Autumn has arrived, and unfortunately that usually means coughs, colds and flu aren't too far behind.
For most people, an irritating cough is exactly that, irritating. But when you've had stoma surgery, or you're living with a parastomal hernia, suddenly coughing and sneezing can feel a little more concerning.
You might find yourself wondering: Am I putting too much pressure on my stoma? Could coughing cause a hernia? Should I hold my stomach when I sneeze?
They're very reasonable questions.
The reassuring bit is that coughing shouldn't normally harm your stoma itself. What it does do is briefly increase the pressure inside your abdomen, which is why you can sometimes feel pulling, pressure or discomfort around your stoma when you cough.
So, with cold and flu season upon us, let's look at what's actually going on and what you can do to feel a little more supported.
Can coughing affect your stoma?
Not usually in the way people first imagine.
Your stoma itself doesn't have the same pain sensation as the surrounding skin and abdominal muscles, so an everyday cough isn't going to hurt the stoma simply because you've coughed.
You might, however, feel the movement around it.
Every time you cough, your abdominal muscles contract and pressure inside your abdomen rises temporarily. If you've recently had surgery, your abdominal wall is weakened, or you already have a parastomal hernia, you're likely to be much more aware of this.
Some people describe a pulling or dragging sensation. Others simply notice themselves automatically putting a hand over their abdomen before they cough.
If that's you, you're certainly not alone.
Can coughing cause a parastomal hernia?
This one needs a little context.
A parastomal hernia develops when part of the abdominal contents pushes through a weakened area of the abdominal wall around the stoma. There isn't usually one single cause.
Lots of things can contribute, including the condition of the abdominal wall, previous surgery, age, body weight and repeated increases in abdominal pressure.
A long-term or persistent cough can be one of those contributing factors because coughing repeatedly increases pressure inside the abdomen.
That doesn't mean one enthusiastic sneeze is going to give you a hernia.
It's more about repeated strain over time.
If you've developed a persistent cough, particularly after recent abdominal surgery, it's worth treating the cough rather than simply putting up with it. Your GP or pharmacist can advise on what's appropriate for you.
Should you support your stomach when you cough?
You can, and many people find that it feels much more comfortable.
If you know a cough or sneeze is coming, try placing your hand gently over the area around your stoma.
A folded towel or small cushion can work well too, especially if your abdomen is still tender after surgery.
You're not trying to press hard or physically stop your abdomen from moving. Think of it more as giving the abdominal wall a little bit of external support while it contracts.
It can also take away some of that instinctive feeling of needing to brace yourself.
What about wearing stoma support wear when you have a cough?
If you already wear ostomy support wear comfortably, there's generally no reason you can't continue wearing it when you've got a cough or cold.
In fact, this is one of those everyday situations where some people particularly appreciate having a little extra abdominal support.
A comfortable support garment can give the abdomen a more supported feeling when you're coughing, sneezing, moving around or getting in and out of bed.
The important thing is that the garment is appropriate for you and isn't restricting the normal function of your stoma or pouch.
At Comfizz, we divide our support wear into three levels:
Level 1 – Light Support
Gentle everyday support for the abdominal area and stoma pouch.
Level 2 – Medium Support
A step up in support, often chosen for everyday activity or when people want a more supportive feel around their abdomen.
Level 3 – Firm Support
Our firmest support, including support belts, and often used by people who need greater abdominal support, including some people living with a parastomal hernia.
It's worth saying that firmer isn't automatically better.
The right level depends on you, your body, your stoma, what you're doing and whether you're managing an existing hernia.
If you're unsure, our Find the Right Ostomy Support Level guide is a good place to start.
Can support wear stop a parastomal hernia developing?
We need to be careful not to overpromise here.
Support garments are widely used to support the abdominal area after stoma surgery and by people living with parastomal hernias. Lots of people also tell us that they simply feel more secure and confident while wearing one.
What we can't say is that wearing support garments guarantees you won't develop a parastomal hernia; there are too many factors involved for it to be that simple. However, one particular clinical trial did show some very encouraging results in reducing hernia incidence by wearing support wear.
Support wear is better thought of as one part of looking after and supporting your abdominal wall, alongside things such as gradually rebuilding strength after surgery, sensible lifting techniques and dealing with problems such as a persistent cough rather than ignoring them.
What if you already have a parastomal hernia?
If you already have a hernia, you've probably noticed that it can change shape during the day.
It might look larger when you're standing, lifting, coughing or straining and then reduce again when you're lying down.
