G-Day fellow MaOs,
I have just been informed by one of the companies that make belts for hernias that the belts with a hole in the middle make the hernia worse. It acts like a convex wafer and pushes the hernia out more. Think about it; it makes sense.
Regards, IGGIE
Wow - this makes sense to me and probably the very reason I cannot wear that dang thing! Even though I was measured by two stoma nurses, it made both my hernia and my stoma look like a pimple that was about to pop - NOT A PRETTY SIGHT…and not comfortable at all… Your post has relieved some of my guilt for not wearing it - THANKS IGGIE…jb
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I take part in these forums almost every day. They and the people that contribute to them have made all the difference in my having the courage to live a normal life with an ileostomy. The people here are marvelous and come from all walks of life and from all over the world. Hearing what others have lived through has really helped me put my own experience in perspective. I highly recommend all ostomates and caretakers of ostomates to come join us.
Yes, it's true they don't give the hernia the support it needs, and doctors and ostomy nurses have been saying it for as long as I can remember. Keep up those core exercises; even with a hernia, it's the best thing you can ever do to help yourself.
How would you even wear a belt without a hole? Wouldn't it just cause pancaking?
For my belt at least, the hole is barely big enough to pull the bag through. It hugs the ring where the bag attaches to the wafer (2-piece system) and basically holds down the wafer. The hernia would need to pop through the wafer in order to pop through the hole.
Not arguing, but I can't make a bit of sense out of what's being said.
Perhaps it has something to do with a one-piece vs. a two-piece system? jb
I have a hernia and wear a stealth belt, which my ostomy nurse said does not give me enough support. It also causes my output to pancake. She recommended that I order a Nu-Hope hernia support belt. I hope it will help keep the hernia from getting larger, as I am so frustrated with spending my money on colostomy products that don't work for me. They are quite expensive.
Hello all,
Thank you so much, Iggie, for posting this universal topic!
Understanding what a hernia is and, hence, its potential prevention is so fundamental for all of us.
Clearly, 'Prevention is better than cure'.
Clear education, even prior to surgery, needs to be the norm in respect to patient understanding... because so many ostomates have never been appraised of the dangers of lifting, straining, sneezing, and coughing; couple this with a lack of weight management and body tone management, and we have danger because of the inherent weakness of our stomas - passing through [breaching] our abdominal wall!
So we need to learn to mitigate our weakness - and from day one of our surgical colectomy!
In my humble opinion, any form of support worn needs our careful consideration:
If 'cure' becomes necessary, then wear something as a supplement - as a preventive part of our management against further stress/damage - but use a bespoke support garment rather than an off-the-shelf device.
Also, as has already been said here, appropriate bespoke 'measured' [controlled] exercise - according to one's state of recovery [age, fitness, and lifestyle - per our Body Mass Index (BMI)] and procedures/complications:
This can be a positive endorsement as muscle wastage is singularly unhelpful - as is body fat, poor tone, and poor posture [we need to aid our own support of our stomas and redirected gut].
There is no one solution to fit all - we are individuals, and also if we have a hold-up or backup whereby there is excess in our tract that is not clearing through and being expelled through our stoma, this will have an unduly detrimental pressure and potentially cause more damage... so diet and times of eating in relation to one's activities/lifestyle is an encompassing part of the equation.
We need to be true to ourselves and do, with due diligence, what works best diet and lifestyle-wise for our individual circumstances.
Early awareness to avoid emergency surgery:
There is no 'easy' solution - and even using a bespoke garment needs 'considered' design and use -- especially in cases where a looped bowel has pushed through the abdominal wall - the danger here is an unmanaged blockage - which, if left to build, is then requiring emergency surgery to resolve... It is always far better to try and be mindful when an exacerbation is building - and take extra care so that the additional buildup/stress on the abdominal wall is counter-managed wherever possible... For it is a given fact that the outcome stats for elective surgical repair far outweigh the trauma of emergency unplanned intervention by a non-familiar surgeon who has no former knowledge of his/her patient.
The cynic/'accuracy' would point out that the stoma is in itself a breach of the abdominal wall - creating a fundamental weakness - and as such, there is no fail-safe long-term answer to an eroding situation - just our best education and our best focus in honest diligence of responsible self-management!
