• Most para-stomal hernias are asymptomatic and require reassurance that a surgical repair is not needed.
- A cautious approach should also be taken for those with mild symptoms, particularly if frail or significant other illnesses exist, because of the high recurrence rates following surgery.
- Most patients with mild symptoms can be managed with stoma hernia belt which is much like a corset.
- Life threatening complications are rare. Urgent or emergency repair is sometimes needed because of obstruction or risk of bowel twisting or strangulating. Patients should be educated about signs and symptoms of acute obstruction or strangulation which include vomiting, abdominal pain, and extreme tenderness over the hernia. If these occur, the patient should be advised to present to hospital early to be assessed by a surgeon.
• Surgery (with / without mesh)
Common indications for elective repair include:
a) Increasing size of the para-stomal hernia
b) Skin breakdown or dermatitis around the stoma
c) Intermittent bowel obstruction
d) Stoma appliance dysfunction and leakage
Note: Laparoscopic para-stomal hernia repair has more recently increased in popularity.