Registered Nurses' Association of Ontario

Practice Considerations to Prevent Parastomal Hernias in Persons Who Anticipate or Live with an Ostomy

  • Conduct a risk factor assessment related to body mass index (BMI) and waist circumference preoperatively, postoperatively and on an ongoing basis.
  • Provide referral to a registered dietician for education regarding nutrition and weight management.
  • Provide immediate postoperative education on: heavy lifting, weight transfer, splinting with coughing, nausea, or vomiting.
  • Provide education to avoid lifting no more than 10lbs for the first month after surgery, and then slowly work back up to lifting normal weights.
  • Provide information on support garments. 
  • Surgeons should recommend abdominal exercises with specific instructions on when to begin and how to perform them. For instructions on how to perform specific exercises, please refer to Table 3: Abdominal Exercises 
  • Provide appropriate referral to a physiotherapist to provide education on abdominal exercises and proper body mechanics to perform during the first three months after surgery.
  • Provide education on what a parastomal hernia is.
  • Have an anti-emetic protocol in place immediately after surgery.
Clinical Management
Supporting Adults Who Anticipate or Live with an Ostomy
Point of Care Resources