This topic is about managing a small incisional hernia that appeared after an ileostomy. The person noticed a slight bulge near their stoma and a painless bulge below the navel. An ultrasound confirmed a small incisional hernia. They are seeking advice on whether this hernia needs repair and how to manage it.

Here are some helpful insights and advice:

1. Treatment Options for Small Incisional Hernias
- Surgery is not always necessary for a small, asymptomatic hernia. The risks of surgery might outweigh the benefits.
- Monitoring the hernia is often a successful approach, especially if it remains symptom-free.
- Surgery becomes necessary if the hernia causes pain, changes color, or leads to symptoms like vomiting.

2. Support Belts and Garments
- Wearing an ostomy or hernia belt can help limit the growth of hernias. Some people use belts like the Brava Belt by Coloplast or custom belts with a stoma opening.
- Belts should be fitted while lying down to reduce the hernia and should be worn all day, except when showering.
- If the current belt does not cover the hernia, consider a longer or full-torso garment for better support.

3. Risk of Enlargement and Recurrence
- Small hernias can remain stable, but factors like coughing, heavy lifting, weight gain, or weakened tissue from steroids can cause them to enlarge.
- Even after repair, hernias can recur. Wearing support garments and using hand-splinting techniques when coughing or sneezing may help prevent this.

4. Surgical Techniques and Recovery
- Standard repair involves closing the defect and reinforcing it with mesh, often done laparoscopically for small defects.
- Larger or multiple defects might require open abdominal-wall reconstruction with a full sheet of mesh.
- Recovery can involve significant pain, similar to doing many sit-ups, with activity restrictions lasting about four weeks before resuming exercises like weight training.

5. Practical Precautions
- Avoid lifting heavy objects and manage your weight.
- Support your abdomen when coughing or sneezing.
- Keep an eye on the hernia's size, color, pain level, and any digestive symptoms. Seek immediate care if there are signs of incarceration.