Hernias and You
So your doctor or stoma nurse has just told you that you’ve got a hernia around your stoma or where you were cut open for your operation? You may well have a picture of the old fashioned trusses that were used to support hernias, but your hernia isn’t like that at all!
Let’s see what the problem is for ostomists who have a hernia (ostomists are people with a colostomy, ileostomy or urostomy).
There are two types of hernia which we, as ostomists can get. The first is called a parastomal hernia and the second is an incisional hernia. A parastomal hernia forms around your stoma and makes your abdomen stick out around the stoma. The bulge may be the size of half a tangerine, half an orange, or, in really bad cases, as big as half a melon! We need to think about our bodies for a bit to understand what has gone wrong. Under the skin of our abdomen, there is a flat sheet of muscle which holds our intestines in. When the surgeon made our stoma, he or she had to cut a hole in this muscle to bring the end of the small intestine (or ileum) in the case of an ileostomy or urostomy, or the end of the large intestine (or colon) in a colostomy, out to the surface of our abdomen. This, unfortunately, makes a weak area around the stoma and this can stretch, allowing, usually, a section of small intestine to be pushed up around the stoma, making the swelling.
How did you get this?
It could be that you’ve been lifting things, which were too heavy. Most ostomists have a recommendation to lift no more than 50lb, carefully, and some of us have a weight limit even lower than that because we have had several abdominal operations. The most likely cause, however, is a cough or, even more likely, a strong sneeze. These can increase the pressure inside our abdomens and actually push the small intestine out through the muscle, causing the skin to bulge around our stoma.
This is a real nuisance as the curved surface makes sticking the pouch and flange on more difficult, so leaks are more likely. Also there may be discomfort if the bulge is particularly big and it does make our waistlines larger than they were. They do tend to either disappear or get smaller when we lie flat on our backs, but that’s not much help, as we don’t spend all day like that!
The second type of hernia is the incisional hernia. When we had our surgery, most of us will have had a cut from somewhere below our ribs to a bit above our groin. The surgeon cuts through the skin and muscle to get to our intestines. The problem is that scar tissue which joins the muscle back together again isn’t as strong as the muscle. This means it can tear, particularly if we’ve had more than one operation there, as the surgeon will try to open up the same cut each time more surgery is done. If the scar tears, then the intestine underneath can be pushed through to make a bulge. The same causes of lifting, sneezing and coughing apply here too. You would notice a lump somewhere along the line of the scar, which, again, tends to disappear when lying flat.
If you think you’ve got a hernia, you must discuss this with your doctor or stoma nurse to make sure that the lump or swelling is a hernia. It is best to have this checked so that you can get proper advice and guidance. So what can we do about either of these types of hernias? Firstly we must avoid making them worse! So be extra careful when lifting, and try to support your abdomen when coughing or sneezing by putting a hand on and around your stoma. You might think about surgery. Unfortunately surgery to repair a parastomal hernia or incisional hernia is only about 50% effective. So half of the people who have surgical repair will get their hernia back again or, even worse, have to have more surgery to remove the plastic mesh which the surgeon used to do the repair because it has got infected. This can be even worse than it sounds already, as the wound may have to be left open to heal from the inside out as the infection may prevent it from being stitched or clipped closed.
However, all is not lost!
Fulcionel make a range of really effective support garments for men and women who have either incisional or parastomal hernias. The range is designed to effectively support the hernia as well as reduce the lump of the hernia, this assists greatly to allow the flange to stick properly. In fact, I’m wearing mine as I write this! They are available on prescription in a range of attractive styles and your stoma nurse can measure you to ensure that you get a good fit. Do remember that, as an ostomist, you are entitled to free prescriptions no matter what your age. Your stoma nurse can fill in the form for you to get free prescriptions if you don’t get them already. This means, of course, that you will be supplied with your Fulcionel garments at no cost to you! The garments wash at 40C for normal washing and can be tumble dried on the low heat setting afterwards. Or, if they become soiled, they can be washed at 60C for hygiene reasons, but still tumble dried on the low heat setting. They are made of top quality, long lasting stretch and other materials by the UK’s top manufacturer of underwear, so the garments are of the highest possible quality and wash and wear beautifully.
If you have a colostomy, you may choose to have a garment with no hole for the stoma pouch as your stoma only ‘works’ occasionally. However, if you have an ileostomy or urostomy, then you can have a hole cut in the garment to fit around your pouch. Your stoma nurse will make sure that the hole is in the right place and you will be asked to send a sample of your pouch and flange as the garments are made specifically for you, rather than, as with other manufacturers, with a draw string around the hole on the ‘one size hole fits everybody’ principle. In fact, the Fulcionel garments can also be supplied with two holes for stoma pouches for ‘greedy people like me who have two stomas – in my case, an ileostomy and a urostomy. I can assure you that both the fit and support is excellent! The garments are worn during the daytime only. You would take them off for having a bath or a shower and also when going to bed.
