Hernia: Everything you need to know

A hernia is simply a protrusion of an organ (such as the intestine or part of the stomach) from its normal position. This happens when the muscles or tissues surrounding the organ become weak, allowing the organ to protrude through that weak spot. It's like a bulge in one part of the body.

It's like a tube in a tire bulging out from a weak spot.

What are the causes of hernia?

There are several main causes of hernias. Let's look at them one by one:

Congenital defects:

Some babies may have weak spots in their abdominal muscles when they are born. It's just the way their bodies are built. These people are more likely to develop hernias.

Aging:

As we age, every part of our body gradually weakens. Muscles are no exception. When muscles weaken over time, hernias can occur.

Straining:

• Heavy Lifting: This condition can occur in people who lift heavy objects continuously, such as those who carry goods or those who build buildings (construction workers).
• Prolonged Standing: People who work in jobs that require them to stand for long periods of time are also at risk.

Cough and Constipation:

• Chronic Cough: If you have a constant cough, it can put pressure on your abdominal muscles, which can eventually lead to a hernia.
• Constipation : When you are constipated, straining during bowel movements puts pressure on your abdominal muscles. If this continues, a hernia can develop.

Pregnancy:

When you are a mother, the growing baby inside your belly puts a lot of pressure on your abdomen. This can cause some mothers to develop a hernia.

Obesity:

If you are very obese, your abdominal muscles will always have to bear extra weight. This can also cause a hernia to form over time.

Abdominal Surgeries:

If you have had abdominal surgery, if the wound does not heal properly, a hernia can occur through the incision. Therefore, you need to be very careful after surgery.

What are the places where hernias can occur?

Hernias most often occur in these places:

Abdomen:

Hernias can occur anywhere in the abdomen.

Groin:

The groin is where the thigh and abdomen meet. Hernias are also common here.

Diaphragm:

The diaphragm is the muscular wall that separates the chest and abdomen. A hole in it allows part of the stomach to protrude upward.

Previous Surgical Sites:

A hernia can occur through the scar where abdominal surgery was performed.

What are the types of hernias?

There are different types of hernias. These are classified according to where the hernia is located.

Inguinal Hernia:

• This is the most common type of hernia.
• This is most common in men.
• Part of the intestine passes down a path called the inguinal canal, similar to putting your hand in a trouser pocket.

Femoral Hernia:

• This is also a type of hernia that occurs in the groin.
• Fat- like substances come out from a place called the femoral canal, which is slightly below the inguinal canal.
• This happens a little more to women.

Hiatal Hernia:

• There is an opening in the muscular wall called the diaphragm through which the esophagus (the tube through which we eat) passes down. That hole has become large, and the upper part of the stomach protrudes through that hole into the chest.
• This can cause things like food getting stuck in the throat and heartburn.

Umbilical Hernia:

• This name is given to the fact that part of the intestine protrudes from the belly button.
• Most of the time, this is congenital. Sometimes it gets better on its own.

Incisional Hernia:

• If a hernia occurs where abdominal surgery was performed, it is called an incisional hernia.
• This is what can happen if you're not careful after surgery.

Ventral Hernia:

• A hernia located somewhere in the front of the abdomen (between the chest and abdomen) is called a ventral hernia.
• Umbilical hernias and incisional hernias also fall into this category.
• Ventral hernias that occur above the stomach are also called epigastric hernias .

Perineal Hernia:

• These are very rare.
• The pelvic floor is a layer of muscle located at the bottom of our abdomen. A perineal hernia is when organs protrude through a weak spot in it.

What are the symptoms of hernia? (Symptoms)

Not everyone experiences the same symptoms. Some people may not have any problems at all. However, these things may happen:

• Bulge/Lump: The herniated disc may appear swollen. This may not always be visible. The bulge may appear when lifting, bending, or coughing.
• Pain/Discomfort: You may feel a pressure, a pulling, or a slight ache in the area.
• Cough/Laugh: This pain/discomfort may increase when coughing or laughing.
• Heartburn/Acid Reflux : If you have a hernia in your chest (hiatal hernia), it can feel like food is coming up into your throat, causing heartburn. This is called acid reflux.

Are the symptoms different for women and men?

