This topic is about recognizing a hernia around the stoma, especially when there is swelling but no pain. The main concern is whether a hernia can exist without causing any pain. Here are some helpful insights and advice on this matter:

1. A hernia can indeed be painless. Many people have experienced large or multiple hernias, such as ventral and parastomal hernias, without any discomfort, just noticeable bulging.

2. Keep an eye out for visible signs like a new or growing bulge around the stoma, an abdomen that appears "like a soccer ball," or a mound-shaped rise under the appliance.

3. Even if there is no pain, there are potential risks like bowel obstruction or strangulation. It's important to monitor your output and seek medical help if the flow slows down or stops.

4. It's advisable to get a professional assessment. Consulting with a colorectal or ostomy surgeon can provide an accurate diagnosis and peace of mind.

5. Surgical options vary:
- Small, early hernias in otherwise healthy individuals might be repaired using laparoscopic surgery, which involves minimal cutting.
- Mesh repair is a common method but may leave some stiffness or an unusual sensation at the repair site.
- Hernias often recur, and some people choose to avoid or delay surgery unless symptoms become more severe.

6. Non-surgical management strategies include:
- Wearing an ostomy support belt along with snug underwear to help hold the area in and reduce bulging.
- If a bulge protrudes, lying flat on your back can help it settle before re-securing the appliance.

7. Decision-making is very personal. It's important to gather information about your specific situation, weigh the risks and benefits, and choose the approach—whether it's watchful waiting, conservative support, or repair—that best suits your health and lifestyle.