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Parastomal hernia: prevention and treatment | CION Cancer Clinics
A parastomal hernia is a bulge beside the stoma, where bowel pushes through the weak spot the stoma passes through. It is one of the most common long-term stoma problems. A properly fitted support belt, safe lifting and gentle tummy exercises may lower the chance, though nothing prevents it for certain. This page explains the signs, the emergency signs and how treatment is decided. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a parastomal hernia, and can a belt prevent it?
- What raises the chance of a hernia?
- How can you protect the stoma from a hernia?
- How is a parastomal hernia treated?
- What do people get wrong about parastomal hernias?
- What do the words in the scan report mean?
- Common questions about parastomal hernias
The short answer
What is a parastomal hernia, and can a belt prevent it?
A parastomal hernia is a bulge beside the stoma, where part of the bowel pushes through the weak spot in the tummy muscle the stoma passes through. A well-fitted support belt, careful lifting and gentle tummy exercises may lower the chance, but nothing prevents it for certain.
Why it happens
To make a stoma, the surgeon brings the bowel out through a gap in the tummy wall. That gap is a natural weak point. Over months and years, pressure from coughing, lifting or straining can widen it, and the bowel begins to bulge through.
What it looks and feels like
A swelling around or beside the stoma, often bigger when you stand, cough or strain, and smaller when you lie down. Some people feel a dragging ache. Others notice only that the bag no longer sits flat and starts to leak.
How common it is
It is one of the most common long-term stoma problems, particularly with a colostomy. Many hernias are small and cause little trouble. The published rates vary widely between studies, so your surgeon is the right person to ask about your own chance.
This page cannot tell you whether a bulge you have is a hernia. A doctor or stoma nurse needs to examine it.Who is more likely
What raises the chance of a hernia?
Some of these you can change. Some you cannot. Knowing which is which helps you put your effort where it counts.
Things you can work on
- Heavy lifting too soon after surgery
- A long-standing cough, especially from smoking
- Straining with constipation
- Gaining a lot of weight around the tummy
Things you cannot change
- Older age
- Weaker tummy muscles after more than one operation
- A wound infection after surgery
- The type and position of the stoma
Other health conditions
Diabetes, long-term steroid medicines, chest disease and poor nutrition can all slow healing of the tummy wall. Tell your team about every condition you have, and every medicine you take, even the ones that seem unrelated to the stoma.
Treatment for the cancer
Chemotherapy or radiotherapy around the time of surgery can affect how the tissues heal. This is not a reason to avoid treatment. It is a reason to be careful with lifting.
Not sure whether this applies to you?
Ask an oncologistPrevention
How can you protect the stoma from a hernia?
Get the belt fitted properly
Ask your stoma nurse to measure you for a support belt or support underwear. A belt bought without measuring may be too loose to help or too tight around the stoma.
Lift the safe way
Avoid heavy lifting until your surgeon says you can. After that, bend your knees, keep the load close to your body and wear the belt. Water pots, gas cylinders and grandchildren all count.
Support the stoma when you cough
Place a flat hand or a folded towel over the stoma when you cough, sneeze or laugh hard. It takes pressure off the weak spot.
Build the tummy muscles slowly
Gentle exercises taught by a physiotherapist or stoma nurse can strengthen the tummy wall. Start only when your team allows it, and avoid sit-ups unless you are told they are safe.
!
When a hernia cannot wait
Go to the nearest emergency department today if the bulge becomes hard and painful and will not go back when you lie down, if the stoma turns dark red, purple or black, or if output stops and you begin vomiting. Part of the bowel may be trapped and losing its blood supply. Say that you have a stoma and a hernia.
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Treatment
How is a parastomal hernia treated?
Many hernias are managed without an operation. The team watches the hernia, fits support wear and helps adjust the bag so it stops leaking. Surgery is usually considered when the hernia causes pain, repeated blockages, leaks that cannot be controlled, or a risk of the bowel becoming trapped.
