This topic is about choosing the right hernia support belt, especially for those with a stoma. It highlights the importance of being cautious when selecting belts with or without a stoma hole, as the wrong choice can worsen a parastomal hernia. Here are some helpful insights and advice:

1. **Be Careful with Hole-Style Belts**
- Many people, including long-term ostomates, have found that belts with holes can make the hernia or stoma protrude more, feel uncomfortable, or even cause blockages.
- Some healthcare professionals have been advising against these types of belts for years.

2. **When a Hole Might Be Useful**
- For those using high-output, two-piece appliances or needing easy pouch access, a well-sized hole can prevent the belt from squeezing the pouch, reduce pancaking, and make drainage easier.
- Canadian Best Practice Recommendations suggest that no-hole belts provide even support, while hole belts can help with venting and reducing leakage anxiety if the hole is correctly sized and positioned.

3. **Importance of Fit and Customization**
- The wrong hole size can lead to leaks, skin issues, or loss of support. The opening should align with the rigid wafer area.
- Some have had mixed experiences with custom belts, like those from Nu-Hope, where hole sizes were not ideal. Customization is often necessary for double ostomies, though it can take time and may be covered by insurance.
- Options like Stealth Belt offer reinforced panels for extra support, and bespoke garments can be tailored to precise measurements.

4. **Alternative Support Options**
- Options like stretchy high-waist pants or wide abdominal binders offer light support without specific openings.
- Belts with an internal plastic cup exist but may shorten wear time due to pouch squeezing.
- Some people only wear belts during high-risk activities and remove them when sitting to relieve pressure.

5. **Exercise, Weight, and Posture**
- Maintaining core strength, managing weight, and avoiding heavy lifting or straining are crucial for prevention and management.
- A belt is a supportive tool, not a cure; surgical repair is the definitive treatment for a worsening hernia.

6. **Information Resources**
- Resources include Nu-Hope and Stealth Belt products, articles in the IA Journal, and Canadian Best Practice Recommendations.
- Online searches can provide additional studies and supplier information.

7. **Practical Tips**
- The belt should fit snugly but allow two fingers underneath; loosen it when sitting.
- Trial and error is common, so try samples or adjustable models.
- Expect shorter flange wear time with tight support, requiring more frequent changes.
- If using convexity, ensure the belt doesn't add too much pressure over the wafer.
- Keep in touch with healthcare professionals, as their knowledge can vary, and be proactive in your care.