Symptoms · Stoma
A bulge beside a stoma
The short answer
A bulge beside your stoma, especially when you cough or stand, is usually a parastomal hernia: bowel pushing through the muscle wall next to the stoma. It is the most common later problem with a stoma and can make the bag leak. Many can be managed with a support belt and watchful waiting. Go to the emergency room if the bulge is hard and painful, or if the stoma stops working with vomiting or a swollen belly.
How patients describe it
- A bulge next to my stoma
- The bag does not stick any more
- My stoma looks longer than before
- A heavy feeling around the stoma
- Pain near the stoma
Go to the emergency room now if you have
- A hard, very painful bulge
- No output from the stoma, with vomiting or a swollen belly
- A stoma that turns dark, purple or black
- Heavy bleeding
- Sudden severe pain
What can cause it
Parastomal hernia
A bulge beside the stoma that grows with coughing or standing. The reported rate varies widely, from about 5 in 100 to as many as half of people within two years.
Next step: Examination; a scan if needed.
Stoma prolapse
The bowel pushes out through the stoma, which looks longer. It happens in about 3–10 in 100 people.
Next step: See your stoma nurse or surgeon.
A swelling or abscess near the stoma
A tender, red or hot lump with or without pus.
Next step: See a doctor the same day.
A bowel blockage
Cramps, vomiting, a swollen belly, and no output.
Next step: Go to the emergency room.
What you can do now
- Wear a support belt or hernia support if your stoma nurse advises it
- Avoid heavy lifting and straining
- See your stoma nurse about the fit of the bag
- Aim for a healthy weight
- Tell your surgeon if you are planning to have the stoma reversed
Tests your doctor may order
- Examination standing and lying down
- Ultrasound or a CT scan
When is surgery needed?
- Many parastomal hernias are managed without surgery.
- Repair, usually with a mesh, is for a hernia that is painful, blocks the bowel, or makes the bag unmanageable.
- Reversing the stoma, when possible, removes the stoma itself. Your surgeon will explain whether it suits you.
Related operation guides
Questions people ask
Can I exercise with a stoma hernia?
Walking is good. Avoid heavy lifting and sit-ups, and use a support belt if your stoma nurse advises it.
Will it get bigger?
It may grow over time. Supporting the area and avoiding straining helps.
Will reversing the stoma fix it?
Reversal can remove the need for a bag. A hernia can also form at the old stoma site, so discuss the plan with your surgeon.
This page gives general information and does not replace the advice of your treating team. In an emergency, go to the nearest emergency room.