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Verified By Dr Prof Kanhu Charan Das June 11, 2023
A hernia is a condition where an inside organ pushes out through an opening made by a flimsy point in your muscles.
Hernia is the protrusion of a muscle or tissue through the weakened wall of a cavity (eg: abdomen or pelvic floor) from its original site. Usually, hernia appears as a bulge arising from the cavity. It can occur in many areas of the body. The most common areas where hernias are observed are the abdomen and pelvic floor, groin, upper thighs and umbilicus (belly button area).
Abdominal and inguinal hernias are the most common. Men suffer from inguinal hernias more often than women.
Hernia can be of many types. But some of the most common types of hernia are as follows:
It is the most common type of a hernia. According to western studies, inguinal hernias constitute 75% of all cases of hernia. In this condition, a part of the intestine protrudes through the weakened abdominal wall cavity and appears at the groin or the inguinal region. This type of hernia results from weakened muscles due to ageing, strenuous physical activity and repeated coughing. Abdominal weakness that leads to a hernia could also be a result of an injury or an abdominal surgery This is of 2 types:
This occurs when the upper part of the stomach slides through an opening in the diaphragm (hiatus) through which the esophagus passes. Increase pressure on the muscles around the stomach leads to pushing of the stomach through the diaphragm.
Umbilical hernia occurs when a part of the small intestine protrudes through the umbilicus and appears as a bulge at the umbilicus. It is more common in newborns and in women with multiple pregnancies.
These hernias are less common and appear in the upper part of the thigh. A part of the intestine enters into a region called as a femoral canal and appears at the upper thigh. It is commonly seen in obese or pregnant women due to a wider pelvic structure.
This is the least common type of hernias of the pelvic floor and usually does not present externally as a bulge. It is seen in women with significant weight loss and multiple pregnancies.
Most hernias develop after birth. These are called acquired hernias. But some hernias are present in newborn babies and are observed at or before birth. These hernias are called congenital hernias.
Depending on the site of origin various types of a hernia have been described.
In most cases, hernia has no obvious reason for taking place. Except those cases when hernia is formed as a complicated result of abdominal surgery, one cannot tell for sure why it happens. It is caused by the combination of increased intra-abdominal pressure and the consequent weakening of muscle or fascia. Sometimes, this muscle weakness is present at birth – which is a congenital cause. It might also occur later on in life due to activities or medical conditions that put pressure on the abdominal wall. These include:
The causes of a hernia are different for different types. Each of the specific types of a hernia may have a specific cause.
Causes of an inguinal hernia include:
Though the actual cause of a femoral hernia is not yet known, it could arise as a result of the weakening of the femoral canal. The femoral canal is a tube-like structure in the front portion of the thigh and contains lymph nodes and connective tissue. It is weakened due to several reasons –
Natural ageing process could be one of the major causes of an obturator hernia. As the ageing process results in loosening of the muscle mass and fatty tissue, intestine and abdominal contents can pass from the pelvis to the thigh through the obturator canal.
Women are more likely to develop an obturator hernia when compared to men. Among women, those who have given birth multiple times are more vulnerable. Some other causes of an obturator hernia include loss of muscle tissue, sudden weight loss, and malnutrition.
This type of hernia is most common in babies but can rarely occur in adults as well. Babies who are born premature or low birth-weight are vulnerable to this type of hernia.
In adults, umbilical hernia could be caused by the sudden pressure on the weak part of the abdominal muscle. Causes of this hernia in adults include:
Hiatal hernia diseases occurs due to injuries or damages that weaken muscles tissues. . The factors that cause such extreme pressure include:
The most common symptom of Hernia is a painful lump or bulge in the affected part of the body. Generally, it can be pushed back into the abdomen. In severe cases, the bulge becomes firm and cannot be pushed back. Other common symptoms include:
Patients with Hernias may be symptomatic or asymptomatic. Symptoms of a hernia are related to its size, location, and presence of complications. In patients who are asymptomatic, the patients are diagnosed during a routine medical or physical examination for an irrelevant or unrelated symptom or problem.
Each type of hernia may be characterized by a varied set of symptoms, apart from the general symptoms. Some symptoms of a hernia based of their type are as follows:
Common signs and symptoms that indicate an inguinal hernia include –
In the case of femoral hernia, most of the small-sized hernias go unnoticed. Only the large hernias could be noticeable and can cause discomfort. There could be a bulge in the groin area, near the upper thigh. The bulge might appear and become worse when standing up, lifting heavy weights or being subject to a strain of any other kind. Hip pain could be a major symptom for a femoral hernia as these hernias are located very close to the hip bone.
In severe cases, femoral hernia could lead to the obstruction of intestines and put an individual’s life in danger. Symptoms that indicate strangulation or obstruction of intestines include:
This hernia could interfere with the blood flow to the intestines. Hence emergency treatment is required. If delayed, the condition may become fatal.
