What is Hernia? Causes, Symptoms and Treatments

INTRODUCTION:

A hernia occurs when an internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.

In many cases, hernias cause no or very few symptoms, although you may notice a swelling or lump in your tummy (abdomen) or groin (the area between the abdomen and the upper thigh on either side of the body).

The lump can often be pushed back in, or will disappear when you lie down.  Coughing or straining may make the lump appear.

TYPES OF HERNIA:

  1. Inguinal hernias:  These occur when fatty tissue or a part of your bowel pushes through into your groin at the top of your inner thigh.  This is the most common type of hernia, and it mainly affects men because of a natural weakness of the muscles in this area and the fact that the inguinal canal is the opening that allows the spermatic cord and testicle to descend from within the abdomen.  The opening normally closes after the testicular descent, but sometimes it does not.  This type of hernia is often associated with ageing and repeated strain on the abdomen.  About 96% of all groin hernias are inguinal.
  2. Incisional hernias:  These occur when the intestine pushes through the abdominal wall at the site of previous abdominal surgery.  This type is most common in elderly or overweight people who are inactive after abdominal surgery.
  3. Femoral hernias:  These occur when the intestine enters the canal carrying the femoral artery into the upper thigh.  Femoral hernias are most common in women, especially those who are pregnant or obese because of their wider bone structure.
  4. Umbilical hernias:  These occur when part of the small intestine passes through the abdominal wall near the navel. Common in newborns, it also commonly afflicts obese women or those who have had many children.
  5. Hiatus hernias:  These occur when part of the stomach pushes up into your chest by squeezing through an opening in the diaphragm (the thin sheet of muscle that separates the chest from the abdomen). This type of hernia may not have any noticeable symptoms, although it can cause heartburn in some people.
  6. Epigastric hernias:  These occur when fatty tissue pushes through your abdomen, between your navel and the lower part of your breastbone (sternum).
  7. Spigelian hernias:  These occur when part of your bowel passes through your abdomen at the side of your abdominal muscle, below your navel.
  8. Diaphragmatic hernias:  These occur when organs in your abdomen move into your chest through an opening in the diaphragm. These can affect babies, if their diaphragms do not develop properly while in the womb; but these can also affect adults.
  9. Muscle hernias: These occur when part of a muscle pushes through your abdomen. They can also occur in leg muscles, as the result of a sports injury.

CAUSES:

Ultimately, all hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia; the pressure pushes an organ or tissue through an opening or a weak spot. Sometimes, the muscle weakness is present at birth; more often, it occurs later in life.

Anything that causes an increase in pressure in the abdomen can cause a hernia, including:

  1. Straining on the toilet (due to long-term constipation, for example).
  2. Persistent cough.
  3. Enlarged prostate.
  4. Straining to urinate.
  5. Being overweight or obese.
  6. Abdominal fluid.
  7. Lifting heavy items.
  8. Peritoneal dialysis.
  9. Poor nutrition.
  10. Smoking.
  11. Physical exertion.
  12. Undescended testicles.

SYMPTOMS:

If you have a hernia, you should see your doctor immediately.

Hiatal hernias produce symptoms that are usually worse after meals.  These symptoms may be made worse when lying flat and may resolve with sitting up or walking.  They are:

  1. Heartburn, as chest pain or burning.
  2. Nausea, vomiting, or retching (dry heaves).
  3. Burping.
  4. Waterbrash, the rapid appearance of a large amount of saliva in the mouth that is stimulated by the refluxing acid – GERD (gastroesophageal reflux disease) – contents of the stomach travels backwards into the esophagus due to reverse peristalsis.

Umbilical hernias produce symptoms of:

  1. Pain.
  2. Vomiting.
  3. The bulge (in both children and adults) that is tender, swollen, or discolored.

Inguinal hernias produce:  

  1. Pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting.
  2. Weakness, pressure, or a feeling of heaviness in the abdomen.
  3. A burning, gurgling, or aching sensation at the site of the bulge.
  4. Hernia becoming firm or tender, or cannot be pushed back in (these symptoms could mean that the blood supply to a section of organ or tissue trapped in the hernia has become cut off (strangulation), or that a piece of bowel has entered the hernia sac and does not go back into the abdomen (blocked or obstructed).

A strangulated hernia and obstructed bowel are medical emergencies and need to be treated as soon as possible.

TREATMENT

Surgery:

There are two main ways surgery for hernias can be carried out:

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.

Keyhole (laparoscopic) surgery – this is a less invasive, but more difficult technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia. The abdomen is inflated with gas to improve visualization and space,  and the whole operation is performed under general anesthetic.  Surgical repair of a hernia guided by a laparoscope allows for the use of smaller incisions, enabling a faster recovery from the operation.

Most people are able to go home the same day or the day after surgery and make a full recovery within a few weeks.

If your doctor recommends surgery, it is important to be aware of the potential risks as well as the possibility of the hernia recurring.  Make sure to discuss the benefits and risks of the procedure with your surgeon, in detail, before having the operation.

Tags: hernia , prostate , Lumps , constipation , muscle weakness

 

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