When to Worry About Hernia Pain

A hernia is a medical condition where organs, tissues, or intestines begin pushing through the surrounding connective tissues and usually occurs in the abdominal wall. While this is the most common form of hernia, it is known to appear in other areas of the body. It can be a painful condition, causing a bulge due to the additional pressure, and affects all age groups, though is most common among men over the age of 40. 

With how common hernia is and in many cases the person not knowing they have the condition, when should someone worry about having hernia pain? 

Hernia Symptoms

Before discussing when to worry about the pain caused by hernias, it’s important to know the signs of having the condition. Some people have a hernia without ever experiencing discomfort or pain but may still have a bulge appearing in the affected area. It may not be a constant bulge, instead only appearing while coughing or jumping, even disappearing when you lay down. Other hernia symptoms include:

• Shooting pain
• Constipation
• Vomiting
• Feeling of pressure in the area
• Problems with swallowing
• Heartburn
• Coughing

Types of Hernia

There are several types of hernia that a person can have, differentiated from where it forms:

Inguinal Hernia

This type of hernia describes a small part of the bowel pushing through the abdominal wall and into the groin area, which may also contain part of the intestine. There are two types, direct and indirect. The former results from a weak spot developing in the lower muscles of your abdomen and the indirect is from the inguinal canal not closing properly before being born. 

Femoral Hernia

A femoral hernia appears in the upper part of the thigh, around the groin area, and is caused by the bowel pushing through a tear or weak spot in the abdomen. This hernia type can prevent blood from reaching the herniated bowel. 

Umbilical Hernia

A type of hernia that develops around the belly button in infants. They form when a part of the intestine loop pushes through a small opening in the abdominal muscle. Umbilical hernias often close naturally by the age of 5 years old. 

Incisional Hernia

The cause of this hernia from tissue protruding from the site of a surgical scar that is still healing. 

Epigastric Hernia

This is from tissue pushing through the abdominal wall between the breastbone and belly button, usually occurring when there is an issue with keeping your abdominal muscles from coming together properly. 

Causes of Hernia

While there are specific causes for the various types of hernias listed above, there are general reasons why hernias form and risk factors that increase the chances of developing a hernia:

• Using tobacco
• Persistent straining from diarrhea, sneezing, or coughing
• Overuse of a muscle
• Lifting heavy objects
• Carrying excessive weight on your body’s frame

When to Seek Treatment for Hernia

If you notice the following symptoms, you should immediately see your doctor or a hospital:

• Sudden pain that quickly worsens
• Nausea and vomiting
• Fever
• Discoloration of the hernia bulge, especially red, purple, or any darkening
• Constipation and/or the inability to pass gas.

If you find any unexplained bulges or experience more severe symptoms like pain, you should schedule an appointment with your doctor to assess what it is. A doctor can diagnose a hernia from a physical exam and may perform additional tests to determine the extent of the hernia:

• An ultrasound
• A computed tomography (CT scan)
• Barium X-rays to see the digestive system and intestines
• Endoscopy to examine the stomach and esophagus

Hernia Surgery

Depending on the type of hernia you have and the extent of the condition, your doctor may recommend lifestyle changes, exercise, and medications to better manage the symptoms. If these treatments aren’t successful, there are two forms of hernia surgery available:

Laparoscopic surgery: a small incision is made in the hernia to repair it.

Open repair surgery: larger incisions are made to access the full hernia as it is a more complex repair.

Proliance Puyallup Surgeons’ depth of experience and empathy makes us the foremost provider of hernia treatments in the region. We encourage you to contact us to discuss treatments available to you.

Do Hernias Hurt? Symptoms, Types, and Treatment

Hernia symptoms, including pain, can differ depending on the type of hernia you have. Typically, most hernias don’t initially include symptoms, although sometimes the area around your hernia can be sensitive.

You may also feel periodic twinges or a pulling sensation. As your hernia grows, discomfort may grow as well.

