What is Hernia?

Fascia tissue is a band of connective tissues located beneath the skin. These connecting, stabilizing and enclosing tissues are broken through by fatty tissues or a part of any organ. This occurrence is called Hernia. In Hernia, sometimes the organs push through the muscle openings as well. One of the most common types of Hernia is when intestine breaks through the weakened abdominal wall.

A Hernia can appear in the abdomen, belly button, upper thigh and groin areas. Hernia, if kept untreated, neither goes away naturally nor poses any life-threat.

Types of Hernia

There are multiple types of Hernia from which these 5 are the most common ones:

  • Inguinal (inner groin) The bladder or the intestine peeps through the groin inguinal canalor, the abdominal wall. Almost all the groin hernias are inguinal. Men have a tendency to lose strength in this region with aging. An Inguinal hernia is the result of this weakness.
  • Femoral (outer groin) Femoral Hernia, one of the most uncommon Hernias is painful lumps in the upper-inner groin and thigh. The pain decreases with lying down and increases with straining or coughing.
  • Incisional (result of an incision) In a case where any abdominal surgery was done previously and the same didn’t heal properly, the intestine hits and comes out through the abdominal wall. Three types of people are most prone to an incisional hernia: older people, excessive overweight people and people who have lived completely sedentary life after an abdominal operation.
  • Hiatal (upper stomach area) Hiatal Hernia is the pushing of the lungs to the diaphragm muscle.This is a treatable condition. It can last as short as a year to as long as a lifetime.
  • Umbilical (belly button) Before a person is born, the umbilical cord passes through the abdominal muscle. With Umbilical hernia, a portion of the patient’s intestine sticks out through it.

Hernia Symptoms

Irrespective of the type of Hernia, primarily a lump or bulging is seen in the affected area. Only for the Inguinal Hernia, the lump is seen on sides of the pubic bone; specifically where the groin and thigh meet.

A Hernia is well palpable and can be felt more while changing postures and walking. If the Hernia has developed with babies and infant, the bulging is visible the most when it’s crying. Babies are most prone to Umbilical Hernia.

Apart from these, other types of Hernia (Inguinal) symptoms are:

  • Constant or periodical discomfort or pain in the affected area. In most of the cases, the lower abdomen is the affected area.
  • Increase in the pain and the discomfort while changing positing, coughing and lifting some object.
  • Heaviness and pressure in the abdominal area
  • General weakness
  • A gurgling, burning or aching sensation around the spot

Apart from these, symptoms of a hiatal hernia include:

  • Chest pain
  • Difficulty swallowing
  • Acid reflux (when stomach acid moves to the esophagus)

In most of the cases, the early phases of Hernia are asymptomatic and patients don’t feel the problem till their daily activity is disrupted.

Causes of Hernia

Muscle strain and muscle weakness are jointly responsible for Hernia. Depending on what is responsible for this complication, a hernia can grow rapidly or over a long period of time.

Muscle weakness, the main cause of Hernia is caused by:

  • A congenital defect, failure of the abdominal wall near the womb
  • Chronic Coughing
  • Age
  • Damage from any surgery or injury

Other reasons for muscle weakness are:

  • Pregnancy as it puts pressure in the abdomen
  • Constipation as it creates a strain on the bowel movement
  • Persistent coughing or sneezing
  • Heavyweight lifting
  • Sudden gain of  weight
  • Fluid accumulation in the abdomen
  • Surgery in that area

Who are at risk of Hernia?

A Hernia is pretty common in India. The risk factors of Hernia are:

  • A family history
  • A  chronic cough
  • Being overweight
  • Smoking that welcomes chronic coughing
  • Chronic constipation

Cystic fibrosis is a life-threatening disease that damages the digestive system and the lungs.  This disease has a direct connection with Hernia. Cystic Fibrosis interrupts the normal efficiency of lungs which leads to chronic coughing.

Diagnosis of Hernia

For an Incisional hernia, multiple physical examinations are done. The physician often makes the diagnosis by feeling the bulging within the patient’s body.

Endoscopy and barium X-ray are 2 tests done for Hiatal Hernia.

With barium X-ray, multiple photographs are captured with the affected digestive tract. Prior to the examination, the patient is given a liquid solution of barium. This liquid helps to show the digestive track more prominently in the X-ray.

With Endoscopy, a small camera is inserted at your esophagus and stomach with a tube through the throat.

With both the tests, the internal situations of the organs and their functions are vividly shown.

For Umbilical Hernia, the diagnosis is generally done with an ultrasound.

Hernia Treatment

Whether and what type of treatment you need depends on the stage and the background of the Hernia. A hernia can be treatedbroadly by three types of treatments:

  • Lifestyle changes
  • Medications
  • Surgery

Changes in lifestyle include:

  • Avoiding heavy meals
  • Do muscle strengthening exercises
  • Avoiding foods that cause heartburn or acid reflux
  • Avoiding tomato-based foods
  • Giving up smoking

Treatment with medications include:

  • Medicines that reduce stomach acid
  • Proton pump inhibitors
  • H-2 receptor blockers

Treatment with surgery includes:

  • If the Hernia is rapidly growing, the best treatment is to get it operated. In most of the cases, the hole in the abdominal wall is repaired.
  • Hernia surgery can be done in 2 ways: open surgery and laparoscopic surgery. For open surgery, the patient may need up to 6 weeks to walk around normally.
  • Every type of Hernia is not fit for laparoscopic surgery. If the part of the intestine moves down into the scrotum, then open surgery is the only alternative left.
Content Reviewed By: Dr. Ved Prakash