Definition and Overview

Hernia is a medical condition characterized by an organ protruding through an opening in the tissue or muscle containing it. A good example is when the intestine breaks through the abdominal wall. Majority of hernias occur in the abdominal region, although they are also common in the groin. Hernias are not known to be life threatening, but the condition will not heal on its own and may present potentially dangerous complications in the future. For this reason, specialists recommend surgery to immediately treat the condition.

Hernias are identified according to the areas that are affected:

  • Inguinal Hernia - When the intestines push through a tear in the abdominal wall, most likely in the inguinal canal, it is identified as an inguinal hernia. Around 70 percent of hernias are of this type and occur mostly in men. The spermatic cord that holds up the testicles is located at the inguinal canal. After birth, the testicles will descend through this area, and the canal should completely close. Unfortunately, this does not happen all the time. If it doesn’t close completely, it becomes a weak area prone to hernias.

  • Hiatal Hernia - The organs located in the stomach are separated from those in the chest by the diaphragm muscles. If there’s a weak spot in the diaphragm, the stomach organs can protrude through that spot.

  • Incisional Hernia - This type of hernia only occurs after abdominal surgery when the area where the incision was performed is still weak. If the intestines push through that weak area, it is identified as an incisional hernia.

  • Umbilical Hernia - This happens in children under 6 years old. The intestines can push through the abdominal wall near the belly button creating a bulge. However, there is a chance that the condition may fix itself before the child turns one year old. If not, surgery will need to be performed to correct the condition.

Causes

The primary cause of hernia is weak muscles, but this can happen due to numerous reasons such as a congenital defect, chronic coughing, surgery, constipation, weight lifting, and sudden weight gain or obesity. Other established causes include pregnancy, ascites (fluid in the abdomen), and constipation. A family history of hernias is also proven to increase the risk of having the condition.

Key Symptoms

The most noticeable symptom is pain and discomfort in the area affected by the hernia while coughing, lifting heavy objects, or simply bending over. There can also be a burning sensation where the hernia has occurred.

Hernias can also cause an acid reflux where contents of the stomach, including acid, move up to the esophagus. You can also experience chest pain or difficulty in swallowing.

Sometimes hernia does not display any symptom and is only discovered during a routine check-up or while diagnosing a different medical condition.

Who to See and Types of Treatment Available

Most hernias are diagnosed through a physical exam. While hernias that create a bulge in the abdominal region or groin can easily be identified, some types of hernias can only be diagnosed through a barium X-ray or a procedure called endoscopy.

In a barium X-ray, the patient drinks a liquid containing barium. Barium will show up on an X-ray, displaying the digestive tract. The doctor then studies the images and identifies the area where the hernia has occurred.

In an endoscopy, a small camera attached to the end of a long, narrow, and flexible tube is inserted in the throat all the way to the stomach, passing the esophagus. The camera allows the doctor to see the location of the hernia in real time.

Once the hernia is identified, the doctor formulates a treatment plan. However, if the hernia is significantly small, treatment may not be necessary although the doctor may need to monitor the condition just in case it progresses.

Hiatal hernia can be treated through a simple change in lifestyle, such as changing the diet, staying away from heavy meals, and monitoring the weight to ensure that it’s within a healthy range.

If the hernia is causing too much discomfort or pain, it’s likely that the doctor will recommend surgery to repair the damaged area. During the surgery, the surgeon may apply a patch, called a surgical mesh, to close the hole or sew the damaged area altogether.

The surgeon may decide to perform an open surgery or laparoscopic surgery. Since an open surgery takes a lot longer to perform and to recover from, most recommend laparoscopic surgery, which is a minimally invasive procedure proven to be more effective and safer for patients. This is performed through small incisions near the affected area. Small surgical instruments are used to repair the damage, and a camera monitors the progress. Recovery from this type of procedure is significantly faster compared to traditional surgery.

Resources:

  • National Institute of Diabetes, Digestive and Kidney Disorders
  • National Library of Medicine
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