The bulge is particularly noticeable upon tensing the abdominal wall muscles - such as occurs when coughing, sneezing, straining or simply standing.
Stomas pose an additional problem.
When a stoma is brought out to the surface of the abdomen it must pass through the muscles of the abdominal wall, thus a potential site of weakness is immediately created. In the ideal situation the abdominal wall muscles form a snug fit around the stoma opening. However, sometimes the muscles come away from the edges of the stoma thus creating a hernia - in this case, an area of the abdominal wall adjacent to the stoma where there is no muscle. Factors that can contribute to causing a stoma hernia to occur include coughing, being overweight or having developed an infection in the wound at the time the stoma was made. The development of a stoma hernia is often a gradual phenomenon, with the area next to the stoma stretching and becoming weaker with the passage of time.