At my 6 week follow up after ostomy surgery I asked my surgeon if it would be safe to lift heavy weights (building up safely and slowly of course). He said go for it. The most likely complication that I would face would be a parastomal hernia. However, even if I chose not to lift weights I would be likely to develop one, since most ostomates do.
In fact it is the most common long term complication following stoma creation, and can affect as many as 78 percent of us, most often in the first 2 years following stoma creation.
This was pretty shocking to learn, and I decided to dig deeper into what is known about this common complication. As it turns out, this is not an area that has had much study. Most of the information is about how to repair the hernia surgically, with very little information on how to prevent them in the first place.
However one recent study from the University of Michigan found a statistically significant association between less exercise and higher incidence of parastomal hernia. Other findings include:
parastomal hernias are associated with poorer quality of life
future research is needed with a focus on physical therapy for ostomy patients as a strategy to prevent parastomal hernias
Other risk factors for developing a parastomal hernia include:
older age
obesity
diabetes
smoking tobacco
low tensile strength of abdominal wall
If that is the case, then it follows that we might be able to prevent, or at least mitigate the risk of parastomal hernias by following the right exercise program to strengthen the abdominal wall following stoma creation, in addition to maintaining a healthy body weight and making other lifestyle changes.
Obviously more research is needed in this area. The current estimate is that there are 135,000 Canadians living with an ostomy (1 out of about every 300 people). That's a significant number of Canadians who could benefit or could have benefitted from this important information.
Had I not asked about lifting weights, I'm not sure the risk of parastomal hernia would have been communicated to me, leaving some room for opportunity.
A shift in the conversation from,
"you will likely have this happen regardless of your actions"
to,
"engaging in the right exercise program might reduce the risk of this happening"
could make a big difference for a lot of people.
Coming soon: how I strengthened and continue to strengthen my core following my stoma surgery.
Styliński R, Alzubedi A, Rudzki S. Parastomal hernia - current knowledge and treatment. Wideochir Inne Tech Maloinwazyjne. 2018 Mar;13(1):1-8. doi: 10.5114/wiitm.2018.72685. Epub 2018 Jan 16. PMID: 29643952; PMCID: PMC5890847. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890847/#:~:text=In%20fact%2C%20numbers%20ranging%20from,incidence%20usually%20attributed%20to%20ileostomy.]
Park, Jemin M.D.1; Rivard, Samantha J. M.D.1; Maguire, Lillias M.D.1,2; Varlamos, Christopher B.S.1; Duby, Ashley M.S.1,2; Hendren, Samantha M.D., M.P.H.1. Parastomal Hernia Rates and Exercise After Ostomy Surgery. Diseases of the Colon & Rectum 66(6):p 823-830, June 2023. | DOI: 10.1097/DCR.0000000000002395 [https://journals.lww.com/dcrjournal/abstract/2023/06000/parastomal_hernia_rates_and_exercise_after_ostomy.11.aspx#]
Christopher T. Aquina, James C. Iannuzzi, Christian P. Probst, Kristin N. Kelly, Katia Noyes, Fergal J. Fleming, John R.T. Monson; Parastomal Hernia: A Growing Problem with New Solutions. Dig Surg 1 January 2015; 31 (4-5): 366–376.[https://karger.com/dsu/article/31/4-5/366/116677/Parastomal-Hernia-A-Growing-Problem-with-New]