The topic at hand is about deciding when a parastomal hernia, which is a type of hernia that can occur around a stoma, should be surgically repaired. The person asking the question is unsure whether to address the hernia while it's still small or wait until it becomes more problematic. Here are some insights and advice shared by others:

1. Consider leaving the hernia alone unless it causes significant issues. Many people have lived with unchanged hernias for years. Surgeons often recommend repair only if the hernia interferes with pouching, causes pain or blockage, or if it can be addressed during another abdominal surgery.

2. Be aware of the high risk of hernia recurrence after repair. The abdominal wall around a stoma is already weakened, and fixing one defect can lead to another. Even with mesh repair, there is about a 20% chance of failure.

3. If repair becomes necessary, seek a surgeon experienced in parastomal hernia repairs. A member shared that their first repair by a general surgeon failed, but a second repair by a specialist lasted 20 years. Robotic mesh repair can be effective, though recovery may take a few months.

4. Weight management and overall health are important. Surgeons might require weight loss or even bariatric surgery before attempting hernia repair or stoma reversal to improve outcomes.

5. Core strengthening is encouraged, but choose low-impact methods. Research supports core exercises to prevent hernia enlargement and possibly reduce its size. Avoid high-stress exercises like traditional sit-ups, crunches, and heavy lifting. Safer options include walking, swimming, yoga, Pilates, and physiotherapy-guided routines. Always wear a hernia support belt during activities.

6. Watch for warning signs that might necessitate surgery, such as rapid growth, pain, repeated blockages, pouching problems, or cosmetic concerns affecting quality of life.

7. Practical lifestyle tips include limiting lifting to less than 25 pounds (approximately 11 kg), using a well-fitting hernia or ostomy support belt for daily activities and exercise, and searching for stoma-safe abdominal exercise programs through forums or charities offering online classes.