There is another type of hernia which is helped by the Fulcionel garment. This is the umbilical hernia which is rather like an incisional hernia. In this case, the hernia pushes the ileum though the weak area around the umbilicus or navel, making a bulge very similar to an incisional hernia. The Fulcionel garment helps with this by supporting the hernia in the same way as it does for an incisional hernia. However the hernias which other people get – femoral and inguinal hernias – aren’t suitable for the Fulcionel garments as it was not designed to help with these since surgery is very effective in dealing permanently with these. The inguinal hernia, a male problem, is where a loop of ileum is pushed down where the spermatic cord leaves the abdomen to pass down to the testicle in the scrotum. It would appear, in the worst cases, as a swollen scrotum because of the ileum pushed into it. The other is the femoral hernia, which happens when a loop of ileum is forced down the femoral canal where the nerves and blood vessels to the leg leave the abdomen to go to the leg. It is felt as a bulge in the groin. Do remember that if you have either of these, that you should discuss this with your doctor who will almost certainly refer you for surgery. It is often day case surgery for the inguinal and femoral hernias with swift recovery and virtually 100% success rate.
Doctors are trying to invent new ways of dealing with the hernias that affect ostomists, particularly the parastomal hernia. However, success is still limited and wearing a well-designed support garment such as the Fulcionel is the best way of dealing with parastomal and incisional hernias in the long term.
With your stoma properly supported, any pain or discomfort disappears
You are then able to get back on with living. Your waist is flattened too because you won’t have the lump from your hernia showing any more because the Fulcionel garment is providing proper support for you. Having tried other, inferior support garments, I can assure you that the Fulcionel garments really do help to stop hernias from becoming worse and the support does give a sense of reassurance and comfort.
This article was written by Terry Gallagher who had a colostomy in the past, and now has an ileostomy and a urostomy with hernias around both stomas, and an incisional hernia additionally. His recommendation of Fulcionel garments is made purely from his own personal experiences with both Fulcionel and other support garments.
So your doctor or stoma nurse has just told you that you’ve got a hernia around your stoma or where you were cut open for your operation? You may well have a picture of the old fashioned trusses that were used to support hernias, but your hernia isn’t like that at all!
Let’s see what the problem is for ostomists who have a hernia (ostomists are people with a colostomy, ileostomy or urostomy).
There are two types of hernia which we, as ostomists can get. The first is called a parastomal hernia and the second is an incisional hernia. A parastomal hernia forms around your stoma and makes your abdomen stick out around the stoma. The bulge may be the size of half a tangerine, half an orange, or, in really bad cases, as big as half a melon! We need to think about our bodies for a bit to understand what has gone wrong. Under the skin of our abdomen, there is a flat sheet of muscle which holds our intestines in. When the surgeon made our stoma, he or she had to cut a hole in this muscle to bring the end of the small intestine (or ileum) in the case of an ileostomy or urostomy, or the end of the large intestine (or colon) in a colostomy, out to the surface of our abdomen. This, unfortunately, makes a weak area around the stoma and this can stretch, allowing, usually, a section of small intestine to be pushed up around the stoma, making the swelling.
How did you get this?
It could be that you’ve been lifting things, which were too heavy. Most ostomists have a recommendation to lift no more than 50lb, carefully, and some of us have a weight limit even lower than that because we have had several abdominal operations. The most likely cause, however, is a cough or, even more likely, a strong sneeze. These can increase the pressure inside our abdomens and actually push the small intestine out through the muscle, causing the skin to bulge around our stoma.
This is a real nuisance as the curved surface makes sticking the pouch and flange on more difficult, so leaks are more likely. Also there may be discomfort if the bulge is particularly big and it does make our waistlines larger than they were. They do tend to either disappear or get smaller when we lie flat on our backs, but that’s not much help, as we don’t spend all day like that!
The second type of hernia is the incisional hernia. When we had our surgery, most of us will have had a cut from somewhere below our ribs to a bit above our groin. The surgeon cuts through the skin and muscle to get to our intestines. The problem is that scar tissue which joins the muscle back together again isn’t as strong as the muscle. This means it can tear, particularly if we’ve had more than one operation there, as the surgeon will try to open up the same cut each time more surgery is done. If the scar tears, then the intestine underneath can be pushed through to make a bulge. The same causes of lifting, sneezing and coughing apply here too. You would notice a lump somewhere along the line of the scar, which, again, tends to disappear when lying flat.
