This topic is about understanding why ostomy-related hernias form and how they can change the size and appearance of a stoma. A person noticed that the area around their stoma has become larger and is curious about the causes of hernias and whether they can make the stoma appear as a visible "ball" under clothing.

Here are some insights and advice on this topic:

1. Main contributing factors:
- Poor or uneven healing of the abdominal incision or muscle layers.
- Strain on the abdominal wall from activities like coughing, lifting objects heavier than about 6 pounds, or bending and reaching soon after surgery.
- Severe respiratory illnesses, such as bronchitis, that cause prolonged coughing.
- The individual surgical technique and how each person’s muscle tissue heals; sometimes hernias appear even when patients avoid lifting or coughing.

2. Typical course:
- Once a hernia appears, it generally enlarges over time. The bulges can range in size from a "soccer ball" to a "volleyball" and may make clothing protrude noticeably.

3. Diagnosis:
- If there is uncertainty from a visual examination, a CT scan can confirm the size and contents of the hernia.

4. Surgical repair:
- There are high recurrence rates after repair, especially for parastomal hernias, which makes many surgeons hesitant to operate unless complications arise.
- Some patients seek multiple surgical opinions or wait for consultation at specialized hospitals before making a decision.

5. Non-surgical management:
- Using an ostomy/hernia support belt or stoma guard can help keep the bulge flatter and provide abdominal support.
- Continuing to restrict heavy lifting and avoiding activities that increase abdominal pressure may help slow the progression, though it is not guaranteed to prevent enlargement.