That said, there are some amazingly focused and experienced surgeons who are able to go the extra miles to help - but in the end, as Iggie says, we need to "think about it" ... very carefully ... and then be honest and mindful of how we manage our own situations - every day!
Valuable patient self-help resource for the prevention and management of hernias:
I would love to be able to access a full professional exposition of this very topic on here - written by a medically informed ostomate - for it is, in my opinion, a much misunderstood element of our education - because we are not taught how to best prevent and help ourselves to mitigate further damage when our weaknesses in the abdomen cause a need for support. Support being in the form of practical preventative behavior which, in my humble opinion, needs to be impressed upon us as a positive need to understand - not a complication that can be dismissed!
Perhaps if there are medics/specialists/physios who are able to be definitive - this might help enormously - and as a non-medic and non-trained therapist, I might find such a practical and fully explained discourse invaluable!
AI can also help in this regard, particularly when fully queried with all its sources [citation links] defined - MAO would be helping its members in addressing this research as the practical prevention and treatment of the hernia is a topic relevant to every member on site!
Thank you.
Best wishes to all
~ ~ ~ ~ ~ Jayne ~ ~ ~ ~ ~
My ostomy nurse also recommended the NuHope hernia support belt. I'm still waiting on it to arrive as my double ostomy status requires a custom-made belt. Fortunately, insurance is paying for this one.
The belt I have is similar to a Stealth Belt (I think). It provides quite a bit of pain relief.
Both the belt I have and the NuHope belt have holes in them.
That's my goal today: reach out to Nu-Hope and see if they have a belt that will work with my current bag. I did my walk yesterday; I'm up to 20 minutes now, YAY! I was okay, but then later in the day it hurt, and I was so very tired. I sometimes think that pain is exhausting in itself.
I know there aren't many here that post or comment from the UK. In the latest I.A. journal, there is the best info I've ever seen written about support garments and hernia belts: understanding the myths, evidence, and benefits. It's well worth reading for anyone who can get a copy of it.
IA = Ileostomy and Internal Pouch Association
https://iasupport.org/information-support/
Edit / additional info:
As a few members on here also are double baggers - please see my comment in reply to Ben's helpful suggestion ............. I turned up specific sites [2] for double baggers AND a raft of pertinent info for hernia understanding and management.
Suggest perplexityai is worth using - because the subject is explorable and providing one does the full groundwork one can begin to gain a balanced understanding of the more subtle points involved - because it seems that the balance of benefit and reward is an involved - and personal equation.
Best
J
When I got my parastomal hernia a couple of years ago, my surgeon operated and got rid of it.
IGGIE
Hole vs No Hole
There have been differing opinions in the literature on whether a hole is necessary in the garment/belt. The argument "against" states that a hole should not be made to ensure the support is evenly distributed across the abdomen. Others suggest that placing a hole in the garment/belt ‘mimics' the problem it is trying to relieve.
The argument "for" states there are times when a hole allows a person to wear a garment/belt without causing further problems. The hole allows the pouch to be pulled through and worn outside the garment/belt — this can allow free passage of urine, feces, and flatus and may reduce pancaking and anxiety about pouch leakage.
In general, convex appliances are not recommended for hernia management, but a hole may avoid additional pressure coming from the garment/belt covering the convex part of the appliance. Also, a garment/belt with a hole still provides support for the weight of a large hernia — care must be taken with the size of the hole to avoid stoma prolapse or the skin bulging through.
It can take a bit of trial and error before finding a belt that is comfortable and provides hernia support. The idea is to provide some compression while supporting the hernia.
The "Nurses Specialized in Wound, Ostomy and Continence Canada. (2023, May). Parastomal Hernia Prevention, Assessment, and Management: Canadian Best Practice Recommendations. 1st Ed." document contains the following statements:
"A support garment without a stoma opening (hole) to accommodate the ostomy appliance provides consistent support distributed across the abdomen and hernia. If the support garment has too large a hole created to accommodate the pouching system, there is potential for the stoma to prolapse or the skin to bulge through the hole in the garment. Stomas that require a convex wafer may have extra pressure applied to the peristomal skin from too small a hole in the garment and particularly if the hole is reinforced with extra material or plastic. Poorly fitting garments or garments that are not worn tightly may shift with activity during the day and disrupt the ostomy pouch, potentially causing leakages.
