What is a hernia?
Your muscles help hold your organs in place, but sometimes muscles are injured or weaken, allowing your intestine, bladder or stomach to push through. A hernia occurs when an organ or fatty tissue protrudes through a weak spot in the surrounding muscles or connective tissues. The most common types of hernias are:
- Inguinal hernia: The intestine or bladder pokes through a natural weak spot in the inner groin.
- Femoral hernia: The intestine extends into the femoral artery canal in the upper thigh.
- Incisional hernia: The intestine sticks out of the abdominal wall at the site of an incision from previous abdominal surgery.
- Umbilical hernia: The small intestine protrudes through the belly button muscles.
- Hiatal hernia: The upper stomach pushes through an opening in the diaphragm where the oesophagus extends from the mouth to the stomach.
If a hernia continues to grow or starts to cause complications, hernia surgery may be necessary.
Sometimes a hernia appears as a bulge or lump that you might be able to push back in, or it may disappear when you lie down. Additionally, it may become more noticeable when you cough, laugh or exert yourself. However, hiatal hernias do not usually cause a bulge or lump. Instead, hiatal hernia symptoms include acid reflux, heartburn, and regurgitation of liquids and/or food.
Certain conditions can weaken your muscles, which can cause a hernia to develop. These conditions can include, but are not limited to:
- Straining during bowel movements or whilst urinating
- Long-term coughing
- Cystic fibrosis
- Enlarged prostate
- Improperly lifting heavy items
- Being overweight or obese
- Giving birth
- Abdominal surgery
Men have a higher risk of developing inguinal hernias, and women have a higher risk of developing umbilical hernias, especially if they have had multiple pregnancies.
When to see a doctor about your hernia
Many hernias do not cause any symptoms and do not require urgent medical attention. However, a hernia can sometimes cause pain or discomfort. Many people with a hernia will see a doctor when it starts to swell, becomes sore, and/or their symptoms worsen when standing, straining or lifting heavy objects. During an examination, a doctor can determine whether a hernia may respond to conservative treatment or if hernia surgery is required.
Sometimes, immediate hernia surgery is required when an inguinal hernia causes an obstruction or becomes strangled. You should make an appointment with your doctor or seek emergency medical services as soon as possible if you experience the following hernia symptoms:
- Acute abdominal pain
- The hernia bulge cannot be pushed back and feels firm
In many cases, if you do not experience hernia symptoms, your doctor may suggest a “watch and wait” approach unless your hernia is likely to cause complications in the near future. For example, femoral hernias are riskier than other hernias because there is a 40% chance they will lead to strangulation within two years of diagnosis.
Non-surgical treatment methods include wearing a binder that keeps the hernia in place using gentle pressure; however, a doctor should oversee this treatment as there is a risk of developing complications.
Though some people can live for months or years with a hernia without adverse side effects, a hernia cannot fully heal without surgery.
Types of hernia surgery
Generally, there are two types of hernia surgery, which are:
- Open surgery: Using a larger incision, this surgery seals the hernia with mesh, sutures, or both.
- Laparoscopic (keyhole) surgery: Using a small incision, a camera at the end of a tube is inserted into the body, and tools are passed through the tube to repair the hernia.
Both types of hernia surgery require general anaesthesia; however, it usually takes longer to recover from open surgery because of the larger incision. Your doctor will determine which hernia surgery is right for you based on the size and location of your hernia.
Risks of hernia surgery
Like any medical procedure, hernia surgery comes with some risks. These risks include pain at the incision site, infection, damage to surrounding tissue, scar tissue development, and risks associated with general anaesthesia. Your doctor can discuss the risks of hernia surgery with you and help you determine whether those benefits outweigh those risks.
Some hernias, such as those caused by abdominal surgeries, cannot be prevented. However, there are some things you can do to help avoid inguinal hernias, including:
- Practice proper lifting techniques: Anyone who engages in heavy lifting, whether at the gym or at work, is at risk of developing an inguinal hernia. To reduce that risk, practice proper lifting techniques, divide the lifting load, or use a hand truck.
- Maintain a healthy weight: Being overweight strains your abdominal muscles, which can lead to a hernia. Speak with your doctor about safely reducing your weight through dietary changes and exercise.
- Focus on building your core strength: Strengthening the major muscles in your pelvis and abdomen helps prevent hernias by keeping those muscles strong and elastic so that they are less likely to develop a gap. Yoga and Pilates are wonderful ways to increase your core strength.
- Manage diabetes: If you struggle with uncontrolled diabetes, you have a higher risk of developing a hernia, and if you have hernia surgery, it can make it more difficult to heal.
- Quit smoking: Of course, smoking is detrimental to your overall health. It can increase the chances of having a hernia by causing conditions such as chronic obstructive pulmonary disorder (COPD), which can lead to chronic coughing.
- Add fibre to your diet: Including fibre in your diet can help prevent constipation and straining, reducing your chance of developing a hernia.
If you suspect you have hernia symptoms and are concerned about whether you need hernia surgery, consult an experienced doctor who can evaluate your situation.