So if you're going through a spell of frequent coughing, you may find the bulge becomes more noticeable while you cough. You might also feel pressure, aching or a dragging sensation around the area.
Some people find that a supportive waistband or hernia support belt makes everyday activities more comfortable.
But hernias vary enormously, so there's no single garment that's right for everyone.
If yours suddenly becomes more painful, noticeably changes, or starts making it difficult to get a reliable seal with your stoma pouch, have a chat with your stoma nurse.
Can a cold or flu affect stoma output?
Sometimes, yes although it isn't necessarily the cold itself that's responsible.
When you're ill, you might eat less, drink differently, take medication or generally have an upset digestive system. Any of these can change what's normal for your stoma.
This is particularly worth keeping an eye on if you have an ileostomy, as very watery or increased output can increase the risk of dehydration.
You know your 'normal' better than anyone.
If your output suddenly becomes much higher or more watery than usual, keep a close eye on your fluid intake and how you're feeling.
Feeling very thirsty, dizzy or light-headed, having a dry mouth, passing much less urine or noticing that your urine is unusually dark can all be signs that you're becoming dehydrated.
If you're concerned, speak to your stoma nurse or healthcare team.
Can you take normal cold and flu remedies with a stoma?
Having a stoma doesn't automatically rule out ordinary cold and flu treatments.
However, what you can safely take will depend on your other medications and medical conditions, so if you're unsure, your pharmacist is usually a very good first port of call.
It's also worth remembering that being unwell can sometimes change your appetite, fluid intake and bowel function, so keep an eye on anything that feels noticeably different from your normal routine.
When should you contact your stoma nurse?
Most coughs and colds will come and go without causing any problems with your stoma.
But if something around your stoma has genuinely changed, don't automatically put it down to having been coughing.
Get advice if you notice a new or rapidly increasing bulge, worsening abdominal pain, unusual swelling, repeated leaks because your body shape has changed, or a significant change in your stoma or its output.
And if you're experiencing severe abdominal pain, vomiting, your stoma stops functioning, or the stoma itself changes colour significantly, seek urgent medical advice.
So, what's the best thing to do when you have a cough and a stoma?
Mostly, the same things you'd normally do — rest, look after yourself and give your body time to recover.
But give your abdomen a little consideration too.
If coughing feels uncomfortable, try supporting the area gently with your hand, a towel or cushion. If you already use stoma support wear, you may find that extra feeling of support particularly welcome while you're coughing. This might be a time to consider stepping up your level of support, so if you wear light level 1 support, then use medium level 2, or even a level 3 garment whilst the cough lasts.
And don't spend the whole week worrying that every sneeze is damaging your stoma. An occasional cough or sneeze is a normal part of life.
The thing to pay attention to is persistent coughing, ongoing discomfort or something around your stoma that has genuinely changed.
Quick questions about coughing and your stoma
Can I sneeze normally with a stoma?
Yes. You don't need to try to stop yourself sneezing because you have a stoma. If your abdomen is tender, gently holding your hand, a folded towel or a small cushion against it may feel more comfortable.
Should I hold my stoma when I cough?
Support the area around your stoma rather than pressing firmly onto the stoma itself. Gentle support is all you're aiming for.
Why does my parastomal hernia stick out more when I cough?
Coughing temporarily increases pressure inside your abdomen, so an existing hernia can become more prominent for a moment. If the bulge remains larger than usual or you've noticed a more lasting change, speak to your stoma nurse.
Would a stoma support belt help when I'm coughing?
It can make some people feel more comfortable and supported, particularly if they already use abdominal support. The right type and firmness of garment will depend on your individual situation.
Can I wear stoma support underwear all day?
Many light and medium support garments are designed to be worn as everyday underwear. Your pouch should still be able to fill and function normally, and the garment should feel supportive rather than uncomfortably restrictive.
A final thought
Having a stoma tends to make you much more aware of your abdomen than you probably ever were before surgery.
A cough, sneeze or unexpected twinge can therefore feel much more significant than it once did.
Most of the time, there's no need to panic.
A little gentle support, knowing what's normal for your own body and understanding when something deserves a second look can make cold and flu season much less worrying.
At Comfizz, we make Level 1 Light, Level 2 Medium and Level 3 Firm ostomy support wear, including briefs, boxers, waistbands, vests and support belts, to help people find a level of abdominal support that works for their everyday life.
If you're not sure where to start, visit our Find the Right Ostomy Support Level guide or get in touch with the Comfizz team.
This article provides general information and isn't a substitute for individual medical advice from your stoma nurse, GP or other healthcare professional.
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