June is Hernia Awareness Month, intended to increase knowledge about a fairly common and treatable condition. There are several different types of hernias, which most often occur within the abdominal area, between the chest and hips. A hernia occurs when an internal organ protrudes through the abdominal muscle.
By far the most common type of hernia is the inguinal hernia. An inguinal hernia occurs when part of the intestine or fatty tissue pokes through the abdominal wall near the top of the thigh. Inguinal hernias are eight times more likely to affect men than women. The hernia may be painful, especially when coughing or bending over. On the other hand, sometimes hernias do not cause any discomfort. The hernia is not necessarily dangerous, but it may lead to health complications if not treated, most often through hernia repair surgery.
An inguinal hernia may cause:
- A bulge in the abdomen near the pubic bone
- Pain and discomfort in the area of the bulge or in the groin area
- A feeling heaviness or pressure in the groin
Occasionally, an inguinal hernia can become incarcerated or trapped in the abdominal wall. This can lead to blood flow to the affected tissue bring cut off, also known as strangulation. This is a potentially life-threatening condition and requires immediate, emergency medical attention. Symptoms of a strangulated hernia include:
- Nausea or vomiting
- Sudden, intense pain
- A hernia bulge that becomes red or purple
- Severe constipation
Causes and Risk Factors
Inguinal hernias are more likely when there is a weakness in the muscle of the abdominal wall. Such a weakness may be present at birth, or it may develop over time. Additionally, strenuous activity, repeated straining during bowel movements and chronic coughing are all potential contributors to hernias.
Key risk factors include:
- Being male
- Getting older
- Family history of hernias
- Smoking; a chronic cough can weaken the abdominal walls
- Repeated constipation
- Previous history of inguinal hernias
Diagnosis and Treatment
An inguinal hernia can usually be diagnosed with a physical examination by your primary care provider. Occasionally, a CT scan or other imaging test may be used to confirm a suspected hernia.
If a hernia is not causing problems, it may be recommended to take a “wait and see” approach. Most often though, surgery is the appropriate treatment for an inguinal hernia.
There are two types of surgery used to repair inguinal hernias.
Open Hernia Repair
In this traditional surgical procedure, the surgeon makes an incision in the groin and pushes the protruding tissue back into place. The weakened part of the wall is repaired by sewing it and possibly inserting a mesh reinforcement. The incision is then sewn or stapled to close it.
Minimally Invasive Hernia Repair
Minimally invasive, or laparoscopic, surgery is a highly effective way to repair hernias.
The advantages of laparoscopic surgery are numerous. Instead of making a large incision of several inches in length, the surgeon is able to perform the surgery by making three or four small incisions and then inserting small tools and a thin, flexible tube with a video camera on the end. The images from the camera are displayed on a television monitor that the surgeon utilizes to see inside the patient’s body and guide the surgical instruments accordingly. This process results in less cutting on the patient and therefore, minimal scarring.
Laparoscopic surgery for hernia repair also provides the advantage of reduced blood loss and decreased risk of infection. Recovery time is faster and hospital stays are shorter. While there is some risk associated with all surgeries, laparoscopic surgeries have a decreased overall risk when compared to traditional, open surgery.
Every patient’s situation is different, so the surgeon will recommend the surgical approach best suited to the patient.
While the cause of inguinal hernias is not always evident, there are definitely some things you can do to lower your risk of developing one:
- Eat a well-balanced diet that includes plenty of whole grains, fruits and vegetables – this helps prevent constipation and straining to complete a bowel movement.
- Be careful when lifting heavy items. Always use proper form.
- Do not smoke. The chronic cough that results from smoking weakens the abdominal wall.
- Maintain a healthy weight. Being obese or overweight is a key risk factor for developing a hernia.
Other Types of Hernias
While inguinal hernias are by far the most common, there are several other types of hernias:
- Femoral hernia: Occurs when part of the intestine or fatty tissue protrudes into the groin. A femoral hernia primarily affects older women.
- Umbilical hernia: This is a similar protrusion that occurs near the belly button. This can affect newborns, but most of those close by the time the child turns 5.
- Hiatal hernia: This happens when part of the stomach pushes upward toward the chest through an opening in the diaphragm.
- Incisional hernia: Is caused when tissue protrudes through an abdominal scar from a previous surgery.
- Epigastric hernia: This is when tissue protrudes through the area between the navel and the sternum.
- Spigelian hernia: This occurs on the side of the abdominal muscle, below the navel.
- Diaphragmatic hernia: When abdominal organs move upward into the chest cavity through an opening in the diaphragm, this type of hernia may result.
“With more than 3 million cases a year in the United States, hernias are not unusual. In some cases, they can lead to serious health complications if not diagnosed and treated,” says Dr. Paul Gray, a general surgeon. “The good news is that hernia repair surgery is a common, highly effective surgery – if you believe you may have a hernia, see your primary care provider as soon as possible.”
This article contains information sourced from: