Hernia is a condition that occurs in the stomach or intestine. According to Asia Pacific Hernia Society, there are more than 1 million cases in India every year. It causes a localized bulge that is situated in the abdomen or groin. This condition is usually directly diagnosed by feeling for or looking for the bulge. It tends to be harmless and painless mostly. But at times it could bring discomfort and abdominal pain. It may not be life-threatening in the immediate future. But it also requires medical help. So, one should know more about this common health problem.
What is Hernia?
A hernia occurs when an organ or fatty tissue tends to squeeze out through a weak spot in an adjoining muscle or connective tissue known as fascia. It happens when there is a gap or hole in the peritoneum. Peritoneum is the muscular wall which usually keeps the organs in place. This lump or bulge may disappear when the person is lying down. But activities like coughing may make it reappear.
Types of Hernia:
The most common types of hernia include inguinal (inner groin), femoral (outer groin), hiatal (upper stomach), incisional (due to an incision) and umbilical (belly button).
- Inguinal Hernia: In this type of hernia, the intestine or the bladder protrudes out of the abdominal wall or into the inguinal canal that is located in the groin. Most of the groin hernias are of this type. This condition tends to occur more in men.
- Femoral Hernia: This occurs when the intestine gets into the canal that carries the femoral artery. These are mostly common in women, more so if one is pregnant or obese.
- Incisional Hernia: Here, the intestine protrudes through the abdominal wall, but at the same site where a previous abdominal surgery has been carried out. This type of hernia is mostly seen in elderly or overweight people who have become sedentary post the surgery.
- Hiatal Hernia: This happens when the upper part of your stomach pushes through the hiatus. Hiatus is an opening in the diaphragm which lets the esophagus pass.
- Umbilical Hernia: This occurs when a part of the small intestine protrudes through the abdominal wall near the navel. This is mostly seen in newborns and women who are obese or have had many children.
Symptoms of Hernia:
The most common symptom of Hernia is a painful lump or bulge in the affected part of the body. Generally, it can be pushed back into the abdomen. In severe cases, the bulge becomes firm and cannot be pushed back. Other common symptoms include:
- Pain or discomfort usually in the lower abdomen – especially when lifting, coughing, sneezing or bending over.
- A heavy feeling or a kind of pressure in the abdomen.
- A burning or aching feeling at the place of the bulge.
- Acid reflux that is a burning sensation which is caused when stomach acid moves back into the esophagus.
- Pain in the chest
- Difficulty in swallowing.
Causes of Hernia:
In most cases, hernia has no obvious reason for taking place. Except those cases when hernia is formed as a complicated result of abdominal surgery, one cannot tell for sure why it happens. It is caused by the combination of increased intra-abdominal pressure and the consequent weakening of muscle or fascia. Sometimes, this muscle weakness is present at birth – which is a congenital cause. It might also occur later on in life due to activities or medical conditions that put pressure on the abdominal wall. These include:
- Persistent cough or sneezing
- Poor nutrition
- Diarrhea or constipation
- Cystic fibrosis
- Being obese
- Ascites i.e. abnormal collection of abdominal fluid.
- Lifting heavy objects
- Enlarged prostate gland
- Peritoneal dialysis
- Physical exertion
- Recurrent vomiting
- Abdominal surgeries
- Premature birth and low weight at birth
Treatment of Hernia:
Whether you need medical treatment and which, depends on the size of hernia you have and the severity. Your doctor could simply decide to monitor your hernia first. Treatment options include lifestyle changes, medications or surgery.
- Lifestyle Changes: Changes in your diet could sometimes treat the symptoms of hernia but it will not make the condition go away. You should avoid large and heavy meals. You should not immediately lie down or bend over after a meal. You should also try to lose or maintain your body weight. Certain exercises also help to strengthen the muscles around the hernia. But improperly executed exercises could elevate the pressure. So, it is better to take advice from a physical therapist. You should also try to avoid spicy or sour foods which causes acid reflux.
- Medications: If you are diagnosed with hiatal hernia, there are over-the-counter medicines which reduce stomach acid. These include antacids, proton pump inhibitors and H-2 receptor blockers which help to relieve your discomfort.
- Surgery: If your hernia is becoming larger or causing much pain, your doctor may decide it is best to get it operated. The surgeon will treat your hernia by sewing the hole in your abdominal wall. This is usually done by patching it with surgical mesh. They can also be repaired by an open or laparoscopic surgery. The latter uses only a few small incisions to repair the hernia and is less damaging to the tissue all around. Open surgery involves a longer recovery time and you may not be able to move around normally for up to six weeks. Laparoscopic procedures have a much shorter time of recovery but the risk of your hernia reoccurring is higher. Also, the hernias which involve the moving of a part of your intestine into the scrotum cannot be treated by laparoscopy.
Complications of Hernia :
Even minor hernias can cause intense discomfort or pain, especially when you’re straining — such as during physical activity, when you lift a heavy object, or if you have a difficult bowel movement.
Usually, it’s possible to push a hernia back inside the muscle layer it was sticking through — even if it doesn’t stay put. But complications can develop in which a hernia gets trapped and can’t be pushed back.
In the most severe of these cases, the tissue in a hernia can lose its blood supply, die, and become infected. This is a medical emergency that typically requires immediate surgery.
Prevention of Hernia:
While congenital hernias cannot be prevented, the risks of developing other types of hernias can be substantially minimized. The main aim is to avoid putting pressure on the abdomen that weakens the wall. You could do so by:
- Maintaining a healthy weight.
- Using proper techniques when lifting objects at home, work or during sports.
- Eating a healthy diet and exercising regularly to facilitate a normal bowel movement.
- Avoiding smoking to reduce recurrent coughing.
- If a hernia at all develops, medical care should be sought and have it potentially treated before it gets incarcerated.
So, now that you know all about hernia, you can evaluate the hernia situation better if and when you face one. It is very important to get it promptly checked by your doctor even if it is causing you no pain and discomfort. And post-operative measures are even more important to be followed to prevent the hernia from reoccurring.