Many people are fine from that point on. But as we grow older, there is a tendency for our muscles, including the abdominal wall muscles, to lose strength. Where there is a weakness, our muscle tone tends to decrease and the muscles will spread a little. Around the colostomy, the muscle will spread more. As a result, the piece of intestine, instead of coming out straight, will start to curl in the extra space. Someone who could irrigate very easily before, now has trouble because the intestine is folded. If the peristomal hernia becomes very large, or if another piece of the intestine gets caught in the space, major problems arise. If an obstruction occurs, emergency surgery may be required.
Most people who have a peristomal hernia do not have to do anything unless the hernia enlarges to a point where it causes pain. It may also mean that some who have irrigated in the past may not be able to irrigate at all, or the irrigation may take longer. Colostomy hernias are being repaired but while it appears that the surgeon should just tighten the muscle, it cannot be merely pulled together. The colostomy must be taken out of its present location and moved to another spot. Such an operation is not as big as the original surgery, but it is significant. The doctor will weigh the need for such an operation against the severity of the problem. What can one do to avoid a hernia? Don't put on weight. When you do, you stretch the abdominal muscle; and if you have a colostomy in a weakened area, it will get weaker. If you are round and full, try to lose some weight and take the pressure off that muscle.
