Think of a hernia like a bulge in a damaged tire where the inner tube, normally contained by the hard rubber of the tire, extends through a thin or weakened place.
A hernia is a tear or opening in your muscle or tissue that allows part of your insides to bulge out and occupying the space under the skin.
Our abdominal wall contains soft tissues or inner tubes, and if there is a leak or weak spot; the soft tissue like fat or intestines can protrude through. The bulge can be of an internal organ or your intestines.
The opening in the abdominal wall that leads to the hernia is also known as a hernia defect.
What causes a hernia?
In general, the condition starts when the pressure on an organ or your intestines happens in the same area as a weakened muscle or tissue.
Some people are born with weak muscles or tissue that isn’t fully developed. However, most people get hernias as their bodies age and their muscles weaken.
Certain movements or habits can also get a hernia, or worsen an existing condition. Various causes are mentioned here;
- Picking up heavy objects (especially lifting them in the wrong way and with weak muscles)
- Overusing the same muscle
- Straining during coughing, sneezing, diarrhoea, or constipation
- Being overweight or having poor nutrition
- Using tobacco
- Certain rare conditions such as collagen vascular disease or genetic defects involving connective tissue may also cause abdominal hernias.
Types of Hernias
Sometimes you can see the hernia, depending on its location and size.
- These are the most common of all, also referred as groin hernias.
- They occur near the crease between the lower abdomen and the upper thigh.
- In this type, the intestine may protrude through the defect in the abdominal wall, creating a bulge on the right or left side.
- Between 10 to 15% of males and 2% of females could develop in their lifetime.
- They are less common, and would develop in some 10% of both males and females during their lifetime.
- These hernias occur outside the inguinal area of the abdomen, in the epigastrium, the part of the abdominal wall above the umbilicus (belly button) and/or within the umbilicus itself.
The Spigelian hernia
- It is another rarer type of ventral hernia, occurs in the mid-abdomen.
- A ventral hernia type develops when any prior abdominal surgery has weakened the abdominal wall, or where infection in a healing surgical incision causes breakdown of the wound closure.
- Incisional hernias are common in patients who have had intestinal surgery complicated by wound infections.
- About 25 to 30% of both males and females will develop an incisional hernia when a wound infection occurs after abdominal surgery.
This type of hernia develops in the upper thigh near the groin. These are much less common and are mostly found in women.
They occur in association with your belly button and are found more commonly in babies.
- This type of hernia occurs when a part of the upper stomach comes through an opening in your diaphragm, or chest wall.
- It can cause acid to leak from your stomach into your esophagus which may lead to heartburn, indigestion, and acid reflux.
Congenital diaphragmatic hernia
- This type of hernia can be due to some birth defects like when our diaphragm doesn’t form right. This can create space for your stomach to move into your chest.
- It can be diagnosed when you’re a baby or later in life.
- People may have other severe health issues like your stomach can crowd your chest organs, like your lungs and heart. Talk to your doctor about how to treat and manage these.
How is a hernia diagnosed?
Though you might not have any symptoms, however, you can see the bulge in the affected area. Sometimes, individuals can report symptoms like pressure, a cough, heartburn, and difficulty swallowing.
When you experience severe symptoms like shooting pain, vomiting, and constipation, visit your doctor immediately.
Your doctor usually can detect a hernia in a physical exam. They also might order tests to further assess your condition and the cause.
An ultrasound test uses sound waves to scan your body. A barium X-ray takes images of your digestive area and intestines. A computed tomography (CT) scan also uses X-rays to get pictures. An endoscopy studies your esophagus and stomach using a small camera at the end of a flexible tube.
Depending on your state of health, your doctor may suggest monitoring your condition through routine changes like your diet, activity, and habits. Medicines may help lessen hernia symptoms.
If the hernia symptoms don’t improve or worsen further, your doctor will suggest surgical treatment to minimize the risk of complications. Having a hernia will eventually require surgery to repair, and there are several different ways surgeons go about it.
Hernia repair is conducted using one of two surgical approaches.
Open Surgical Repair
- The surgeon makes an incision directly over the hernia defect and sews the prosthetic mesh to the abdominal wall.
- The surgery is done on an outpatient basis, usually under local anaesthesia with conscious sedation.
- This approach is very successful in the repair of small hernias.
- A hernia may be repaired using a minimally invasive, or laparoscopic, approach performed while the patient is under general anesthesia.
- This method is widely performed method where the surgeon inserts small tubes called cannulas through the abdominal wall at some distance from the hernia defect.
- A mesh prosthesis is then passed through one of the tubes into the abdomen and fixed to the under surface of the abdominal wall with stitches and staples. This technique is used for both small and large hernias of the abdomen.
Can a hernia be prevented or avoided?
The answer is NOT ALWAYS. Because some hernias like congenital hernias are caused by genetics that you can’t avoid or you also can be born with weak muscles that make it easier to get a hernia later in life (1).
However, you can reduce your chance of getting some types of hernias by
- Eating smaller meals
- Losing weight if you’re obese
- Avoiding or limiting alcohol and tobacco
- Avoiding or limiting certain foods (such as things that are spicy or high in fiber)
- Using proper lifting techniques to prevent strains
Must read – How to avoid eating disorders on your own?
Most types of hernias can be treated and corrected. However, it’s common for hernias to come back. Talk to your doctor or surgeon about the best treatment option for you and how to prevent recurring hernias.