OVERVIEW
Hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall.
Hernias are common in the area of your abdomen between your chest and hips, but they can also develop in the region of your upper thighs and groin.
While most hernias don’t pose a life-threatening hazard right away, they also don’t go away on their own. Surgery may occasionally be necessary to avoid potentially serious side effects.
Types
Inguinal hernia
Inguinal hernias are the most common type of hernia. They 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 your groin. In men, it’s the area where the spermatic cord passes from the abdomen to the scrotum. This cord attaches to the testicles. In women, the inguinal canal contains a ligament (called the round ligament) that helps hold the uterus in place.
Because the testicles descend through the inguinal canal soon after birth, inguinal hernias are more common in men. Behind them, the canal is planned to almost entirely close. Occasionally, the canal won’t completely shut, creating a weak spot. Study up on inguinal hernias.
Hiatal hernia
When a portion of your stomach pushes through the diaphragm and into your chest cavity, it is known as a hiatal hernia. The diaphragm is a muscular sheet that contracts to bring air into the lungs, aiding in breathing. It divides the organs in your chest from those in your abdomen.
The majority of cases of this kind of hernia occur in adults over 50. If a child has the syndrome, a congenital birth defect is often to blame.
Gastroesophageal reflux disease is usually always brought on by hiatal hernias (GERD). The stomach’s contents seep backward into the esophagus in GERD, giving the patient a burning feeling. Find out more about hiatal hernias.
Umbilical hernia
Children and infants may experience umbilical hernias. When the intestines protrude through the abdominal wall close to the belly button, they develop. If your child is weeping, you might see a bulge in or close to their belly button.
Only an umbilical hernia frequently resolves by itself when the muscles of the abdominal wall get stronger. By the time the child is 1 or 2 years old, this usually occurs. dependable source If the hernia has not disappeared by the time the child is five years old, surgery can be done to treat it.
Umbilical hernias can also occur in grownups. They can develop as a result of the abdomen being repeatedly strained by situations including obesity, ascites, or pregnancy. Learn more information about umbilical hernias.
Ventral hernia
When tissue protrudes through a gap in your abdominal muscles, it is known as a ventral hernia. When you’re lying down, you can find that a ventral hernia gets smaller.
Even while a ventral hernia can develop from birth, it’s more likely to happen later in life. Obesity, pregnancy, and rigorous activity are frequently contributing factors to the development of ventral hernias.
At the location of a surgical incision, ventral hernias can also develop. An incisional hernia can develop as a result of surgical scarring or weak abdominal muscles at the surgery site. About ventral hernias, keep reading.
Femoral hernia
Femoral hernias are an uncommon kind of hernias.
Sometimes a painful lump in the inner upper region of the leg or groin indicates the presence of a femoral hernia. When you lie down, the lump frequently vanishes or might be pushed back in. The lump could show up when you cough or strain.
Incisional hernia
Abdominal surgery can result in incisional hernias. Up to 15 to 20 percentTrusted Source of abdominal surgeries requiring incisions result in them. Your chance of getting an incisional hernia might change depending on a number of variables.
Continue reading to find out more about the signs, causes, danger signs, and potential remedies for incisional hernias.
Perineal hernia.
When organs or tissue push through your pelvic floor muscles and into your abdominal cavity, you may develop a perineal hernia. Following pelvic surgery, your chance of developing a perineal hernia is higher. This kind of pelvic floor hernia can also be brought on by injuries and pregnancy. Sitting down might be unpleasant. The perineal hernia has to be surgically repaired.
How common are hernias?
Overall, hernias are common, though some types are more common than others. Inguinal hernias affect around 25% of all men or people assigned male at birth. Hiatal hernias affect around 20% of people in the U.S. and 50% over the age of 50. Congenital hernias occur in about 15% of newborns, mostly umbilical. Incisional hernias make up about 10% of hernias, and all other types make up another 10%.
Causes
Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time.
Some common causes of muscle weakness or strain that can lead to a hernia include:
- a congenital condition, which occurs during development in the womb and is present from birth
- aging
- damage from an injury or surgery
- strenuous exercise or lifting heavy weights
- chronic coughing or chronic obstructive pulmonary disorder (COPD)
- pregnancy, especially having multiple pregnancies
- constipation, which causes you to strain when having a bowel movement
- being overweight or having obesity
- ascites
There are also certain risk factors that make you more likely to develop a hernia. They include:
- being born prematurely or having a low birth weight
- being older
- chronic cough (likely due to the repetitive increase in abdominal pressure)
- cystic fibrosis
- pregnancy
- chronic constipation
- being overweight or having obesity
- smoking, which leads to the weakening of connective tissue
- a personal or family history of hernias
Treatment
A hernia can only be adequately treated by surgical correction. The extent of your hernia and the intensity of your symptoms will determine whether you require surgery.
Simply keeping an eye on your hernia for potential consequences may be enough for your doctor. This strategy is known as cautious waiting.
Wearing a truss might occasionally assist to reduce the symptoms of a hernia. An undergarment that provides support and helps to retain the hernia in place is called a truss. Before using a truss, always check with your doctor to ensure that it fits properly.
If you have a hiatal hernia, over-the-counter (OTC) and prescription medications that reduce stomach acid can relieve your discomfort and improve symptoms. These include antacids, H2 receptor blockers, and proton pump inhibitors.
