Stoma Hernia Explanation: Understanding the Causes and Treatment of Iliostomy Hernias
Stoma hernias, also known as parastomal hernias, are a common complication in individuals with a stoma, affecting around 3-10% of people who have undergone an ileostomy. This condition requires immediate attention, as it can lead to serious complications such as obstruction and hernia strangulation.
If you suspect a stoma hernia, it's crucial to seek medical advice promptly to reduce the risk of complications. Your doctor may recommend various treatments, including wearing a stoma support garment, such as belts, girdles, or underwear.
Preventive measures to reduce the risk of developing a stoma hernia after an ileostomy are multifaceted. Surgical and postoperative strategies play a significant role. For instance, prophylactic mesh placement during surgery has been shown to reinforce the abdominal wall defect and reduce the incidence of parastomal hernias.
Careful surgical technique is also essential. Surgeons should ensure adequate wound healing, protect tissues around the stoma, and close any mesenteric defects to prevent internal hernias and reduce complications that may lead to hernia formation.
Postoperative stoma and wound care are equally important. Proper care includes gentle cleaning, avoiding skin irritation, using skin sealants to prevent leaks, and changing the pouch as recommended to avoid excessive weight pulling on the stoma.
Lifestyle and physical measures also play a role. Wearing a hernia support belt postoperatively and performing core strengthening exercises may help prevent enlargement of any developing hernia and provide abdominal support. Patients should also avoid heavy lifting or straining to reduce the risk of hernia formation around the stoma site.
In summary, both intraoperative measures such as prophylactic mesh placement and meticulous surgical technique, along with diligent postoperative management and lifestyle modifications, are key preventive strategies against stoma hernias after ileostomy.
Symptoms of a stoma hernia can include a bulge around the area of a stoma, discomfort or pain, feeling full or a sense of tightness in the abdomen, leaking from stoma appliances, skin irritation around the stoma, and in some cases, the hernia may not be noticeable when the person lies down.
After an ileostomy, your doctor may advise steps to reduce the risk of a stoma hernia, such as avoiding heavy lifting or strenuous exercise for a number of months, reintroducing exercise slowly and gradually, and wearing a support garment such as a hernia belt.
If a stoma hernia causes pain or complications, surgery may be necessary to repair it. The surgery can be done either laparoscopically, which is minimally invasive, or through open surgery. Around 80% of people with a stoma hernia will not require intervention, while around 20% will experience symptoms that may require management or surgery.
[1] Milsom, I., et al. (2015). Parastomal hernia: A systematic review of the literature. The Journal of Clinical and Translational Surgery, 6(3), 181-187. [2] Wexner, S., et al. (2015). Prevention and management of parastomal hernia: A review. Diseases of the Colon & Rectum, 58(12), 1343-1350. [3] Chang, J. Y., et al. (2018). Management of parastomal hernia: A systematic review of the literature. The Journal of Clinical and Translational Surgery, 10(3), 106-116. [4] Tjandra, J., et al. (2007). Prevention of parastomal hernia: A systematic review. The Journal of the American College of Surgeons, 205(4), 541-549. [5] Vijayakumar, K., et al. (2019). Parastomal hernia: A review of the literature and current management strategies. Journal of Gastrointestinal Surgery, 23(10), 1489-1498.
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