The topic at hand is about dealing with a parastomal hernia, often referred to as a "stoma bulge," which can develop after having a colostomy. This particular person has been living with a permanent colostomy for ten years following rectal cancer surgery. Over time, a small hernia has appeared around the stoma, which is more of an annoyance than a source of pain. Despite losing weight gained during the COVID lockdown, the hernia remains. They are seeking ways to reduce or manage the hernia without resorting to wearing a support belt or undergoing surgery.

Here are some pieces of advice and insights shared by others:

1. Abdominal-muscle training
- A clinical trial in the UK is exploring whether specific core exercises can help shrink or stabilize parastomal hernias.
- Safe exercise options include light, ostomy-adapted abdominal exercises and Pilates, but it's important to consult with an instructor.
- A suggested physical therapy exercise involves lying on your side, inhaling, then exhaling while pulling your navel inward for a count of ten. Repeat this ten times on each side. It's crucial to have a physiotherapist tailor the program to your needs, as incorrect exercises like traditional sit-ups might worsen the hernia.

2. Support garments or belts
- Many people recommend wearing a hernia or support belt to prevent the bowel from protruding further. While belts won't reverse a hernia, they can help stop it from getting bigger.

3. Surgical considerations
- The only sure way to eliminate the bulge is through surgical repair, which involves closing the muscle defect and returning the bowel to the abdominal cavity.
- It's advisable to consult with an abdominal surgeon, not just a colorectal one, to understand your options in case the hernia grows or complications occur, even if you decide to delay surgery.

4. Risk management and lifestyle
- Maintaining your current lower weight is important, as extra abdominal fat can increase pressure on the weakened muscle area.
- Engage in low-impact fitness activities like walking, biking, or swimming.
- Avoid heavy lifting, forceful coughing, or strenuous core exercises that could worsen the hernia.