Intense abdominal workouts with a stoma: Safe or risky?

Hi gang,

I'm sure this question has come up a million times, but I just didn't have time to search this morning. So is it okay (safe) to workout your abs hard with a hole in them with a stoma sticking through? I don't mean an occasional sit up once in a while... I mean a hard workout done 3 or more times per week. Any chance the muscles could pinch off the stoma over time? Going to ask my primary care doc that I see tomorrow, but I'm pretty sure she won't have a clue... so I'm asking the real experts... you guys.

Thanks in advance,

Bob

Bob,

I would say it's probably not a good idea right after surgery. But after about 4-6 months when you're more back to a normal routine, I would say take it easy first and build your stomach muscles slowly. Just tense your abs while you're standing at first. A hernia belt probably wouldn't be a bad idea either. I've never heard of a stoma being pinched off or constricted from building your abs.

You may also want to search the forums about working out. I've had an ileostomy for 24 years with no real issues working out. I took it slow after my surgery as to not risk a hernia. And I was standing 8-12 hours a day at work. I would tense/tighten my stomach muscles all day and eventually felt comfortable doing a normal ab workout. Now, my 6-pack is under a slight layer of beer belly over the course of the years but I know it's there...lol Hope this helps.

Bain

I used to do 500 sit-ups 5 days a week. It never did me any harm... Like all exercise, start off slow and work your way up. Sit-ups are the best exercise to hopefully prevent us from developing a hernia.

Talk to your WOCN and perhaps surgeon. Certainly ask them about getting fitted for a hernia support belt to help prevent a hernia.

Thanks for the comments, guys! Talked to my primary care doc yesterday just because I had to see her for my routine yearly follow-up, and I asked her about doing abdominal exercises with that sewer pipe sticking through my abs. She got that puzzled look on her face, just like the Grinch when he's talking to Max asking how to keep Christmas from coming. Then she said not to do sit-ups because those are too uncontrolled. She suggested crunches and nothing hanging. She really had no clue... but it was fun to watch her try to BS her way out of it. I like having fun with doctors this way. The good ones will just tell you straight out they don't know. The not-so-good ones feel obligated to answer the question regardless. Anyway, I hear what y'all are saying and will take it slow. Not sure I understand why exercising would increase the propensity for a hernia, since the muscles would be getting stronger, not weaker... but will research that one also.

Regards,

Bob

The hernia would occur through the stoma, when we exercise we have a tendency to produce pressure in our abdomen due to holding our breath at times. You can help prevent hernias by using a hernia belt and breathing out during the exertion.

Hi medic361,

Thanks for explaining that. But please continue to teach me some more. As I understand it, a "hernia" is when something pushes its way through something else... like intestines through a weak abdominal wall in normal folks. It sounds like you're saying the hernia in this case would be the abdominal muscle pushing through the stoma, where that part of the intestine passes through the abdominal wall. Sort of like constricting it, but ending in a puncture. Am I reading you right? If I am, do me one better. A hernia belt would help to stop something inside the body from pushing through the abdominal wall and out of the body... but if the abdominal muscle were to pierce the stoma, it would be going left to right and not in and out. So how would the belt help? Not seeing how the breathing would help either, as that would help with something inside trying to push outside as well, not something constricting and piercing left to right. Sounds like you need to put a tube or guide inside the end of the stoma to stop a full puncture by the muscle, which isn't possible. Maybe I'm not understanding this right. Sorry if I'm being dense.

Thanks,

Bob

Ok, so stoma just means a hole. The open end of the colon is a stoma, also the hole through which the colon passes is a stoma. What occurs when a person gets a hernia around the stoma is the intestines push through the already formed hole in the abdominal muscles and forms a hernia around the stoma, a peristomal hernia.

Bro, proceed with caution. I too used to work out super hard, but even after waiting a really long time after my final surgery, I ended up causing a prolapse. The VA decided it best to install a mesh screen to keep a prolapse from happening again, and that bit is true. They said I'd be able to do sit-ups in time, but idk...maybe I work out too hard, maybe I didn't wait long enough, I don't know. With the mesh, of course, it's not an issue even a little bit...I just now have my body growing into an oil-based product now.

Bob,

I will have mine (colostomy) 6 years in November. I started doing light workouts and built the weight up. Be very careful, I gave myself a hernia and it is no fun. Pay attention to what your stomach muscles are telling you (I didn't and am paying for it now). It has been a solid 6 weeks and I am about to try planks for exercise. Leg lifts will be what I work up to.  

No matter your feeling about the doctor and their knowledge, always ask the experts here. This group is just fantastic for all things stoma.  

Best of luck and be safe.  

Had the same concern 5 years ago. The answer is to go slow at first. Give time to heal up after surgery. But I have worked the abdominal area hard for 5 years, three times a week. Held a dumbbell out arms length while sitting down and swinging it left and right, up and down, and feel the strain and pain. The result has been hard flat stomach muscles and no tightening around the stoma. My worry has always been the surgical staples holding things together inside ever since I saw an x-ray of myself once... What are those little shiny things in the shape of fingernail clippings? But all has gone well, no problem. In this regard, I keep aware of the difference between sore muscles and possible internal injury regarding staples. Because of that concern, I have never done a lot of hard stretching such as deadlifts. That seemed to be more of a risk internally, but it may not be. I have been jogging consistently... 2 or 3 miles since 1996, again no problems. But jogging is getting harder to do, feet and knees getting old, lifting getting easier with age however. I am 74 years old and feel great, hard stomach... If you are younger, more power to you.

Hi Jim,

Thanks for the reply! You sound like you're in great shape at age 74....that's awesome. I figure my memory will be completely gone by the time I'm 74, so I won't be working out much, but it's good to know I can. I hear ya regarding the staples. Whenever I get an abdominal CT scan it looks like someone went nuts with the stapler as well. No worries about them pulling out as your skin has grown completely around them by now. They're a temporary fix that stay with you forever. Someone needs to invent bio-degradable stainless steel. Got also got a few big SS screws holding my right bicep tendon to my forearm.....always wonder if the X-ray scanner at the airport picks them up.

Thanks again,

Bob

Doing too much strenuous exercise on the middle and lower abdomen can result in you having a peristomal hernia. We can't "strain" like we used to and it doesn't take too many repetitive strains for the intestine to pop out from the muscle wall behind the stoma. Heavy lifting should also be avoided.

That's really too general of a statement, I exercise hard regularly including my abdominals. I also work in a strenuous job that requires frequent heavy lifting.

The important thing is to build your strength back slowly.

Whoa dude, how did everyone skip over the fact you mentioned a magical mesh screen to prevent a prolapse? Your post actually made me decide to join the community so thanks homie. Is there any other information you're willing to provide about this "screen"? I've gone down the Google rabbit hole a bit and saw notes on a few different procedures like the "smart" and "storm" screens. I'm wondering things like... Did you get the screen? If so, where did you get it done? Does your screen have a name like the ones I stated? Any and all information would be great. I'm sure you can imagine how grateful I am.