WHAT IS A HERNIA?
A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. 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.
The most common forms of hernia are:
- Inguinal hernia: In men, the inguinal canal is a passageway for the spermatic cord and blood vessels leading to the testicles. In women, the inguinal canal contains the round ligament that gives support for the womb. In an inguinal hernia, fatty tissue or a part of the intestine pokes into the groin at the top of the inner thigh. This is the most common type of hernia and affects men more often than women.
- Femoral hernia: Fatty tissue or part of the intestine protrudes into the groin at the top of the inner thigh. Femoral hernias are much less common than inguinal hernias and mainly affect older women.
- Umbilical hernia: Fatty tissue or part of the intestine pushes through the abdomen near the navel (belly button).
- Hiatal (hiatus) hernia: Part of the stomach pushes up into the chest cavity through an opening in the diaphragm (the horizontal sheet of muscle that separates the chest from the abdomen).
Other types of hernias include:
- Incisional hernia: Tissue protrudes through the site of an abdominal scar from a remote abdominal or pelvic operation.
- Epigastric hernia: Fatty tissue protrudes through the abdominal area between the navel and lower part of the sternum (breastbone).
- Spigelian hernia: The intestine pushes through the abdomen at the side of the abdominal muscle, below the navel.
- Diaphragmatic hernia: Organs in the abdomen move into the chest through an opening in the diaphragm.
What Causes a Hernia?
Except for an incisional hernia (a complication of abdominal surgery), in most cases, there is no obvious reason for a hernia to occur. The risk of hernia increases with age and occurs more commonly in men than in women. A hernia can be congenital (present at birth) or develop in children who have a weakness in their abdominal wall. Activities and medical problems that increase pressure on the abdominal wall can lead to a hernia.
Some common causes of muscle weakness or strain that can lead to a hernia include:
- A congenital condition that occurs during development in the womb and is present from birth
- Damage from an injury or surgery
- Chronic coughing or chronic obstructive pulmonary disorder (COPD)
- Strenuous exercise or lifting heavyweights
- Pregnancy, especially having multiple pregnancies
- Constipation, which causes you to strain when having a bowel movement
- Being overweight or obese
- Fluid in the abdomen, or ascites
- A personal or family history of hernias
- Cystic fibrosis
- Smoking (leading to weakening of connective tissue)
- Being born prematurely or with a low birth weight
- Enlarged prostate
- Straining to urinate
- Peritoneal dialysis
- Poor nutrition
- Undescended testicles
What are the Symptoms of Hernia?
A hernia in the abdomen or groin can produce a noticeable lump or bulge that can be pushed back in, or that can disappear when lying down. Laughing, crying, coughing, straining during a bowel movement or physical activity may make the lump reappear after it has been pushed in. Discomfort or pain in the area around the lump may also be present.
More symptoms of a hernia include:
- Swelling or bulge in the groin or scrotum (the pouch that contains the testicles).
- Increased pain at the site of the bulge.
- Pain while lifting.
- Increase in the bulge size over time.
- A dull aching sensation.
- A sense of feeling full or signs of bowel obstruction.
- A heavy feeling in the abdomen sometimes comes with constipation or blood in the stool.
- Discomfort in the abdomen or groin when lifting or bending over.
- A burning or aching sensation at the bulge
- Weakness or pressure in your groin
- A hard time swallowing
- Shooting pain
- Pain and swelling around the testicles
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. In the case of hiatal hernias, there are no bulges on the outside of the body. Instead, symptoms may include heartburn, indigestion, difficulty swallowing, frequent regurgitation (bringing food back up), and chest pain.
To diagnose your condition, your doctor will first perform a physical examination. During this examination, your doctor may feel for a bulge in your abdominal or groin area that gets larger when you stand, cough, or strain. Your doctor will then take your medical history and ask questions related to your lifestyle. Your doctor will also likely use imaging tests to aid in their diagnosis. These can include things like:
- abdominal ultrasound, which uses high-frequency sound waves to create an image of the structures inside the body.
- CT scan, which combines X-rays with computer technology to produce an image.