Diagnosis
Your doctor will do a physical examination before diagnosing your ailment. A bulge in your abdomen or groin that becomes bigger when you stand, cough, or strain could be felt by the doctor during this examination.
Your doctor will then take your medical history. They may ask you a variety of questions, including:
- When did you first notice the bulge?
- Have you experienced any other symptoms?
- Do you think something in particular may have caused it to occur?
- Tell me a little bit about your lifestyle. Does your occupation involve heavy lifting? Do you exercise rigorously? Do you lift weights professionally or recreationally? Do you have a history of smoking?
- Do you have a personal or family history of hernias?
- Have you had any surgeries in your abdominal or groin area?
Your doctor will also likely use imaging tests to aid in their diagnosis. These can include:
- Abdominal ultrasound. Abdominal ultrasound uses high-frequency sound waves to create an image of the structures inside the body.
- Abdominal CT scan. Abdominal CT scan combines X-rays with computer technology to produce an image.
- Abdominal MRI scan. Abdominal MRI scan uses a combination of strong magnets and radio waves to create an image.
If your doctor suspects a hiatal hernia, they may use other tests that allow them to assess the inside of your stomach:
- X-rays of your digestive tract. A healthcare professional will have you drink a liquid containing diatrizoate meglumine/diatrizoate sodium (Gastrografin) or a liquid barium solution. These liquids help your digestive tract appear highlighted on X-ray images.
- Endoscopy. During an endoscopy, a healthcare professional threads a small camera attached to a tube down your throat and into your esophagus and stomach.
Surgery
Your surgeon could decide it’s best to do surgery if your hernia is getting worse or giving you discomfort.
If the hernia creates an additional hole in your abdominal wall, the surgeon may choose to treat your hernia by stitching the abdominal wall hole closed. Typically, surgical mesh is used to fix the hole in this situation.
One of the body’s passages may occasionally expand significantly wider than it should due to a hernia. This could happen, for instance, at the area where the esophagus is supposed to pass through the diaphragm. Surgery can be done in certain circumstances to tighten the opening
Both open and laparoscopic surgery can be used to treat hernias.
A small incision is made near the hernia during open surgery, and the protruding tissue is subsequently pushed back into the abdomen. After that, they stitch the area shut, occasionally adding surgical mesh for reinforcement. They finally stitch up the wound.
The hernia is fixed via laparoscopic surgery using a small camera and tiny medical instruments. It simply needs a few little incisions and does minimal harm to the nearby tissue.
Not all hernias can be treated laparoscopically. Your surgeon will consult with you to decide which procedure is most appropriate for your situation if your hernia needs to be repaired through open surgery. Learn more about the treatment for inguinal hernias.
What happens if a hernia is left untreated?
You might not experience much pain from a little hernia. But hernias do have a tendency to enlarge over time. More tissue progressively makes its way through the incision as it continues to weaken and stretch. More tissue pushing through increases the likelihood that it may get imprisoned, causing discomfort and other problems.
Pregnancy and hernia
Consult a doctor if you believe you have a hernia while pregnant. They can assess it to see if there are any health dangers.
Hernia repair can frequently be postponed until after birth. A minor hernia that was present before or throughout pregnancy may need to be surgically repaired if it starts to grow or cause discomfort. This procedure is advised to be done in the second trimester of pregnancy.
Hernias that have previously been treated may recur during subsequent pregnancies. This is due to the impact pregnancy puts on abdominal muscles, which may already be weak from surgery.
Additionally, hernias can develop after a cesarean birth. A doctor makes an incision into the abdomen and uterus during a cesarean birth. These incisions are subsequently used to deliver the baby.
At the location of a cesarean birth, an incisional hernia can occasionally develop. Find out more information about hernias that develop after a c-section.
Hernia in babies
Babies with umbilical hernias are born between 10 and 25 percent of the time. Additionally, kids who are delivered preterm or with low birth weight are more likely to have this form of hernia.
Abdominal hernias happen close to the belly button. They develop as a result of improper closure of the muscles around the umbilical cord opening. As a result, a section of the gut protrudes.
You could detect an umbilical hernia in your child more when they scream or cough. Children’s umbilical hernias normally cause little discomfort. But if you experience symptoms like pain, nausea, or swelling where the hernia is, you should get emergency medical help.
If you detect that your child has an umbilical hernia, take them to the pediatrician.
Prevention
You can’t always prevent a hernia from developing. Sometimes a hernia occurs because of an existing inherited condition or a previous surgery.
However, you can make some simple lifestyle adjustments to help lower your risk of a hernia. These steps aim to reduce the amount of strain you place on your body.
Here are a few general prevention tips:
- If you smoke, consider quitting. You can work with your doctor to create a smoking cessation plan that’s right for you.
- See a doctor when you’re sick to avoid developing a persistent cough.
- Maintain a moderate body weight.
- Try not to strain while having a bowel movement or during urination.
- Eat enough high fiber foods to prevent constipation.
- Perform exercises that help to strengthen the muscles of your abdomen.
- Avoid lifting weights that are too heavy for you. If you must lift something heavy, bend at your knees and not your waist or back. Also avoid holding your breath when lifting heavy objects. Instead, exhale during the lift to decrease the chance of a hiatal hernia happening or worsening.