Hernia - Causes, Symptoms, Diagnosis and Treatment
Health Education

Hernia

Dr.Suresh Kumar Vummineni profile Authored by Dr.Suresh Kumar Vummineni on 28 Nov 2013 - 12:58.
A hernia is a protrusion of the organ from the tissue or muscle holding it in place.  This is called an abdominal hernia. Hernia can be best explained with an example: the intestines may break through a weakened area in the abdominal wall, when the wall holding the organ is weakened and the organs can bulge through the opening.
 
There are several types of abdominal hernias, each named by their location. Hernias are most common in the abdomen. However, they can also appear in the upper thigh, belly button, and groin regions. Though majority of hernias are not immediately life threatening, they will not go away on their own and will require surgical correction to prevent potentially dangerous complications.
 
Hernias may or may not be painful at the site, visible or felt as a lump. In some cases more vague symptoms result from pressure on an organ by getting stuck in the hernia, sometimes leading to organ dysfunction. 
 

Common Hernia types

Inguinal

Inguinal hernias are the most common type of hernia. They make up about 70 percent of all hernias, according to the British Hernia Centre (BHC). These hernias occur when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal.

The inguinal canal is found in the groins of both men and women. In men, it is the area where the spermatic chord passes from the abdomen to the scrotum. This chord holds up the testicles. In women, the inguinal canal contains a ligament that helps to hold the uterus in place.

This type of hernia is more common in men than in women.

Hiatal

A hiatal hernia occurs when part of your stomach protrudes up through the diaphragm into the chest. The diaphragm is a sheet of muscle that helps you breathe by contracting, drawing air into the lungs. It separates the organs in the abdomen from those in the chest. 

This type of hernia is most common in patients over 50 years old. If a child has the condition, it is typically caused by a congenital (birth) defect. Hiatal hernias almost always cause gastro-esophageal reflux when the stomach contents leak backward into the oesophagus, causing a burning sensation.

Umbilical

Umbilical hernias occur in babies and children under six months of age if their intestines bulge through the abdominal wall near the bellybutton. Parents may notice a bulge in or near their child’s bellybutton, especially when the child is crying. An umbilical hernia is the only kind that usually goes away on its own, typically by the time the child is one year old. If the hernia has not gone away by this point, surgery may be used to correct it.

Incisional

Incisional hernias can occur after an abdominal surgery. There is a tendency of intestines pushing through the incision scar or the surrounding, weakened tissue.

 

Hernias are caused by a combination of muscle weakness and strain. A hernia can develop quickly or over a long period of time, depending on its cause.

Common causes of muscle weakness include:

  • Failure of the abdominal wall to close properly in the womb (congenital defect)
  • Age
  • Chronic coughing
  • Damage from injury or surgery
     

Factors that strain your body and may cause a hernia include:
 

  • Being pregnant (puts pressure on your abdomen)
  • Being constipated (causes you to strain when having a bowel movement)
  • Heavy weight lifting
  • Fluid in the abdomen (ascites)
  • Suddenly gaining weight
  • Persistent coughing or sneezing

The most common symptom of a hernia is a bulge or lump in the affected area. In Inguinal hernia, a lump where the groin and thigh meet may be observed.

In the case of a baby, hernia is observed by feeling the bulge when the child is crying. A bulge is typically the only symptom of an Umbilical hernia.

Common symptoms of an inguinal hernia include:

  • pain or discomfort in the affected area especially when bending over, coughing, or lifting
  • weakness, pressure, or a feeling of heaviness in the abdomen
  • a burning, gurgling, or aching sensation at the site of the bulge

Symptoms of a Hiatal hernia include:

“Acid reflux cause stomach acid moving backwards into the esophagus and causes a burning sensation or a chest pain with difficulty felt while swallowing. In some 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,” says Dr. Suresh, General Surgeon. 

A physical examination can detect an Inguinal or Incisional hernia when a bulge in the abdomen or groin that gets larger on standing, or a cough, or a strain can show up as a bulge.

Hiatal hernia may be diagnosed with a barium X-ray or endoscopy. These tests allow the doctor to see the location of the stomach inside your body. A barium X-ray is a series of X-ray pictures of the digestive tract that are recorded after a liquid solution containing barium is taken, which shows up well on X-ray images. An endoscopy involves threading a small camera attached to a tube down the throat and into the esophagus and stomach. If a child has an umbilical hernia, the doctor may perform an ultrasound. 

Several factors increase the risk of developing a hernia, including:

  • A personal or family history of hernias
  • Being overweight or obese
  • A chronic cough
  • Chronic constipation
  • Smoking

Conditions such as cystic fibrosis can also indirectly increase your risk of developing a hernia. Cystic fibrosis impairs the function of the lungs, causing a chronic cough.

Most Inguinal hernias enlarge over time putting pressure on surrounding tissues and cause pain.

Incarcerated hernia is the most complicated of a hernia. It occurs when a loop of intestine becomes trapped in the abdominal wall. This in turn may lead to obstruction of the bowel. Strangulation can also occur if blood flow is slowed. A strangulated hernia is a medical emergency. It requires immediate surgery. Hernias can become bigger, infected, or stuck in one spot.

Surgery

Hernias are repaired with surgery. During the surgeries the bulging intestine is put back into place. The damaged wall is also repaired. Hernia treatment is mostly done by the mesh repair (a piece of mesh is inserted to provide extra support) except in congenital hernia. Congenital Hernia is treated by Herniotomy  ( the surgical correction of a hernia by cutting through a band of tissue that constrictsit)

“Laparoscopic surgery with mesh is the treatment adopted in most cases except contraindicated from anaesthisia. This type of surgery repairs the hernia using a very small incision. The repairs are done using a lighted, thin tube and small surgical instruments” says Dr. Suresh.

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.