This topic is about dealing with a parastomal hernia, which is a type of hernia that can occur around a stoma. The person sharing their experience is concerned about the pain and size of their hernia, as well as the challenges they face when changing their ostomy appliance. They are seeking advice and insights from others who might have faced similar issues.

Here are some helpful points and advice shared by others:

1. Pain is not uncommon with parastomal hernias. Many people experience significant discomfort, especially when not wearing a support garment or after eating.

2. Proper external support is crucial:
- Consult with a stoma nurse or general practitioner to assess your needs, as some off-the-shelf belts may not provide adequate support.
- Custom-made "corset" style supports from a hospital orthotics department can be more effective for large hernias. These supports often have openings for the pouch and are reinforced with rigid plastic.
- You can find examples of support belts, like the Nu-Hope Ostomy Support Belts, which offer additional information and styles.

3. When changing the pouch:
- Some people manage to change their pouch while standing in front of a mirror, even if the hernia doesn't subside. They immediately reapply the corset after changing.
- Ensure that the belt has a cut-out or flange to prevent pressure directly over the stoma, which can cause leaks.

4. Hernia size can vary greatly. One person's hernia measured approximately 4 inches high by 8 inches wide and contained multiple smaller hernias. The size of the hernia doesn't necessarily dictate the level of pain; proper support or surgical repair can make a difference.

5. Surgical repair might be necessary:
- Sometimes, multiple repairs are needed. For instance, two failed mesh repairs were eventually resolved with a porcine (pig-skin) mesh that has been effective for three years.
- If support garments are not providing relief or if the hernia continues to grow, consider consulting a colorectal or stoma surgeon about elective repair.

6. If you experience skin-related pain under the stoma:
- Check for white, sore areas of distressed skin.
- Circular barrier rings, like the "Extra Seal" style (e.g., Eakin Cohesive Seals), can protect the skin and may help delay or avoid additional surgery.