What to do with stoma hernia

With the development of society, people's living standards have improved, and the development of science and technology has also been increasing, especially in medicine, where great progress has been made. In the past, when medical science was relatively backward, if people in China suffered from uncommon diseases, they had to go abroad for treatment. Now we can treat most serious illnesses ourselves, especially some major operations. Stoma hernia is a common surgical complication. So what should we do about it?

Parastomal hernia is a common complication after intestinal stoma surgery. It refers to a hernia formed when the contents of the abdominal cavity protrude abnormally through the weak abdominal wall or defect around the stoma. Hernia formation is related to the time after surgery. For example, the incidence of hernia within 1 year after surgery is 36% to 48%, while after 20 years it is 36% to 100%.

Causes

1. The stoma intestinal segment is poorly fixed or healed with the peritoneum and abdominal wall fascia, resulting in increased abdominal pressure and the small intestine or colon protruding from the stoma.

2. There is a gap between the stoma colon and the lateral peritoneum, and the small intestine herniates and causes internal hernia.

3. The stoma is located outside the rectus abdominis muscle, the fascia opening is too large, the abdominal muscles are weak (the elderly or those who have passed away), or the incision is infected or the muscle tone decreases due to weight gain.

4. The area around the abdominal stoma has undergone multiple surgeries, the abdominal wall is weak, and the abdominal pressure is continuously increased, such as chronic cough, burping, and straining to defecate or urinate.

Clinical symptoms

There are no obvious clinical signs in the early stage, only slight swelling next to the stoma. As the hernia gradually increases, it becomes more obvious when standing, and is often accompanied by abdominal pain, bloating and other symptoms. It decreases or disappears when resting or lying down.

Nursing measures

1. One-piece ostomy bags with softer bottoms should be selected as ostomy appliances, and two-piece ostomy bags, especially convex ostomy bags, should be avoided to reduce the problem of increased abdominal force on the patient when filling or operating the ostomy buckle and collecting bag to fit tightly.

2. If colostomy irrigation is performed on a lumen sigmoid colostomy or a single-lumen descending colostomy, the irrigation should be stopped.

3. Wear a suitable stoma belt to relieve local discomfort.

After using the stoma belt, the parastomal hernia was significantly reduced and the discomfort of abdominal distension was relieved.

4. Patients should not lift heavy objects and should use both hands to restrain the stoma site when coughing to reduce abdominal pressure. If the injury is serious, notify the doctor and assist the doctor in preparing for surgical repair.

Precautions

1. Observe whether there is any protruding mass on the abdominal wall on the side of the intestinal stoma, whether the mass retracts in the supine position, and whether there are any abdominal discomfort symptoms.

2. Avoid actions that increase abdominal pressure, such as lifting heavy objects, bending over, etc., and actively treat chronic cough.

3. When doing actions that increase abdominal pressure, such as coughing or sneezing, hold up the stoma with both hands and press inwards.

4. Eat a balanced diet and keep bowel movements smooth.

5. Have regular follow-up visits and resolve problems promptly if discovered.