The kinds of operation
A surgeon may repair the gap, often with a mesh, a flat sheet of material that strengthens the tummy wall. Sometimes the stoma is moved to a new spot on the other side. Repairs can be open or keyhole. Ask your centre which approaches it offers and why one is suggested for you.
Who surgery may not suit
Repairs can come back, and another operation carries its own risks. For someone who is frail, has serious heart or lung disease, or is still having cancer treatment, the team may feel that support wear is the safer choice. That is a decision for you and your treating team together.
What to ask
Ask what the repair involves, how likely the hernia is to return, how long recovery takes, and what happens if you choose to wait. Ask too whether the stoma will stay in the same place, and whether you will need a different bag afterwards.
If you are waiting for a planned repair, keep wearing your support wear and learn the emergency signs on this page. Waiting is common and is often the safer choice while recovery from cancer treatment continues.Commonly believed
What do people get wrong about parastomal hernias?
"Wearing a belt means a hernia will never happen."
A belt may help, but the evidence is still limited. It is one part of prevention, along with safe lifting, cough support and gentle exercise. Keep watching for a bulge even if you wear one.
"A hernia means the surgery was done badly."
The gap in the tummy wall is part of making any stoma. Hernias develop after careful surgery too. It is a known complication, not by itself a sign that something went wrong.
"Once there is a bulge, you must have an operation."
Many people live with a small hernia for years using support wear and a well-fitted bag. Surgery is weighed against the risks of another operation.
"You should stop moving to protect the stoma."
Too little activity weakens the tummy muscles and adds weight. Walking and gentle exercise agreed with your team help more than resting all day.
On your report
What do the words in the scan report mean?
- Parastomal
- Beside the stoma. A parastomal hernia is a hernia next to it.
- Reducible
- The bulge goes back in when you lie down or press gently. This is the usual kind.
- Incarcerated
- The bulge is stuck and will not go back. It needs a prompt review.
- Strangulated
- The trapped bowel is losing its blood supply. This is an emergency.
- Mesh
- A flat sheet of material a surgeon uses to strengthen a weak tummy wall during a repair.
- Resiting
- Moving the stoma to a new place on the tummy.
Questions we are asked
Common questions about parastomal hernias
Where can I get a stoma support belt in Hyderabad?
Stoma supply shops, larger medical stores and appliance companies sell them. Before you buy, ask your stoma nurse to measure you and suggest a type. The belt should support the tummy without pressing on the stoma itself.
Should I wear the belt all day and at night?
Most people wear it when they are up and active, and especially when lifting, and take it off in bed. Your stoma nurse may advise differently if you already have a hernia. Follow what they tell you for your own situation.
Can a hernia make the bag leak?
Yes. The bulge changes the shape of the skin, so a flat baseplate stops sealing well. A stoma nurse can suggest a more flexible or convex bag and a different way of fitting it. Tell them as soon as leaks start.
Can I still do housework and go to work?
Usually yes. Wear your support belt, avoid heavy lifting and ask for help with water pots, cylinders and heavy shopping. If your job involves hard physical work, discuss it with your surgeon before you return.
Is a mesh put in at the first operation to prevent a hernia?
Some surgeons use a preventive mesh when making a stoma. Studies have given mixed results, and it is not suitable for every patient. Ask your surgeon whether they considered it for you and what they weighed in deciding.
How will the doctor confirm it is a hernia?
Usually by examining you lying down and standing while you cough. A small or unclear hernia may need a CT scan to see what is in the bulge. The scan also helps the team plan any repair.
Will the hernia go away if I lose weight?
The gap does not close on its own. Losing extra weight around the tummy can lower pressure on it and may stop it getting bigger. Any change in diet should be agreed with your team, especially during cancer treatment.
Can a parastomal hernia come back after repair?
Yes. Hernias can return after repair, and this is one reason surgeons do not operate on every hernia. Ask your surgeon how likely it is with the repair they suggest, and what you can do to lower the chance.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Sources
- NHS — Colostomy
- NHS — Hernia
- American Cancer Society — Ostomies
- Macmillan Cancer Support — Cancer information and support
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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