Which of the following is a risk factor for peristomal hernia?

• A. Steroid therapy
• B. Regular exercise
• C. Large incision during stomal creation
• D. Wound infections

Answer: (A)

Steroid therapy weakens tissue healing and the strength of the abdominal fascia around the stoma. Corticosteroids suppress collagen synthesis and fibroblast activity, leading to slower, less robust wound healing. When the fascial opening that supports the stoma is inherently weakened, it becomes easier for abdominal contents to push through and form a peristomal hernia as intra-abdominal pressure varies. Regular exercise tends to strengthen the abdominal wall and is not a risk factor. While wound infections and technique-related factors can contribute to hernia development, the systemic effect of steroids on collagen and healing makes steroid therapy the most consistent and direct risk factor among the options.