Hernias involve a protruding internal organ or body part being pushed through the muscle or tissue. The most common types include:

• Inguinal hernia. Most commonly found in men, these occur when the intestine or, very rarely, the bladder extend into the groin via the inguinal canal.
• Femoral hernia. Though less common, femoral hernias are often confused with inguinal hernias because they occur in a similar area for similar reasons. However, these involve a bulge appearing in the lower abdomen, groin, hip, or upper thigh.
• Hiatal hernia. These occur when part of the stomach extends into the chest through openings in the diaphragm.
• Umbilical hernia. Most commonly found in infants, these occur when part of the intestine pushes into the abdomen through the belly button.
• Incisional hernia. Of those who undergo an abdominal surgery, 33 percent will develop an incisional hernia. Also known as ventral hernias, these develop when the closed tissue and muscles don’t entirely re-attach, allowing internal structures to protrude through the weakened area.

Inguinal hernia

The most common symptom for an inguinal hernia is a bulge in the groin, which can appear without warning as a result of excess strain, such as:

• heavy lifting
• violent sneezing, such as from allergies
• chronic coughing, such as from smoking
• straining when urinating or having a bowel movement
• increased internal pressure in the abdomen

These bulges tend to become more visible in an upright position and may cause pain or discomfort in your groin when:

• bending over
• lifting
• coughing
• laughing

Other symptoms include:

• burning or aching in the area of the bulge
• heavy dragging sensation in your groin
• pressure, sensitivity, or weakness in your groin
• swelling and discomfort around the testicles if the protrusion descends into the scrotum

Femoral hernias

Femoral hernias, especially small- or medium-sized ones, might not present any symptoms. However, larger ones might cause pain or discomfort when standing up, lifting heavy objects, or if they appear in the upper thigh or hip.

Umbilical hernias

For babies with umbilical hernias, the bulge may only appear when crying or coughing. These are usually painless for children, but adult umbilical hernias may cause some discomfort in the abdomen.

Hiatal hernias

Hiatal hernias tend to be so small that there’s a chance you won’t feel them at all. However, larger ones could result in the opening in your diaphragm also becoming larger, which makes you more susceptible to other organs extending into the chest. This may feel like heartburn.

Other symptoms include:

• stomach pressure, including squeezing or twisting sensations
• chest pain
• acid reflux due to increased stomach acid retention
• difficulty breathing or swallowing
• indigestion

Stomach acid retention may also result in stomach ulcers, which can bleed and lead to low blood counts.

Incisional hernia

Incisional hernias depend on the size of the incision. They often develop within three weeks to six months after a procedure but can occur at any time.

A bulge or protrusion at the site of the incision is the most common symptom but if too much tissue or intestine gets stuck in the weak spot, it can create severe pain when the tissue loses blood supply. This is a medical emergency and requires immediate care.

Hernias may be susceptible to several complications if left untreated, such as:

• pressure on surrounding tissues or muscles
• incarcerated or strangulated hernia
• bowel obstruction
• tissue death

An incarcerated hernia occurs if the hernia gets trapped in the abdominal wall, which can result in an obstructed bowel or strangulation.

When the hernia is strangulated, it means that blood flow to the intestine has been cut off. This is a life-threatening condition and requires immediate repair.

Symptoms for these complications include:

• fever
• sudden pain that progressively worsens
• nausea or vomiting
• a bulge that turns to a dark color, such as red or purple
• inability to pass gas or make bowel movements

Surgery is the most likely treatment for relieving large or painful hernias. Your doctor may also recommend surgery as a preventive measure, to ensure there are no complications later on. Surgical options range from minimally invasive surgery to open surgery.

Open surgery

Open surgery involves a small incision, pushing the protruding tissue back into your body and securing the incision so the tissue doesn’t herniate again.

This often requires the surgeon to strengthen the herniated area with mesh. Once the tissue is in its rightful place, the incision is closed with stitches or stapled.

This procedure is typically performed with local anesthesia, general anesthesia, or sedation.

Rest is recommended, however, you should move around to encourage proper circulation and improve recovery. Be careful not to overexert yourself, as it may still be a few weeks until you can return to your regular levels of activity.

Depending on the site of your hernia, your surgeon will give you specific instructions on what activities you can do and when you can return to exercising and other regular activities.

Minimally invasive surgery

Minimally invasive surgery, also known as laparoscopy, involves a series of small incisions. A gas is used to inflate the affected area, which makes it easier for the surgeon to see the structures to be treated.

Another tube with a small camera will then be inserted into one of the incisions, with the others serving as entry points for the surgeon’s tools.

