This topic is about managing a large parastomal hernia that developed alongside an ileostomy, which occurred after complications from spinal surgery. The person dealing with this situation has found it challenging to get local support and is seeking advice on how to manage the hernia, especially since surgery is not currently an option due to the risks associated with anesthesia.

Here are some helpful suggestions and insights:

1. Wear a well-fitted hernia support belt as much as possible to help slow down the enlargement of the hernia.

2. Try to avoid activities that increase pressure in the abdomen, such as lifting heavy objects, straining, or carrying heavy shopping bags.

3. Schedule regular check-ups with a colorectal surgeon or a doctor who specializes in hernia repair. It's a good idea to get at least two professional opinions.

4. Even if surgery isn't an option right now, keep an eye on the hernia for any signs of pain, blockage, or rapid growth.

5. Look for a certified ostomy nurse (WOC/ET nurse) for guidance. If local services are unavailable, the United Ostomy Associations of America website (www.uoaa.org) can help you find a nurse or support group nearby.

6. For pouching:
- Use a soft, flexible system and cut the wafer opening slightly larger than the stoma size.
- Be aware that the stoma may widen when the hernia is under pressure, such as when sitting or standing.
- Reinforce the wafer edges with additional tape or barrier strips to ensure a good seal.
- Remove appliances gently using adhesive remover to protect the skin, which may be more delicate over the hernia.

7. If conservative measures don't work and the hernia continues to grow or causes problems, surgery might eventually be necessary. Discuss the risks and benefits with specialists.

8. It's important to note that hernias often get larger over time and can come back quickly even after repair, so ongoing caution and support are crucial.