifting: Refrain from activities that cause significant abdominal strain.
- Maintain a Healthy Weight: Reducing excess weight can lower the pressure on your abdominal wall.
- Prevent Constipation: A diet rich in fiber and adequate fluid intake helps prevent straining during bowel movements.
- Apply Counter-Pressure: When you cough, sneeze, or laugh, gently place your hand over your stoma to provide support.
Surgical Management
While conservative measures are helpful, surgery is the only way to permanently repair a parastomal hernia. The decision to proceed with surgery is made in consultation with an expert hernia surgeon.
When Repair Helps: Deciding on Parastomal Hernia Treatment
Surgical parastomal hernia treatment is generally recommended when the hernia causes significant problems or poses a risk of serious complications.
Indications for Surgery
Your surgeon may advise a repair if your parastomal hernia is:
- Causing Pain or Discomfort: If the hernia leads to chronic pain or a persistent aching that affects your daily activities.
- Interfering with Stoma Function: If the bulge makes it difficult to fit your ostomy bag, leading to frequent leaks, skin irritation, or difficulty with irrigation.
- Growing Larger: A hernia that is noticeably increasing in size may be more likely to cause problems in the future.
- Becoming an Emergency: In rare cases, the intestine can become trapped (incarcerated) or have its blood supply cut off (strangulated). This is a life-threatening emergency.
Seek immediate medical attention if you have a hernia and experience:
- Sudden, severe pain around the stoma
- Nausea and vomiting
- No output from your stoma
- Redness, swelling, or a dark discoloration of the stoma or surrounding skin
Modern Surgical Repair Options
The goal of parastomal hernia treatment is to return the herniated tissue to the abdomen and provide a strong, durable repair of the abdominal wall. While older techniques like simple suture repair or stoma relocation have high recurrence rates, modern mesh repairs are now the gold standard.
- Laparoscopic (Minimally Invasive) Repair: This is often the preferred approach. The surgeon makes several small “keyhole” incisions away from the stoma and uses a camera and specialized instruments to perform the repair from inside the abdomen. This technique typically results in less pain, a shorter hospital stay, and a faster recovery.
- The Sugarbaker Technique: This is a specific laparoscopic method that has shown significantly lower recurrence rates compared to other techniques like the “keyhole” mesh repair. In this procedure, the bowel of the stoma is placed against the abdominal wall, and a large, intact sheet of mesh is placed over both the hernia defect and the bowel, creating a strong barrier that prevents tissue from protruding again.
Expert Parastomal Hernia Treatment in Bangalore: The ARKA Anugraha Advantage
Repairing a parastomal hernia is a complex procedure that requires a high level of surgical expertise. At ARKA Anugraha Hospital in Bengaluru, we are a premier institution for hernia care, formally recognized as a ‘Centre of Excellence in Hernia Surgery’.
Our surgical center is led by Dr. M. Ramesh, a pioneer in laparoscopic surgery with over 40 years of experience, and a world-class team specializing in advanced minimally invasive techniques for all types of hernias, including complex cases like the parastomal hernia. Our focus on laparoscopic and robotic repair means our patients benefit from smaller incisions, less pain, and a significantly faster recovery.
What truly sets ARKA Anugraha Hospital apart is our unique integrative and functional medicine approach. We understand that surgery is just one part of the healing journey. We treat the whole person, not just the hernia, supporting our patients with:
- Holistic Pain Management: We integrate evidence-based therapies like acupuncture and guided meditation to minimize post-surgical discomfort and support your body’s natural healing processes.
- Nutritional Optimization: Our team provides personalized nutritional guidance to aid recovery and prevent issues like constipation that can strain the surgical repair.
Optimized Recovery Protocols: Our innovative care plans are designed to reduce stress and promote faster healing, often allowing patients to return home in less than 24 hours after laparoscopic surgery.
Frequently Asked Questions (FAQ)
Q1: Does every parastomal hernia need surgery?
A: No. Many small hernias that do not cause symptoms can be managed conservatively with support garments and lifestyle adjustments. Surgery is typically recommended when the hernia becomes painful, causes problems with the stoma appliance, or shows signs of complications.
Q2: Can a hernia belt or support garment cure my stoma hernia?
A: No. Support garments are an excellent tool for parastomal hernia management. They can reduce discomfort, provide support, and help with pouching issues, but they do not fix the underlying muscle defect. Surgery is the only way to repair the hernia.
Q3: What is the recovery like after parastomal hernia treatment?
A: Recovery depends on the type of surgery. With minimally invasive laparoscopic repair, patients experience less pain and a faster return to daily activities. However, you will need to avoid heavy lifting and strenuous activity for several weeks to allow the repair to heal properly and reduce the risk of recurrence.
Q4: Why should I choose ARKA Anugraha Hospital for my parastomal hernia surgery in Bangalore?
A: ARKA Anugraha Hospital is an accredited ‘Centre of Excellence in Hernia Surgery’ with deep expertise in complex cases like the parastomal hernia. We specialize in advanced, minimally invasive laparoscopic and robotic surgery for a faster, less painful recovery. Our unique integrative medicine approach supports your entire healing journey with holistic pain management and personalized care plans to ensure the best possible outcome.
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