This procedure is typically performed with general anesthesia. Those eligible for minimally invasive surgery tend to experience less post-op discomfort, as well as less scarring.

You may also be able to return to regular levels of activity sooner than those who have open surgery.

Other options

Another option is watchful waiting, where you simply wait to see if your hernia symptoms go away or get worse.

A hernia truss or abdominal binder may also be useful. These are supportive braces designed to keep the hernia in place and prevent it from getting worse.

Braces may not always be helpful and could cause other problems, so talk to your doctor about this treatment method before you pursue it.

Although many hernia types aren’t considered dangerous, they don’t get better on their own and can lead to life-threatening situations if left untreated.

Talk to your doctor if you think you’re experiencing any of the symptoms of a hernia. They can provide a personalized solution to your situation.

You should seek immediate medical attention if you’re experiencing any of the symptoms of a strangulated or incarcerated hernia, such as very painful bulge and if the bulge is red or purple.

Hernia of the abdominal cavity – treatment of abdominal hernia at the Research Institute of Urology and Interventional Radiology named after.

ON THE. Lopatkina

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Abdominal hernia is a muscular hernia, which is the protrusion of internal organs beyond the abdominal wall. This protrusion can occur in places of weakening of the peritoneum into the subcutaneous space or under the tissue layers. The hernial sac in the abdominal cavity can contain any internal organ of the peritoneum.

Abdominal hernia has several stages of development:

1. initial stage – such a hernia of the abdomen can be reduced, and has a small protrusion;
2. canal stage – the internal organs begin to fall into the peritoneal pocket or subdermal layers, but the hernia of the abdomen disappears in a horizontal position;
3. complete stage – the internal organs are completely trapped in the hernial sac and the abdominal hernia no longer disappears when changing position.

Abdominal hernia is not a harmless disease, infringements lead to irreversible negative consequences. Early diagnosis of the disease allows you to start treatment as soon as possible, which reduces the rehabilitation period and the complexity of the operation. Abdominal hernia is treated surgically, and complications can arise not only after surgery.

Complications of abdominal hernia

There are several types of abdominal hernia:

1. external – protrusion of the abdominal hernia occurs through the formed muscle “holes” in the abdominal cavity;
2. internal – protrusion of organs gets into the peritoneal pockets, during the pathological process or injury.

Abdominal hernias can be complicated if the hernial ring impinges on internal organs. A strangulated abdominal hernia compresses the contents of the hernia sac, which disrupts the functioning of internal organs.

Infringements are divided into elastic and fecal, as well as their combination. With the necrosis of part of the intestine, its contents are poured out and intoxication and inflammation occur. Abdominal hernia causes serious consequences in acute intestinal obstruction. With this course, a hernia of the abdomen causes severe pain, accompanied by vomiting, which first has the contents of the stomach, then bile.

Causes of abdominal hernia

Abdominal hernia occurs due to suggestive characteristics such as sex, heredity and overweight. Such signs of abdominal hernia are called predisposing.

Also, a hernia of the abdomen occurs due to producing causes. The main one is an increase in intra-abdominal pressure, which occurs due to severe coughing, persistent constipation, stagnation of urine and difficult childbirth. Leading signs to a hernia of the abdominal cavity is the weakness of the muscles of the abdominal wall. Such a change in the body occurs due to stretching of the abdominal muscles. The weakening is caused by severe injuries, muscle flaccidity and the anatomical structure of the abdominal cavity.

Anatomical features suggest the occurrence of abdominal hernia most often. In the position of the abdominal wall close to the pubic bone at constant pressure, due to sharp inclinations and straining, there is a gradual decrease in the tone of the muscles of the abdominal wall and the formation of hollow pockets, into which intestinal loops most often fall.

Abdominal hernia can also occur as a result of heavy physical labor and heavy lifting. Also, a hernia of the abdomen occurs if there are scars on the peritoneum that were obtained after the section of the abdominal cavity.

Abdominal hernia symptoms

Abdominal hernia has a characteristic symptom of swelling. Abdominal hernia appears when straining and in a vertical position, and disappears when lying down. If the abdominal hernia does not disappear in any position, then it has complications, and is called irreducible.

