This topic is about a person who has noticed their stoma, created from a colostomy two years ago, is growing larger and is wondering if this is normal or if it might be a sign of a problem. They are also considering switching to a larger barrier size and are seeking advice on whether this growth is concerning and when to seek medical advice.

Here are some helpful insights and advice:

1. The stoma was initially recessed and about 25 mm long. The person started with a Hollister convex two-piece cut-to-fit barrier, which has a maximum size of 1-½ inches (38 mm). Over time, they needed to cut larger openings, but there were no leaks, and the output was formed.

2. In the past year, the stoma's growth has accelerated, reaching the edge of the 1-½ inch barrier. They switched to the next Hollister convex size (2-¼ inches or 57 mm) but still cut it at 1-½ inches. The stoma is now not only wider but also protrudes further.

3. Flat barriers were tried but caused issues like "smashing" and pancaking, so convexity works better for them.

4. They are seeking opinions on whether this growth spurt is worrisome and if or when they should seek a medical review.

5. A self-assessment identified a parastomal hernia, which is currently asymptomatic. They plan to start core-strengthening exercises and monitor the situation, noting that prior heavy lifting and prolonged sitting may have weakened their abdominal wall. They are also concerned about the cost of specialized hernia-support garments.

Advice and insights from others include:

- Consult professionals promptly. It's advised to contact the surgeon or ostomy/WOC clinic right away, as unexpected size increases after the initial 6-8 week post-op period can signal issues like prolapse, obstruction, or hernia. Ask to be put on the surgeon’s cancellation list to be seen sooner.

- Differentiate possible complications. A prolapsed stoma usually lengthens but does not widen. A sudden diameter increase accompanied by discomfort or constipation can precede bowel obstruction. If the output remains normal and there is no pain or constipation, the urgency is lower, but evaluation is still recommended.

- For parastomal hernia management, use a properly fitted hernia belt or support garment before beginning any core exercise. Brands like NuHope hernia belt are often insurance-covered in the U.S. Get measured by an ostomy nurse or clinic; the belt should have a customized opening so the pouch/stoma protrudes freely and the output is not blocked. Supportive “hernia pants” are another option; users report good support, and they can be found via NHS supply, Amazon, or eBay.

- For exercise guidance, start only with gentle, low-impact abdominal routines designed for ostomates. Check out ConvaTec’s me+ Recovery Series Phase 3 exercises. Progress slowly, as patience prevents enlarging the hernia. Always wear support when doing any lifting, push-ups, sit-ups, or heavier core work.

- Regarding barrier and pouching considerations, continuing with Hollister convex barriers is fine if they prevent pancaking. Switch sizes as needed to keep a snug fit around the stoma. Monitor for further growth; if the diameter approaches the 2-¼ inch limit, inform your supplier so larger cut-to-fit options can be arranged.