A bowel obstruction is a major symptom that indicates an obturator hernia. In some cases, bowel obstruction presents before a hernia is identified. Understanding the symptoms of bowel obstruction helps one to identify an obturator hernia. Some symptoms of bowel obstruction during a hernia include:
In babies, umbilical hernias can be seen when they are crying, laughing or straining while pooping. In a relaxed posture, this hernia is not visible. Common symptoms of umbilical hernia in children include:
Large hiatal hernias show symptoms but smaller ones have no signs or symptoms. Some symptoms of the larger hiatal hernias include:
These hernias could cause gastrointestinal bleeding, which would further result in vomiting of blood and black stools.
Hernia can occur to anyone but certain individuals are more vulnerable to it than the general population. Factors that put individuals at a higher risk for hernia include:
Risk factors for hernia include diseases and conditions that can weaken muscles or cause increased pressure within the body cavities. Examples of conditions that lead to muscle weakening include:
Sometimes if hernia is neglected and left untreated for a long time, it can cause some serious complications. The hernia in your body can grow and cause problems by putting strain on the nearby tissues resulting in severe pain and swelling in those tissues. As a result of hernia, sometimes your intestines can get trapped in your abdominal wall which can cause severe pain, swelling, nausea, vomiting and constipation.
Most hernias like inguinal or incisional hernias are diagnosed when the doctor conducts a physical examination. Sometimes hernias are visible when you stand upright or can be felt when the patient bears down. The doctor may ask the patient to strain or cough and feel for the swelling in the groin or abdomen.
The doctor examines a patient with inguinal hernia in the standing position. The doctor will look for a cough impulse. The patient is asked to cough and the sac can can be felt or observed. Proper abdominal and pelvic examination of the patient is done depending on the site of the sac.
The aim of a hernia repair is to reposition the herniated bowel and strengthen the weak muscles of the abdominal wall
Medications are required for hiatal hernia. OTC drugs and prescription medications are ordered to relieve symptoms of a hiatal hernia. Medicines like antacids, H2 receptor blockers, and proton pump inhibitors are commonly prescribed for the treatment.
Surgery is a key option in most cases to relieve discomfort and prevent serious complications.
In open hernia repair, the surgeon makes an incision or a cut in the groin and pushes the protruding tissue back into the abdomen. This is done after application or administration of local or general anesthesia. Following this, a synthetic mesh is reinforced after the surgeon sews the weakened area. This is also called as hernioplasty. The opening is then closed with stitches or surgical glue. A person who underwent open hernia repair would take several weeks to resume normal activities.
In laparoscopic repair, a surgeon operates through several small key-hole cuts in the abdomen. Gas is used to inflate the abdomen for a clear view of the internal organs. A laparoscope or a small tube which contains a tiny camera on one end is inserted through one of the cuts. The internal organs are seen through the camera on a screen. The surgeon uses the other cuts to repair a hernia identified in the body.
The patients who undergo a laparoscopic repair experience far less discomfort compared to those who have undergone open surgery. The scars are also very minimal or small. These patients can resume normal activities sooner.
This procedure was found effective for people who have had hernias recur after traditional hernia surgery. It was also seen to be a good choice for those with hernias on both sides of the body.
This procedure is said to have minimum complications when performed by an experienced professional.
Changes in lifestyle will not make a hernia go away but it can play an effective role in keeping the body weight in a controlled range. Body weight is the major trigger factor for a hernia. Dietary alterations, exercise, giving up smoking can improve symptoms to a large extent. Avoiding certain foods like spices and heavy meals can prevent one from experiencing acid reflux and heartburn.
You will be given directions after surgery. Eating clean and adopting a healthy lifestyle will definitely help in recovery. Try to avoid excessive strain in the affected area. Otherwise, it can reappear if not taken care of properly. Hernia recurrence in the body is linked to two main risk factors, smoking and becoming overweight.
There are a few things you can do right:
If you’re expecting a child and suspect you have hernia, consult doctors right away. They’ll be able to do a survey to see if it poses any risks to your health. The repair of a hernia will also be postponed until after the baby is born. However, if a mild hernia that occurred before or after pregnancy has grown or is causing pain, medical treatment to correct it may be recommended. Previously repaired hernias can reappear during subsequent pregnancies. This is because pregnancy puts a strain on stomach muscle tissues that have been damaged by a surgical procedure.
Hernia is caused due to muscle weakness, which cannot be prevented always. Certain activities that cause increased strain on the body can be avoided in order to prevent hernias and also avoid triggering hernias already present. Some tips that help in such prevention include:
So, now that you know all about hernia, you can evaluate the hernia situation better if and when you face one. It is very important to get it promptly checked by your doctor even if it is causing you no pain and discomfort. And post-operative measures are even more important to be followed to prevent the hernia from reoccurring.
Hernia can appear as a swelling in the area where it develops. Some hernias are hidden and may cause symptoms like pain and intestinal obstruction.
Yes, if not treated within time, hernia can lead to complications like obstruction and strangulation (blood vessels supplying blood to the organ are clogged) causing gangrene and death.
Only 10-13% of people experience pain after hernia surgery. If the pain is persistent, neuropathy and ischemia must be ruled out.
Recovery from hernia surgery usually takes one to two weeks. Avoid heavy weight lifting and strenuous exercises after surgery.
