What is a Hernia

An Overview

A hernia occurs when part of an internal organ or body part protrudes through an opening into another area where it ordinarily should not be located. There are many different types of hernias, but the most common is when a portion of the intestine protrudes through a weak area in the muscular wall of the abdomen. The most common types of Hernia In an inguinal (inner groin), incision (resulting from an incision), femoral (outer groin), umbilical (belly button) and hiatal (upper stomach) an inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. The resulting bulge can be painful, especially when you cough, bend over or lift a heavy object. In an inguinal hernia, the intestine or the bladder protrudes through the abdominal wall or into the inguinal canal in the groin. In addition, obesity, poor nutrition and smoking, can all weaken muscles and make hernias more likely.

Types of hernia

The most common types of hernia are

  • Epigastric hernia: An epigastric hernia is one that occurs in the epigastric region of the abdomen, which is located above the belly button and below the ribcage.
  • Inguinal (inner groin): An inguinal hernia occurs when a portion of intestine or fat bulges through the lower stomach wall. The bulge usually goes through the inguinal canal, which is located in the groin area.
  • Incisional (resulting from an incision): An incisional hernia can occur after a person has stomach surgery, which usually involves an incision down the middle of the stomach.
  • Femoral (outer groin): A femoral hernia occurs when tissue pushes through a weak point in the groin or inner thigh. The hernia may feel like a small- to medium-sized lump in the groin.
  • Umbilical (belly button): Umbilical hernias are those in which tissues in the body bulge through an area of weakness in the belly button area (umbilicus).
  • Hiatal (upper stomach ): A hiatal hernia is a condition that occurs when a person’s stomach bulges through a weak point in the diaphragm, a muscle that separates the lungs from the abdominal organs.

 Symptoms of a Hernia

For inguinal, femoral, umbilical and incisional hernias, symptoms may include:

  • An obvious swelling beneath the skin of the abdomen or the groin; it may disappear when you lie down and may be tender.
  • A burning or aching sensation at the bulge.
  • A heavy feeling in the abdomen that is sometimes accompanied by constipation or blood in the stool.
  • A heavy or dragging sensation in your groin.
  • Weakness or pressure in your groin.
  • Discomfort in the abdomen or groin when lifting or bending over.
  • A bulge in the area on either side of your pubic bone, which becomes more obvious when you’re upright, especially if you cough or strain.
  • Pain or discomfort in your groin, especially when bending over, coughing or lifting.
  • Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement.
  • Occasionally, pain and swelling around the testicles when the protruding intestine descends into the scrotum.
  • In an older child, a hernia is likely to be more apparent when the child coughs, strains during a bowel movement or stands for a long period.
  • A hernia bulge that turns red, purple or dark.
  • Inability to move your bowels or pass gas.

 Causes of  Hernias

Ultimately, all hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia the pressure pushes an organ or tissue through the opening or weak spot. Sometimes the muscle weakness is present at birth; more often, it occurs later in life. In many people, the abdominal wall weakness that leads to an inguinal hernia occurs at birth when the abdominal lining (peritoneum) doesn’t close properly.

  • Lifting heavy objects without stabilizing the abdominal muscles.
  • A pre-existing weak spot in the abdominal wall.
  • Diarrhea or Constipation.
  • Straining during bowel movements or urination.
  • Strenuous activity.
  • Being born premature or with a low birth weight.
  • Persistent coughing or sneezing.
  • Increased pressure within the abdomen.
  • Pregnancy.
  • Chronic coughing or sneezing.
  • Being overweight.
  • Fluid in the abdomen.

Diagnosis

To diagnose your condition, your doctor will first perform a physical examination. During this examination, your doctor may feel for a bulge in your abdominal or groin area that gets larger when you stand, cough or strain. If the diagnosis isn’t readily apparent, your doctor might order an imaging test, such as an abdominal ultrasound, CT scan or MRI.
Gastrografin or barium X-ray which is a series of X-ray pictures of your digestive tract.

Treatment

If your hernia is small and isn’t bothering you, your doctor might recommend watchful waiting. Sometimes, wearing a supportive truss may help relieve symptoms, but check with your doctor first because it’s important that the truss fits properly. In children, the doctor might try applying manual pressure to reduce the bulge before considering surgery.
During open surgery, the surgeon makes an incision close to the site of the hernia, and then pushes the bulging tissue back into the abdomen. They then sew the area shut, sometimes reinforcing it with surgical mesh.

Prevention

  • Maintain a healthy body weight, which puts less pressure on the abdominal wall.
  • Get enough of the right exercise.
  • Refrain from smoking.
  • Incorporate high-fiber foods into your diet.
  • Refrain from straining when lifting weights. Lifting too-heavy weights can also place excess stress on the abdominal wall.
  • Avoid heavy lifting, or do it carefully. If you have to lift a heavy object, bend down with your knees instead of your waist.
  • Refrain from straining when passing a bowel movement. Eating a high-fiber diet and drinking plenty of water can help make stools easier to pass.

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