This topic is about dealing with a parastomal hernia, which can occur after an ileostomy. A parastomal hernia is when part of the intestine pushes through the abdominal wall near the stoma, causing a noticeable bulge. This can affect how well the ostomy pouch adheres to the skin. The person in this discussion is considering surgical options to repair the hernia and is seeking advice on the best approaches, types of mesh to use, and how to manage the ostomy appliance post-surgery. Here are some insights and advice shared by others:

1. Mesh Options:
- Experiences with mesh vary. Some have had infections or failures with biologic mesh, while synthetic mesh has lasted over a decade for others.
- It's important to find a surgeon experienced in parastomal hernia repairs, as this can impact long-term success.
- Some surgeons avoid using mesh due to infection risks, while others believe it's necessary despite the potential for recurrence.

2. Choosing a Surgeon or Center:
- Look for surgeons or centers specializing in hernia repairs. In the UK, resources like totalabdomen.com can help find specialists.
- Private centers may offer expertise but often require self-payment or insurance.

3. Timing and Techniques:
- Open surgery provides more room for the surgeon but can lead to more pain and longer recovery. Laparoscopic surgery might reduce pain but offers less visibility.
- Hernia recurrence is common, and stoma prolapse can occur after repair, so regular checks are important.

4. Belt and Binder Use:
- Wearing a hernia belt daily can support the defect and improve wafer adherence. It's crucial to be fitted properly and have the belt applied immediately after surgery.
- As hernias grow or after surgery, belt fitting should be re-evaluated.

5. Activity and Lifestyle Tips:
- Limit lifting to 5 pounds (2 kg) to prevent hernia enlargement. Be cautious of activities that strain the abdomen.
- Seek medical attention if severe pain, persistent nausea, or a hard bulge occurs, as these could indicate complications.
- Keep extra pouching systems available, as hernias can affect wafer seals.

6. Appliance Management:
- A convex wafer and hernia belt can help secure the flange over uneven areas.
- Protect skin from irritation by using padding or soft cloth covers under belt snaps.

7. Constipation and Pain Control:
- Opioid pain medications can cause constipation. Some find relief with natural products like magnesium oxide.

8. Psychological and Practical Support:
- Some choose to live with the hernia to avoid surgery risks, emphasizing the need to weigh quality-of-life benefits against potential complications.
- Support from prayer, peer forums, and thorough discussions with surgeons can be helpful coping strategies.