Most of the time, there is no difference. However, an inguinal hernia can sometimes affect the testicles (in men). A femoral hernia in women may not be visible from the back, but it can cause pain in the groin.

Is hernia dangerous? (Complications)

Even if it doesn't seem like a big deal at first, problems can arise over time.

• Incarceration: The part that came out may get stuck and you may not be able to go back in. This can be very painful.
• Strangulation: When the blood supply is cut off, the tissue can die (necrosis/gangrene). This is an emergency . You should see a doctor immediately.

Complications of diaphragmatic hernia:

Complications of a hiatal hernia are a little different. They usually don't get stuck. However, problems like chronic acid reflux can persist. A congenital diaphragmatic hernia (present at birth) is a serious condition. The baby's lungs may not develop properly.

What to do if you have hernia pain?

If you have hernia pain, be sure to see a doctor. Because there can be other diseases that have similar symptoms to a hernia. That's why it's important to know exactly what it is. If the hernia changes color, feels numb, or becomes very hot, or if you're vomiting, see a doctor immediately.

How to diagnose a hernia?

In most cases, a doctor can tell if you have a hernia by simply doing a physical examination. They may ask you to cough or bend over to see if the hernia comes out. Some types of hernias (those that are deep) may need to be diagnosed with a CT/ultrasound scan.

What are the treatments for hernias? (Treatment)

Most hernias require surgery. However, some small hernias, if not too serious, can be treated with a little patience. However, this is up to the doctor. Usually, hernias get bigger over time, so it is better to treat them early. Umbilical hernias, which are located near the baby's belly button, may heal on their own.

Surgery:

During surgery, the part that came out is put back in, and the weak spot in the muscle is either sewn up or reinforced with something like surgical mesh. This is usually not a major surgery. Most of the time, the surgery is done by making a few small holes (laparoscopic surgery) and inserting instruments through those holes. This is less painful. Sometimes, this surgery is done using a robot (Robotic surgery). However, some hernias require surgery through an open incision (open surgery).

Treatment for hiatal hernia:

If a hiatal hernia is causing food to come up into the esophagus, a separate surgery (Nissen fundoplication) can be performed. This involves taking the upper part of the stomach and wrapping it around the esophagus and sewing it shut.

Possible problems after surgery (Side Effects and Complications of Treatment):

• Bleeding
• Wound infection
• Allergic reactions to medications
• Some people may have difficulty urinating for a while.
• After inguinal hernia surgery, some people may have ongoing pain (due to nerve damage).

What happens if a hernia develops? (Outlook/Prognosis)

When you find out you have a hernia, your doctor will look at things like what your hernia looks like and how quickly it will grow to decide whether you need surgery right away or if you can wait a while.

Most hernias require surgery. But don't worry, this is usually not a major surgery. Most of the time, you can go home the same day. The surgery is very successful. However, there is a 10% chance that the hernia will come back. That said, if you continue to do the things that caused the hernia (such as lifting weights, coughing), the chances of it coming back are high.

Living With It

If you have a hernia, but haven't had surgery yet, or it's too late to do it, be aware of these things:

• Work: Depending on the nature of your job, if you have to do heavy lifting or stand for long periods of time, you may need to cut back on those activities. Your doctor may recommend that you find another job.
• Heavy Lifting: Avoid lifting heavy objects as much as possible. If you have to lift something, maintain proper posture, bend your knees, and sit up straight. Lifting incorrectly can make a hernia worse.
• Constipation: If you have constipation, take medication for it. Otherwise, straining while going to the bathroom can make the hernia worse.
• Cough: If you have a persistent cough, take medicine for it. A prolonged cough is not good for a hernia.
• Truss/Restraining Belt: Sometimes the doctor may recommend that you wear a truss/restraining belt to tighten the hernia. This can help control the hernia from protruding a little. However, this is not a permanent solution.
• Symptoms: Pay attention to any changes in your hernia, such as increased pain or color changes. If you notice any such changes, see a doctor immediately.

Frequently Asked Questions (FAQs)

Finally:

Hernias are a common occurrence. However, if you know about them and take precautions, you can reduce the risk of many problems. If you feel anything unusual, it is important to see a doctor immediately for advice.