Conversely, in some cases, depending on stool consistency and level of bowel activity, support garments without a hole for the ostomy pouch may contribute to leakage problems and other issues by holding effluent close to the wafer, pancaking the stool, limiting the capacity of the pouch, and impeding the release of gas buildup. Also, there is a convenience to emptying the pouching system when it is free and external to the support garment, allowing the patient to empty the pouch without having to remove or alter the garment to do so.
To avoid these complications regardless of whether a support garment has a hole or not, it is important for the support garment to be properly fitted and sized, taking into account the person's wishes and comfort and providing the person with continued adjustments or support. The use of belts is individual and not all individuals will need or want a support belt."
Thank you, ATraveler.
Bespoke Solution
The advantage of bespoke design and individual making allows a garment to accommodate a perfectly positioned, correctly sized hole - AND the personal freedom of comfort and use.
Getting the hole exactly the correct size and located in exactly the correct position [laterally and medially corresponding to the middle of one's stoma] within a garment is paramount [millimeters can make a HUGE difference in practicality and comfort].
- Hence, I personally have found the need for a bespoke garment - which actually allows for ladies' personal use throughout the day and night to be achieved without continual removal of the garment [merely the camisole gusset opening and closing - which has been designed to actually work and remain clinically clean during use].
The garments are changed daily and are made in different colors to match bras and bags - thus having a number to wear in rotation offers practicality and certainty of purpose. Clearly, design may be specific, allowing for intimate use and facilitating convenient toileting - unimpeded - whilst also being acceptably 'attractive' and not carrying the look and feel of a medical brace. Appearance makes a huge difference to morale and personal well-being - and ditching the medical appliance feel is a huge bonus - particularly for those who have an active personal life.
I realize that the bespoke route may not be suitable for everyone - but where the need is evident here in the UK, such garments may be specified by one's health professionals [GPs / Consultants] and, as such, may be obtained via the NHS.
It would be inappropriate for me to mention a commercial company here on an open forum .... but it is through a recognized supplier who is accredited to work with the NHS that supplied my garments.
Understand that a time investment is required, as well as a focused intention NOT to give up at the hurdles along the way - some knowledge of your own body and an ability to work as a professional team member allowed me to obtain what eventually was made.
Bespoke solutions take TIME and, by their nature, are not an immediate solution - but an off-the-shelf garment will suffice while the process is pursued.
Hope this helps.
BW
Jayne
UK
There are also good quality garments available as standard sizes and designs.
Personal choice / professional opinion may vary as to the use of a support garment with or without holes, as this will depend upon one's own surgical history and specifically the nomenclature required.
I would add that being persistent and fully involved with the process in order to arrive at a solution specifically designed for oneself is both time-consuming and a challenge - but without a doubt, the rewards when finally the workable garment is put to use are TRANSFORMING.
There ARE solutions to be found - but sometimes these take time and much determination to access.
In my own case, the current garments that I wear are, in fact, providing a 'holding' solution prior to further stages of reparative surgery .... BUT, I WILL WEAR SUPPORT GARMENTS WHEN SURGERY IS COMPLETED - AND BY CHOICE, for if fitted correctly, in time BEFORE a problem develops, this has to be a considerable option - the potentials being more surgery further down the line.
Clearly, it is a very personal journey to find and obtain a solution that suits - in my own experience, whilst 'off-the-shelf' solutions have been reasonable, the comfort and 'freedom' and personal feel-good factor in terms of self-confidence and 'protection' has been a journey worthwhile. One does like to feel 'well presented' and 'safe' whether in intimate mode or daily toileting mode - and saying goodbye to the surgical look, feel, and discomfort of off-the-shelf 'medical' braces/support tubes/sportswear is just another step to reclaiming one's femininity.
BW
Jayne
UK
Ben,
Thank you for your comments - most helpful.
I have found if one copies 'hernia belts: understanding the myths, evidence, and benefits' and puts this into say Perplexity AI - a huge raft of further information comes up - particularly when working through the further info options and checking the citations.
Much medical information may also be obtained including studies and commercial companies too.
