How a stoma hernia appears
One of the first things people often notice is a change in the area around the stoma. A stoma hernia can show as a bulge or swelling behind or around the stoma. It may feel soft to the touch and can vary in size — sometimes small, and in other cases more noticeable.
You may also observe that:
- the stoma looks more prominent or sits differently
- its shape appears to change
- it may look larger or flatter than before
The swelling is often easier to see when standing and may reduce or disappear when lying down.
Why a stoma hernia can develop
A stoma hernia usually develops due to a combination of weakness in the abdominal wall and pressure inside the abdomen.
When a stoma is created, part of the bowel passes through the abdominal muscles. This creates a natural area of weakness. Over time, pressure from activities such as coughing, lifting or straining can cause the area to stretch.
As a result, part of the bowel may push outward, creating the bulge seen in a hernia. This process often happens gradually rather than suddenly.
Symptoms you might experience
Alongside visible changes, you may notice other symptoms.
These can include:
- A bulge behind or around the stoma
- Discomfort or a dragging sensation
- Difficulty keeping your pouch securely in place
- Bloating
- Changes in how your stoma functions
- Discomfort when coughing, lifting or moving
These symptoms can vary, and for many people they remain manageable.
How your care team can support you
If you think you may have a stoma hernia, it’s important to speak with your stoma care nurse or healthcare professional.
Although hernias are not usually an emergency, they should not be ignored. They do not go away on their own and can increase in size over time, which may lead to greater discomfort or practical difficulties.
Your stoma care nurse can assess the area and support you with ways to manage your symptoms.
This may include advice on:
- Adjusting your pouching system
- Selecting products that provide a better fit
- Managing day-to-day comfort
In some cases, a support garment may be recommended. These garments are often tailored to fit your body and can help support the abdominal area around the stoma.
Although rare, a hernia can sometimes cause part of the bowel to become twisted. If this happens, it may require surgical treatment. If something doesn’t feel right, it’s always best to seek medical advice.
Staying in contact with your stoma care nurse can help ensure you have the right support and products for your situation.
Factors that may increase the risk
Some people are more likely to develop a stoma hernia than others.
Factors that may increase the risk include:
- Previous abdominal surgery
- Long-term constipation
- Obesity
- Smoking
- Infection after stoma surgery
- Malnutrition
- Use of steroids
The risk may also be higher if you:
- Are older
- Have or have had cancer
- Have diabetes
- Have high blood pressure
- Have a respiratory condition
These factors can affect how the abdominal wall heals and how much strain is placed on it.
Ways to manage a stoma hernia
If you are living with a stoma hernia, there are practical steps that may help you manage it more comfortably.
You may find it helpful to:
- Follow a balanced and nutritious diet
- Avoid heavy lifting
- Try gentle core exercises to support your abdominal muscles (your stoma care nurse may guide you)
- Sleep on the opposite side to your stoma
- Maintain good posture
- Regularly check your stoma to ensure it is functioning normally
- Wear any support garment provided to you
These small adjustments can help reduce pressure on the abdominal area and support your daily routine.
Moving forward with reassurance
Noticing a change around your stoma can feel unsettling at first. But stoma hernias are a recognised and relatively common part of life for many people with a stoma.
With the right advice, support and small adjustments, they can often be managed effectively.
And if you ever feel unsure, your stoma care nurse and healthcare team are there to guide you — helping you feel more confident and supported in your everyday life.
FAQ: Stoma hernia
How do I know if I have a hernia around my stoma?
A parastomal hernia often makes itself known through a visible bulge or swelling around the stoma, which may be more noticeable when standing, coughing or straining and may reduce when lying down. The area around the stoma may look uneven or the stoma itself may appear to have shifted position. Some people notice that their pouch no longer sits as flat or securely as it used to, or that leaks become more frequent due to the changed contour of the skin. A feeling of heaviness, dragging or mild discomfort around the stoma (particularly towards the end of the day) can also be an early indicator. If you suspect a hernia, a stoma care nurse or surgeon can confirm the diagnosis with a physical examination.
How long can a parastomal hernia be left untreated?
Many parastomal hernias — particularly smaller ones that cause little to no discomfort — can be managed conservatively for months or even years without requiring surgery. Regular monitoring, the use of a supportive stoma belt or hernia support garment, and avoiding heavy lifting can help prevent the hernia from worsening. However, leaving a hernia completely unaddressed without any medical supervision is not advisable. Over time, hernias can enlarge and become more difficult to manage, affect pouch fit, or — in rare but serious cases — lead to a strangulation of the bowel, which is a medical emergency requiring immediate surgery. The decision on when or whether to operate is always made on an individual basis together with a surgeon.
How do you treat a parastomal hernia?
Treatment depends on the size of the hernia and the symptoms it causes. For many people, conservative management is sufficient: a well-fitted stoma support belt or hernia garment can provide stability, reduce discomfort and help prevent further enlargement. Lifestyle adjustments — such as avoiding heavy lifting, maintaining a healthy weight and strengthening the core gently — also play an important role. If the hernia causes significant discomfort, makes pouch management very difficult or poses a risk of complications, surgical repair may be recommended. Surgery typically involves reinforcing the weakened area of the abdominal wall with a mesh, though the recurrence rate after repair can be relatively high, which is why conservative management is often preferred where possible.
What does a parastomal hernia feel like?
The sensation varies from person to person and depends on the size of the hernia. Many people describe a feeling of heaviness, fullness or a dull dragging sensation around the stoma, especially after a long day on their feet or after physical activity. Some notice intermittent aching or pressure in the area, while others experience very little discomfort at all — particularly in the early stages. The bulge itself may feel soft and slightly squishy to the touch, and in many cases it can be gently pushed back in when lying down. If the area around the stoma suddenly becomes hard, very painful or the stoma output stops, this could indicate a strangulated hernia and requires immediate medical attention.