- MRI scan, which uses a combination of strong magnets and radio waves to make an image
If a hiatal hernia is suspected, your doctor may use other tests that allow them to assess the internal location of your stomach:
- Gastrografin or barium X-ray, which is a series of X-ray pictures of your digestive tract. The pictures are recorded after you’ve finished drinking a liquid containing diatrizoate meglumine and diatrizoate sodium (Gastrografin) or a liquid barium solution. Both show up well on the X-ray images.
- Endoscopy, which involves threading a small camera attached to a tube down your throat and into your esophagus and stomach.
Hernias are common in kids, especially babies. They can happen when part of their abdominal wall is weak at birth. You’ll usually notice a bulge in their groin area or around their belly button. Your baby may also cry a lot and refuse to eat. Hernias often bulge when your child cries, coughs, or strains to poop.
What is the Best Treatment for Hernia?
Hernias usually do not get better on their own, and surgery may be the only way to repair them. However, your doctor will recommend the best therapy to address your hernia and may refer you to a surgeon. If the surgeon thinks it is necessary to repair your hernia, then the surgeon will tailor the method of repair that best meets your needs. 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.
Although surgical options depend on individual circumstances, including the location of the hernia, there are two main types of surgical intervention for hernia:
- Open Surgery: Open surgical repair closes the hernia using sutures, mesh, or both, and the surgical wound in the skin is closed with sutures, staples, or surgical glue.
- Laparoscopic Operation (keyhole surgery): Laparoscopic repair is used for repeat operations to avoid previous scars, and while usually more expensive, is less likely to cause complications such as infection. Surgical repair of a hernia guided by a laparoscope allows for the use of smaller incisions, enabling faster recovery from the operation. The hernia is repaired in the same way as in open surgery, but it is guided by a small camera and a light introduced through a tube. Surgical instruments are inserted through another small incision. The abdomen is inflated with gas to help the surgeon see better and give them space to work; the whole operation is performed under general anesthetic.
- Robotic Hernia Repair: Like laparoscopic surgery, it uses a laparoscope and is performed with small incisions. With robotic surgery, the surgeon is seated at a console in the operating room and handles the surgical instruments from the console. While robotic surgery can be used for some smaller hernias or weak areas, it can now also be used to reconstruct the abdominal wall.
Each type of surgery has its advantages and disadvantages. The best approach will be decided by the patient’s surgeon.
While home remedies won’t cure your hernia, there are some things that you can do to help with your symptoms. Increasing your fiber intake may help to relieve constipation that can cause straining during bowel movements, which can aggravate a hernia. Dietary changes can also help with the symptoms of a hiatal hernia. Try to avoid large or heavy meals, don’t lie down or bend over after a meal, and keep your body weight in a healthy range. To prevent acid reflux, avoid foods that may cause it, such as spicy foods and tomato-based foods. Additionally, giving up cigarettes may also help.
Exercise may work to strengthen muscles around the hernia and promote weight loss, helping reduce some symptoms. It’s important to remember that some types of exercise, such as weight lifting or exercises that strain the abdomen, may increase pressure at the area of the hernia. This may cause the hernia to bulge more. The same is true for exercises that are done improperly. If you have a hernia, it’s always best to discuss exercise with your doctor or physical therapist. They can work closely with you to let you know what exercises are fine to do and how to perform them properly to prevent irritating your hernia.
A hernia can be prevented in the following ways:
- Maintain ideal body weight by eating a healthy diet and exercising. Like in every other health issue, weight is crucial here too.
- Eat enough fruits, vegetables, and whole grains to avoid constipation. Keep a watch on your fiber intake.
- Use correct form when lifting weights or heavy objects. Avoid lifting anything that is beyond your ability. Gym equipment’s should be used under supervision.
- See a doctor when you are ill with persistent coughs or sneezing.
- Don’t smoke, as the habit can lead to coughing that triggers a hernia.
A hernia is a condition that is common in today’s time. However effective treatment and following the preventive measures can definitely help with the condition. Hopefully, this article acted as a good guide and gave some information regarding hernia.
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