One of the other helpful elements to gain access to is the various folk who run their own sites and blogs etc - here firsthand experience may be further shared and a sense of specific experience may be shared - including double baggers and other more specialist medical conditions involving the management of stomas.
And indeed the articles to which you refer within Ia and other information may be obtained.
BW
J
Yes Iggy, your point is well taken:
In summary, while hernia belts can offer temporary relief from symptoms, they are not a cure and should be used cautiously under medical supervision. Surgical repair remains the definitive treatment for hernias.
However, for a number of reasons, management to support the abdomen may be required along the way, and for many prior to the formation of a problem.
Thank you so much for opening this topic - it is a crucial question and needs to be understood by us all.
I am so pleased for your personal surgical solution - I wish you well with it and also appreciate that at the end of the day it is a personal choice whether or not, and when, and what type of support folks use - there is no one solution to fit all ......
but in your own wise words .......... we need to think about it
I think many of us have been told that surgical repair is to be avoided and that surgeons are reluctant to take on such a repair. So, some sort of alternate solution is needed.
Hence, the entire line of ostomy support garments. The appropriateness of a support garment will vary greatly by individual. Stoma placement, the amount of support needed, and personal aesthetic impact choice are all factors. I have to contend with two stomas, which means most readily available options do not work for me. I can't really comment on anything besides a belt since that's all I've found that can be modified for me.
Of course, having a support garment is not a replacement for core strengthening exercises.
Well, the whole surgery thing for my hernia takes place at the end of April. The hernia finally became so large and non-reducible that they could not get the scope through to check for recurring cancer (5-year schedule now). One of the things that is mandated in the surgery recovery package is wearing a support belt. We will see exactly what kind of belt that will be and how everything goes. As I recover enough to get back on the computer, I will let everyone know how it goes and what kind of belt they will be giving me.
Anything that acts like a convex wafer leads to a blockage of my ileostomy and puts me in the hospital for a couple of days. I have had my stoma for 40 years and cannot take the chance with a belt or convex wafer. Iggie is spot on, in my opinion. Be very careful with what you use. I feel there is a real shortage of professionals who are aware of many of these issues.
G'day Iggie,
I posted this in 2019, and you immediately replied to it. Memory slipping, old son :)
By the way... 2 months ago, I had that parastomal hernia surgery that you recommended. Thank you :)
Jun 05, 2019 10:41 am
I just noticed that my last post is out of date and, in fact, wrong.
A proper hernia belt should not have a hole in it. I have been wearing an approved belt for a few months now. Oddly, I have found that the adhesive spread and creasing issue (that I earlier posted a pic of) has completely gone. The second and very pleasing aspect with the belt on is that my stoma bulge disappears and is no longer apparent as a bulge through light clothing :)
Hi Oztomate
I am not sure where in your message my memory was slipping. I have only been a member since 2022.
IGGIE
I owe you an apology, Iggie.
You were the very next reply to my 2018 post, but I failed to actually look at the date/time of your reply. It is a pity that this forum does not have a link-to-post feature I could quote, but here is a copy of your post...
Feb 03, 2023 12:34 am
Reply to OzTomate
Good news, Oz. Let's hope it stays that way and that life gets better for you. Regards, IGGIE (Melbourne)
But again, you inspired me to have the hernia op and it has been fab ever since with a flat belly :)
That's great news, mate. Glad you got rid of the little bugger. Where in Vic are you?
IGGIE
Susan is correct. I've been wearing my stealth belt for 4 years. No problems. I have a prolapse, and it does not change it. If you have a hernia adjacent to your stoma, they custom make a belt with a firm area that secures that spot. It costs another $10.
I agree with you. I have a urostoma and wear a belt after each change for a day usually. I find it comfortable. I have a very large hernia, about the size of half a large grapefruit. I also believe that a belt will not prevent or even improve a hernia. But I do not wear one every day.
jim7
I have been wearing a support belt for a month now, and I am not sure that it's doing much except being hot and sweaty.
It was issued by the stoma nurse who specializes in supports.
It has a plastic cup open at the bottom that goes over the stoma, so it doesn't stop any issue.
However, I have to be very careful when bending, as it squeezes the pouch and can force a leak. Since wearing it, I have to change my pouch every day instead of my usual 2 or 3 days.
Anyone else have this type of support?