The topic at hand is about whether it's safe to engage in intense abdominal workouts when living with a stoma. The person asking is concerned that developing strong abdominal muscles might harm the stoma and is looking for advice from others who have experience with this situation, in addition to consulting their doctor.

Here are some insights and advice shared by others:

1. Timing after surgery:
- It's generally recommended to wait about 4-6 months after surgery before starting heavy core exercises.
- Begin with simple exercises like tensing your abdominal muscles while standing and gradually increase the intensity.

2. Build strength gradually:
- Start with light, controlled exercises such as crunches, planks, and leg lifts before attempting full sit-ups.
- Only increase the intensity or resistance when you feel comfortable, and always pay attention to any discomfort in your abdomen.

3. Understanding peristomal hernia:
- A peristomal hernia occurs when the intestine pushes through the abdominal wall around the stoma due to increased internal pressure, not because muscles are damaging the stoma.
- Activities that increase this pressure, like straining, holding your breath, and heavy lifting, can raise the risk of hernias.

4. Prevention strategies:
- Exhale during the effort phase of each exercise to reduce internal pressure.
- Use a properly fitted hernia support belt or garment during workouts and heavy lifting. Consult a WOCN nurse or surgeon for fitting advice.
- Strengthening your core in a controlled manner can help prevent hernias, but over-straining can have the opposite effect.

5. Real-world outcomes:
- Some people have successfully done high-volume sit-ups or intense exercises for years without issues.
- Others have developed a peristomal hernia or prolapse despite taking precautions, highlighting that experiences can vary greatly.

6. Surgical reinforcement options:
- Some have had synthetic mesh screens placed to prevent future prolapse. These are sometimes referred to as "SMART" or "SToRM" screens. Discuss options with your surgical team.

7. Professional guidance:
- It's important to consult both your surgeon and a WOCN nurse before starting or increasing your core exercise routine. They can also provide recommendations for belts or garments.

8. General cautions:
- Avoid intense stretching or heavy deadlifts early on if you're concerned about internal staples or sutures.
- Some people can handle heavy lifting at work, but it's crucial to rebuild strength slowly and maintain proper technique.