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What is a Parastomal Hernia?

A parastomal hernia is the most frequent complication following the construction of a colostomy or an ileostomy, occurring in up to 50 percent of patients. It is simply a bulge or hernia around a colostomy or an ileostomy. This is not unexpected, as the formation of a stoma requires a hole to be made for the end of the bowel to be brought to the surface of the abdomen. This weak spot can stretch over a period of time.

Research has shown that a large percentage of ostomates develop a parastomal hernia after the surgery. It may stay asymptomatic for a while. While lifestyle modifications and products can treat mild cases, surgical intervention may be necessary in severe cases for parastomal hernia repair.

What are the Symptoms of Parastomal Hernia?

The common symptoms of a parastomal hernia are:

  • A bulge or swelling near the stoma.
  • Pain, burning, or discomfort around the stoma site.
  • Leakage and fitting problems with the stoma pouch (sometimes affecting the skin around the stoma site).
  • Episodes of blockages in the functioning of the stoma if the bowel gets caught within the hernia.

When Should You Seek Medical Help?

In its initial stages, a parastomal hernia may not present any symptoms. If you are experiencing any of the listed symptoms after undergoing a colostomy or an ileostomy, you should consult a doctor to get an accurate diagnosis and discuss treatment options. 

Surgery may be advised to treat severe cases. In rare instances, the abdominal contents that spill out are “strangulated”. Here, the tissue dies due to its blood supply being cut off. These instances require immediate emergency surgery.

What Causes Parastomal Hernia?

A parastomal hernia is the most frequent post-surgery complication for ostomates; however, there are other factors that could put you at a higher risk. Some of these include:

  • Obesity
  • Lack of exercise
  • Strenuous activity and straining
  • Smoking
  • Chronic cough
  • Infection of or around the stoma site
  • Ageing

Of all the risk factors, being overweight has been most commonly linked with ostomates developing a parastomal hernia, based on clinical evidence.

How is a Parastomal Hernia Diagnosed?

The doctor will discuss your symptoms, concerns, and medical history with you. A physical examination will follow. The listed symptoms, including an external bulge or protrusion, usually suffice for a diagnosis.

If any confusion persists in terms of diagnosis, imaging tests may be performed for confirmation.

What are the Treatment Options for Parastomal Hernia?

There are several options available to treat a parastomal hernia, each with its own merits and risks. Mild cases can usually be treated using lifestyle modifications, whereas severe cases may require surgery. The major treatment options are:

1. Products and Lifestyle Modifications

For mild cases (especially those made worse by lifestyle decisions), a few small lifestyle changes might be sufficient for successful treatment. These include incorporating more physical activity into your schedule and quitting smoking. Using products such as hernia support garments or belts and skin-protecting creams can help ease the symptoms of parastomal hernia.

2. Parastomal Hernia Repair

Parastomal hernia repair surgery is preferred to treat relatively small parastomal hernias. In this procedure, the surgeon repairs the hernia by narrowing it. There is a high failure rate if the repair is not reinforced with a mesh. This can be an open or keyhole procedure. 

➡️ Learn more about Parastomal Hernia Repair Surgery

3. Stoma Closure or Relocation

If the patient’s bowel health has improved and does not require the stoma anymore for excretion, the stoma may be sewn shut. This may not be suitable for all patients. Another option is to relocate the stoma site. However, this procedure has been shown to increase the chances of recurrence while also creating a second weak spot in the abdominal wall.

4. Mesh to Reinforce the Abdominal Wall

This is the most effective surgical technique currently available for parastomal hernia treatment. Here, a mesh is inserted to reinforce the abdominal wall in addition to parastomal hernia repair surgery or stoma closure. The mesh used may be biological or synthetic. While biological meshes are more comfortable and resistant to infection, they are expensive and not so durable in comparison to synthetic meshes.

Why Choose the Leicester Bowel Clinic?

Book a consultation with us to get treatment for your condition.

At Leicester Bowel Clinic, we focus on bowel health and conditions, digestive issues, and cancer care. Our clinic offers minimally invasive procedures for bowel problems, ensuring effective results and patient comfort. We aim to provide personalised care for our patients and offer the latest treatments for hernias, bowel conditions and rectal disorders.

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Leicester Bowel Clinic at Spire Hospital

  • Wednesdays evenings (Mr Runau) from 6:00 pm until 9:00 pm at: Spire Leicester Hospital Gartree Road Leicester LE2 2FF
  • To arrange an appointment directly with the Spire Leicester Hospital, please call the booking line on 0116 2653685

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Frequently Asked Questions

01. How serious is a parastomal hernia?

A parastomal hernia develops in the majority of ostomates within the first two years of their surgery. While parastomal hernias can stay asymptomatic, there are cases that require immediate attention. It is recommended that you consult a doctor to get an accurate assessment of your condition. Book an appointment with us to get expert advice from our team of well-experienced surgeons, who can assist you throughout the process, from diagnosis to treatment.

02. When should I worry about a parastomal hernia?

In many cases, a parastomal hernia may remain asymptomatic. If you are experiencing increased pain or notice that the bulge is growing in size, you should consult your doctor. These might be signs that the hernia is “strangulated,” meaning its blood supply is cut off. This is a complication that requires immediate surgery. It is best to consult a doctor to better understand the severity of your condition.

03. What is the best treatment for a parastomal hernia?

Lifestyle changes and stoma support products may be effective in managing mild cases. For severe cases, the best treatment option is surgery. There are several surgical options available that can be performed via different approaches, including robotic surgery.