Which measure is recommended to reduce strain on the abdomen during coughing for peristomal hernia?

• A. Splinting of abdomen when coughing
• B. Weight loss programs
• C. Avoid lifting over 5-10 lbs for 6-8 weeks after surgery
• D. Evaluate and possibly change pouching system with hernia development

Answer: (A)

Coughing increases intra-abdominal pressure, which can push at the weakened area around a stoma and worsen a peristomal hernia. Splinting the abdomen provides external support during coughing, so the pressure is distributed more evenly and the force on the abdominal wall is reduced. Using a hand or a soft pillow to gently press over the abdomen at the stoma site during coughing helps protect the abdominal wall and stomal opening, lowering the risk of hernia progression and leakage.

Weight management and general lifting restrictions are helpful for overall healing and reducing long-term strain, but they don’t offer the immediate protection during coughing. Changing the pouching system may improve fit or comfort, but it doesn’t directly lessen the abdominal load produced by coughing like splinting does.