pains

I haven't posted in such a long time. However, I need some suggestions/help.

I'm a post-op Crohn's patient. I have a stoma on the right side which is herniated. I still have my anus or rectal pouch as my doctor calls it and it bleeds, constantly with or without medication. With that said, when I go to the bathroom (I still have frequent trips due to a very irritated rectal pouch) there is a lot of straining. I've noticed recently (the past couple of days) that when I do strain that there is an intense pinching right at the stoma site. I still have a satisfactory output from my stoma so I know that I'm not backed up. I was wondering if the intense pinching when straining is something that I should be concerned about or not? Especially with it being herniated and all. I don't have insurance so, I'm trying to avoid my doctor as much as I possibly can. Thanks in advance for any answers you might have.