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May 09, 2024

If Not a Hernia, Then What?

This topic is about understanding and dealing with an abdominal bulge that appears after an ileostomy or colostomy reversal. The person who started the discussion noticed a bulge on one side of their mid-line incision, which was initially thought to be a hernia but later suggested to be diastasis recti. Here are some helpful insights and advice shared by others:

1. Imaging & Diagnosis
- Always get your own copies of scans and bring them to your appointments.
- If ultrasound and CT results differ, consider asking for more imaging like an MRI or PET scan.
- Seeking a second opinion, especially from specialists in abdominal wall or hernia issues, can be beneficial before deciding on surgery.

2. Possible Causes of a Bulge That Is NOT a Hernia
- Diastasis recti, a separation of abdominal muscles, is common after surgery. You can self-test by lying down with knees bent and lifting your head.
- Post-surgery swelling can last for months but usually gets better. A soft bulge that flattens when lying down often suggests diastasis rather than a hernia.

3. Living With / Monitoring a Suspected Hernia or Diastasis
- Consider wearing a supportive belt daily. Some people recommend the Brava Hernia Support Belt.
- Avoid heavy lifting, coughing fits, or exercises that strain the core until you have a clear diagnosis.
- Keep your weight stable, as sudden weight gain can increase pressure on a hernia.

4. Surgical Options & Considerations (for confirmed large or symptomatic hernias)
- There are different surgical techniques like laparoscopic, robotic, open repair, and Transverse Abdominis Release (TAR) with mesh.
- Ask your surgeon about the type of mesh used and their infection and recurrence rates.
- Large defects can grow over time, so early elective repair might be safer than waiting for an emergency, but consider your personal circumstances and readiness.

5. Coping & Mental-Health Tips
- Visualization techniques can help manage anxiety related to scans and post-trauma stress.
- Stay informed but let your doctor interpret scan results to avoid self-diagnosing.

6. Community Experiences
- Some people have found that CT scans can miss certain issues, but they are still useful tools.
- Many live with hernias using belts and lifestyle changes, though recurrence after repair is common.
- Discuss job security and insurance coverage with your HR department early on.

7. Red-Flag Symptoms Requiring Urgent Review
- Be alert for sudden, painful bulges that can't be pushed back in, skin discoloration, nausea, vomiting, or fever, as these could indicate serious complications.

These insights aim to help those experiencing similar issues navigate their situation with more confidence and understanding.
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