Hernia - When to Approach a Doctor?

Hernia is a common health issue that occurs when there is a protrusion of an internal organ or a body part through a muscular wall or tissue in which it is present. Usually, most hernias occur between the chest region and the hips within the abdominal cavity. It happens because there is a weakness or hole in the abdominal wall (peritoneum) that holds the organs in its appropriate place.

Most often, hernia can be harmless and may not cause any symptoms. However, there are instances where it can cause discomfort and pain. Abdominal problems related to hernia may indicate some serious issue and must not be ignored. Hernias are easily diagnosed by physicians either by feeling them or by looking for obvious bulges.

Symptoms of Hernia

• Presence of a noticeable swelling or lump which may be pushed back or may disappear while lying down
• Persisting or increased pain at the site of bulging
• Occurrence of pain while lifting objects
• Prevailing sensation of dull aches
• Increase in the size of the bulge or protrusion with time
• Sensation of feeling full or signs of obstruction in the bowel

Common Types of Hernia

• Inguinal Hernia: This type of hernia occurs when a small part of the bowel protrudes into the inguinal canal (passage through the abdominal muscles) into the groin. This causes a bulge which usually contains the abdominal tissue lining and fatty lining and may also have the intestinal loop. It is of two types-
• Direct Inguinal Hernia is caused by the development of a weak spot in the lower belly muscles.
• Indirect Inguinal Hernia happens when the inguinal canal does not close before birth.
• Femoral Hernia: This is caused when the intestine evades the canal that connects the femoral artery to the upper thigh. It is more common in pregnant or obese ladies.
• Umbilical Hernia: In this type of hernia, a portion of the bowel or fatty tissue protrudes through an area near the navel as it pushes through a weak spot in the nearby abdominal wall. It usually occurs in premature newborns and infants but may affect adults also mainly due to obesity. While some cases of umbilical hernia are self-resolvable, surgical treatment is required if the hernia persists even after the child is 2 years old or the hernia begins to hurt or grow in adults. Umbilical hernia surgery is a quick small surgery that is done to push the bulge back to its place and strengthen the abdominal walls.
• Incisional Hernia: Here the intestine pushes through the abdominal wall at the site of the previous surgery. It is common in overweight and inactive adults who have undergone surgery in the abdomen or pelvic area.
• Epigastric Hernia: The fatty tissues protrude through the abdominal region between the navel and lower part of the breastbone causing this hernia.
• Hiatal Hernia: This happens when the upper stomach squeezes itself into the diaphragm opening called hiatus and chest cavity. It is caused due to the weakening of diaphragm by aging or abdominal pressure. Hiatal hernia treatment involves medication and lifestyle changes if it poses similar problems as Gastro-Oesophageal Reflux Disease (GERD). Surgery is inevitable if blood supply in the oesophagus is hampered or patients suffer from severe acidic reflux.

Hernia and Treatment options

Treatment choices must be taken by carefully opting between watchful waiting and getting clinical intervention through surgery if severe symptoms persist. Temporary approaches involve using trusses, corsets or binders to hold the hernia in place. Hernia surgery specialist  may choose between herniorrhaphy (open surgery) or laparoscopic surgery depending on the patient’s condition and urgency of the situation.

The risk of hernia can be minimized by healthy habits like avoiding obesity through exercise, consuming balanced diets, quitting smoking and seeking appropriate medical evaluation if required.