If you think you’ve got a hernia, you must discuss this with your doctor or stoma nurse to make sure that the lump or swelling is a hernia. It is best to have this checked so that you can get proper advice and guidance. So what can we do about either of these types of hernias? Firstly we must avoid making them worse! So be extra careful when lifting, and try to support your abdomen when coughing or sneezing by putting a hand on and around your stoma. You might think about surgery. Unfortunately surgery to repair a parastomal hernia or incisional hernia is only about 50% effective. So half of the people who have surgical repair will get their hernia back again or, even worse, have to have more surgery to remove the plastic mesh which the surgeon used to do the repair because it has got infected. This can be even worse than it sounds already, as the wound may have to be left open to heal from the inside out as the infection may prevent it from being stitched or clipped closed.
However, all is not lost!
Fulcionel make a range of really effective support garments for men and women who have either incisional or parastomal hernias. The range is designed to effectively support the hernia as well as reduce the lump of the hernia, this assists greatly to allow the flange to stick properly. In fact, I’m wearing mine as I write this! They are available on prescription in a range of attractive styles and your stoma nurse can measure you to ensure that you get a good fit. Do remember that, as an ostomist, you are entitled to free prescriptions no matter what your age. Your stoma nurse can fill in the form for you to get free prescriptions if you don’t get them already. This means, of course, that you will be supplied with your Fulcionel garments at no cost to you! The garments wash at 40C for normal washing and can be tumble dried on the low heat setting afterwards. Or, if they become soiled, they can be washed at 60C for hygiene reasons, but still tumble dried on the low heat setting. They are made of top quality, long lasting stretch and other materials by the UK’s top manufacturer of underwear, so the garments are of the highest possible quality and wash and wear beautifully.
If you have a colostomy, you may choose to have a garment with no hole for the stoma pouch as your stoma only ‘works’ occasionally. However, if you have an ileostomy or urostomy, then you can have a hole cut in the garment to fit around your pouch. Your stoma nurse will make sure that the hole is in the right place and you will be asked to send a sample of your pouch and flange as the garments are made specifically for you, rather than, as with other manufacturers, with a draw string around the hole on the ‘one size hole fits everybody’ principle. In fact, the Fulcionel garments can also be supplied with two holes for stoma pouches for ‘greedy people like me who have two stomas – in my case, an ileostomy and a urostomy. I can assure you that both the fit and support is excellent! The garments are worn during the daytime only. You would take them off for having a bath or a shower and also when going to bed.
There is another type of hernia which is helped by the Fulcionel garment. This is the umbilical hernia which is rather like an incisional hernia. In this case, the hernia pushes the ileum though the weak area around the umbilicus or navel, making a bulge very similar to an incisional hernia. The Fulcionel garment helps with this by supporting the hernia in the same way as it does for an incisional hernia. However the hernias which other people get – femoral and inguinal hernias – aren’t suitable for the Fulcionel garments as it was not designed to help with these since surgery is very effective in dealing permanently with these. The inguinal hernia, a male problem, is where a loop of ileum is pushed down where the spermatic cord leaves the abdomen to pass down to the testicle in the scrotum. It would appear, in the worst cases, as a swollen scrotum because of the ileum pushed into it. The other is the femoral hernia, which happens when a loop of ileum is forced down the femoral canal where the nerves and blood vessels to the leg leave the abdomen to go to the leg. It is felt as a bulge in the groin. Do remember that if you have either of these, that you should discuss this with your doctor who will almost certainly refer you for surgery. It is often day case surgery for the inguinal and femoral hernias with swift recovery and virtually 100% success rate.
Doctors are trying to invent new ways of dealing with the hernias that affect ostomists, particularly the parastomal hernia. However, success is still limited and wearing a well-designed support garment such as the Fulcionel is the best way of dealing with parastomal and incisional hernias in the long term.
With your stoma properly supported, any pain or discomfort disappears
You are then able to get back on with living. Your waist is flattened too because you won’t have the lump from your hernia showing any more because the Fulcionel garment is providing proper support for you. Having tried other, inferior support garments, I can assure you that the Fulcionel garments really do help to stop hernias from becoming worse and the support does give a sense of reassurance and comfort.
This article was written by Terry Gallagher who had a colostomy in the past, and now has an ileostomy and a urostomy with hernias around both stomas, and an incisional hernia additionally. His recommendation of Fulcionel garments is made purely from his own personal experiences with both Fulcionel and other support garments.
Hernia Support
Fulcionel is designed for hernia support. Using the latest fabrics, the range offers a wide selection of styles and options for both ladies and men. A fitting service is offered to ensure the most effective level of support is provided for the wearer.
The complete Fulcionel range is available on prescription.
CUI DRI is owned by CUI International, a leading healthcare company specialising in medical garments for incontinence, ostomy and hernia support.
For more information, click here.
Fulcionel is designed for hernia support. Using the latest fabrics, the range offers a wide selection of styles and options for both ladies and men. A fitting service is offered to ensure the most effective level of support is provided for the wearer.
The complete Fulcionel range is available on prescription.
CUI DRI is owned by CUI International, a leading healthcare company specialising in medical garments for incontinence, ostomy and hernia support.
For more information, click here.
