Parastomal Hernia: Definition, Symptoms & Complications

Instructor: Alyssa Campbell

Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration.

Parastomal hernias, often caused by straining or coughing, may occur at the site of a stoma. Read this lesson to learn more about how a parastomal hernia happens and common complications to be aware of.

Managing a Chronic Condition

Jan, a 40-year-old accountant, is now accustomed to her new self-care routine. Having undergone recent surgery for the removal of part of her intestines due to cancer, she is unable to rid herself of stool with the help of her lower intestines. Her surgeon created a new hole, or stoma, on her abdomen by taking her healthy intestinal tissue and attaching it to the outside of the body. Now Jan uses a collection appliance and attaches it to her skin to manage her bowel movements.

Jan is happy to be back at work after a long period of recovery. It is tax season and her office is in full swing. To help out, Jan assists in moving some heavy file boxes out to the office area. When she returns to her desk after helping her colleague, she notices the feeling of an abnormal bulge by her stoma. Suspecting a problem, she makes an appointment with her physician.

What is a Parastomal Hernia?

Immediately upon visual inspection, Jan is diagnosed with a parastomal hernia. The physician explains that a hernia develops when there is a hole or weakness is muscular tissue that holds organs in place. Because of her recent abdominal surgery to create a stoma, the intestines were surgically pushed through her abdominal muscles during her operation. The hole created in the abdominal wall is a weak spot where other tissue and possibly intestines are now pushing through. Like most other hernias, parastomal hernias are caused by:

  • Straining during activities like heavy lifting or pulling
  • Coughing or sneezing
  • Injury to the muscle tissue
  • Obesity, being overweight

While parastomal hernias are more likely to happen when the stoma has aged, heavy lifting is determined to be the cause of Jan's issue.

Symptoms of Parastomal Hernias

The physician describes a common list of symptoms associated with parastomal hernias to determine whether treatment might be necessary. The common characteristics of parastomal hernias include:

  • A bulge or soft protrusion at the stoma site
  • Possible pain localized to the center of the abdomen
  • Stoma shape and size distortions

A severe parastomal hernia with an appliance bag is pictured.
A severe parastomal hernia with an appliance bag is pictured

Complications

As Jan's parastomal hernia remains small, the physician encourages her to closely observe the hernia for potential complications. Depending on the severity of the complications, surgical correction may be necessary.

Appliance Concerns

Appliance attachment is critical as it protects the skin from irritation and infection from the stool, as well as keeps the elimination of waste more sanitary for the individual. Dignity is also an issue, as individuals may tend to isolate themselves when having an appliance that won't attach properly.

Waste Regulation

When a parastomal hernia occurs, it changes the shape and may stretch the internal intestines. This could cause unpredictable bowel movement patterns and difficulty regulating normal and healthy stool.

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