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Hernia

What is a hernia?

  • A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall.
  • Sites; Many hernias occur in the abdomen between your chest and hips, but they can also appear in the upper thigh and groin areas.
  • Most hernias aren’t immediately life-threatening, but they don’t go away on their own.
  • Sometimes they can require surgery to prevent dangerous complications.

Symptoms of a Hernia:

  • The most common symptom of a hernia is a bulge or lump in the affected area. For example, in the case of an inguinal hernia, you may notice a lump on either side of your pubic bone where your groin and thigh meet.
  • You may find that the lump disappears when you’re lying down. You’re more likely to feel your hernia through touch when you’re standing up, bending down, or coughing.
  • Discomfort or pain in the area around the lump may also be present.
  • Some types of hernia, such as hiatal hernias, can have more specific symptoms. These can include things like heartburn, trouble swallowing, and chest pain.
  • In many cases, hernias have no symptoms. You may not know you have a hernia unless it shows up during a routine physical or a medical exam for an unrelated problem.

It’s important to recognize the signs of a hernia and to see your doctor if you suspect that you have one.

An untreated hernia won’t go away by itself. Your doctor can assess your hernia and determine how it can best be treated.

Hernias can cause complications that are life-threatening. It’s important that you seek emergency care if you experience symptoms such as nausea or vomiting, fever, or sudden pain.

Early medical care and lifestyle changes can minimize symptoms. However, surgery is the only way to effectively treat a hernia.

There are different types of surgeries available to repair hernias, and your surgeon can advise on which one is right for your condition.

The prognosis for hernia repair surgery is generally very good, but can depend on the nature of the hernia, your symptoms, and your overall health.

In some cases, the hernia may recur following repair.

Surgery:

  • If your hernia is growing larger or causing pain, your surgeon may decide it’s best to operate.
  • They may repair your hernia by sewing the hole in the abdominal wall closed during surgery. This is commonly done by patching the hole with surgical mesh.
  • Hernias can be repaired with either open or laparoscopic surgery.
  • Laparoscopic surgery uses a tiny camera and miniaturized surgical equipment to repair the hernia using only a few small incisions. It’s also less damaging to the surrounding tissue.
  • During open surgery, the surgeon makes an incision close to the site of the hernia, and then pushes the bulging tissue back into the abdomen. They then sew the area shut, sometimes reinforcing it with surgical mesh. Finally, they close the incision.
  • Not all hernias are suitable for laparoscopic surgery. If your hernia requires an open surgical repair, your surgeon will work with you to determine which type of surgery is best for your condition.

Recovery:

  • After your surgery, you may experience pain around the surgical site. Your surgeon will prescribe medication to help ease this discomfort while you recover.
  • Be sure to carefully follow your surgeon’s instructions involving wound care. Contact them promptly if you notice any signs of infection such as fever, redness or drainage at the site, or pain that suddenly worsens.
  • Following your Hernia Repair, you may be unable to move around normally for several weeks. You’ll need to avoid any strenuous activity. Additionally, you should avoid lifting objects heavier than 10 pounds during this period. This is approximately the weight of a gallon of milk. Open surgery often requires a longer recovery process than laparoscopic surgery. Your surgeon will let you know when you can return to your normal routine.

Types:

There are several different types of hernias. Below, we’ll explore some of the most common ones.

Inguinal Hernia:

  • Inguinal hernias are the most common type of hernia.
  • These occur when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal.
  • This type is also more common in men.
  • The inguinal canal is found in your groin.
  • In men, it’s the area where the spermatic cord passes from the abdomen to the scrotum. This cord holds up the testicles.
  • In women, the inguinal canal contains a ligament that helps hold the uterus in place.
  • These hernias are more common in men because the testicles descend through the inguinal canal shortly after birth. The canal is supposed to close almost completely behind them. Sometimes the canal doesn’t close properly, leaving a weakened area. Explore more about inguinal hernias.

Hiatal Hernia:

  • A hiatal hernia occurs when part of your stomach protrudes up through the diaphragm into your chest cavity.
  • The diaphragm is a sheet of muscle that helps you breathe by contracting and drawing air into the lungs. It separates the organs in your abdomen from those in your chest.
  • This type of hernia is most common in people over 50 years old.
  • If a child has the condition, it’s typically caused by a congenital birth defect.
  • Hiatal hernias almost always cause gastroesophageal reflux, which is when the stomach contents leak backward into the esophagus, causing a burning sensation.

Umbilical Hernia:

  • Umbilical hernias can occur in children and babies.
  • This happens when their intestines bulge through their abdominal wall near their belly button.
  • You may notice a bulge in or near your child’s belly button, especially when they’re crying.
  • An umbilical hernia is the only kind that often goes away on its own as the abdominal wall muscles get stronger, typically by the time the child is 1 or 2 years old.
  • If the hernia hasn’t gone away by 5 years of age, surgery can be used to correct it.
  • Adults can also have umbilical hernias. This can occur from repeated strain on the abdomen due to things like obesity, pregnancy, or fluid in the abdomen (ascites). 

Ventral Hernia:

  • A ventral hernia happens when tissue bulges through an opening in the muscles of your abdomen.
  • You may notice that the size of a ventral hernia reduces when you’re lying down.
  • Although a ventral hernia can be present from birth, it’s more commonly acquired at some point during your lifetime.
  • Common factors in ventral hernia formation include things like obesity, strenuous activity, and pregnancy.
  • Ventral hernias can also happen at the site of a surgical incision. This is called an incisional hernia and can happen due to surgical scarring or weakness of the abdominal muscles at the surgical site.

Treatment:

  • The only way to effectively treat a hernia is through surgical repair.
  • However, whether or not you need surgery depends on the size of your hernia and the severity of your symptoms.
  • Your doctor may want to simply monitor your hernia for possible complications. This is called watchful waiting.
  • In some cases, wearing a truss may help to ease the symptoms of a hernia. This is a supportive undergarment that helps to hold the hernia in place. You should always see your doctor to make sure that a truss fits properly before using it.
  • If you have a hiatal hernia, over-the-counter and prescription medications that reduce stomach acid can relieve your discomfort and improve symptoms. These include antacids, H-2 receptor blockers, and proton pump inhibitors.

Hernia in Pregnancy

  • If you’re pregnant and think that you have a hernia, be sure to see your doctor.
  • They can evaluate it and determine if it poses any health risks.
  • Often, hernia repair can wait until after delivery. However, if a small hernia that’s present before or during the pregnancy begins to get larger or cause discomfort, surgery may be advised to repair it.
  • The preferred time to do this is during the second trimester.
  • Hernias that have been previously repaired may come back with later pregnancies. This is because pregnancy places a strain on abdominal muscle tissue that may have been weakened by surgery.
  • Hernias can also occur following a cesarean delivery, also known as a C-section. During a cesarean delivery, an incision is made into the abdomen and uterus. The baby is then delivered through these incisions. An incisional hernia can sometimes occur at the site of a cesarean delivery. 

Complications:

  • Sometimes an untreated hernia can lead to potentially serious complications. Your hernia may grow and cause more symptoms.
  • It may also put too much pressure on nearby tissues, which can cause swelling and pain in the surrounding area.
  • A portion of your intestine could also become trapped in the abdominal wall. This is called incarceration. Incarceration can obstruct your bowel and cause severe pain, nausea, or constipation. If the trapped section of your intestines doesn’t get enough blood flow, strangulation occurs. This can cause the intestinal tissue to become infected or die. A strangulated hernia is life-threatening and requires immediate medical care.

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