At the beginning of the disease, a hernia of the abdomen can only be recognized by examination with fingers inserted into the hernia canal. When coughing, a hernia of the abdomen may protrude most clearly.

Abdominal hernia is palpable and visible visually. To clarify the diagnosis, a hernia of the abdomen is subjected to a screening study, if necessary, computed tomography and magnetic resonance imaging are used.

Abdominal hernia is accompanied by severe pain at the site of the protrusion, nausea, vomiting and bloating.

In addition to accompanying symptoms, abdominal hernia has clinical signs that lead to weakening and are expressed by inflammation and the development of intestinal obstruction.

Abdominal hernia treatment

Painful spasms and accompanying symptoms in abdominal hernia lead to urgent surgery. If it is impossible to carry out the operation, the hernia of the abdomen is subjected to constant wearing of a bandage.

Contraindications for surgical treatment of abdominal hernia: infectious diseases, tuberculosis, oncological diseases, pregnancy in the third trimester, advanced age. If a hernia of the abdomen infringes on part of the intestine, then surgery is the only way to save life.

Abdominal hernia surgery involves cutting off the hernial sac with its contents and suturing the muscles. Most often, surgery occurs under local anesthesia and general anesthesia. Preparation for removal of a hernia of the abdominal cavity consists in hygienic cleanliness, that is, taking baths and removing hair from the area of ​​​​operation, as well as emptying the intestines and bladder.

Abdominal hernia with strangulation should be operated on as soon as possible so as not to cause intoxication of nearby internal organs. During this operation, the hernial crust is carefully dissected so that the contents do not spill out. The strangulated area is resected and removed. With a hernia of the abdominal cavity, pinching of the vessels that could get into the hernial sac is monitored. Veins and vessels are carefully connected to restore blood circulation and saturation of the peritoneal organs.

Treatment of an abdominal hernia with strangulation should always be carried out urgently. A hernia of the abdomen causes quick complications, so it is absolutely impossible to set it.

The postoperative period after abdominal hernia resection depends on the complexity of the treatment and the patient’s condition. On average, bed rest is observed on the 7-10th day after the operation, therapeutic and preventive physical education is prescribed on the second day, but under the strict supervision of a doctor and instructor.

Branches and departments that treat abdominal hernias.

Hernia of the white line of the abdomen – symptoms, diagnosis and treatment.

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White line of the abdomen (aponeurosis) is the conventional name for the abdominal area between the rectus muscles. It runs strictly vertically along the axis of the human body from the pubic bone to the solar plexus. Normally, the width of the aponeurosis can vary between 3-7 cm and, with such indicators, does not allow the abdominal organs to protrude beyond the abdominal wall. Under the influence of certain factors, thin tendon joints can weaken and diverge, as a result of which such a pathology as a hernia of the white line of the abdomen develops. With timely diagnosis and proper treatment, a hernia of the white line of the abdomen can be successfully corrected with a minimum percentage of relapses, and the patient has every chance to return to his usual way of life.

Depending on localization, it is divided into several types:

• epigastric hernia of the white line of the abdomen;
  This is the most common type of the disease – about 80% of all detected cases. In this case, a hernia of the white line of the abdomen is localized in the epigastric region and often occurs after abdominal operations on the organs of the gastrointestinal tract.
• paraumbilical hernia of the linea alba;
  Paraumbilical hernia of the white line of the abdomen is diagnosed less frequently than epigastric and is often congenital.
• hypogastric hernia of the linea alba.
  Due to the dense connection of the fibers of the aponeurosis, the hypogastric hernia of the white line of the abdomen is the rarest type in the typology of this disease.

Usually a hernia of the white line of the abdomen is an acquired disease, but there are also hereditary cases diagnosed in children under the age of three years (periumbilical hernia of the white line of the abdomen).

Complications of hernia of the linea alba

Hernia of the linea alba causes a small number of complications, but it is important to understand the dangers of each.

The most serious complication that a hernia of the white line of the abdomen can cause is the infringement of organs. With the course of the disease, the size of the hernial sac increases, and fragments of the organs of the gastrointestinal tract (small or large intestine, stomach, liver) or one of the leaves of the greater omentum are drawn into it. Hernial gates have a small lumen, therefore, organ infringement is highly likely to occur. This complication can be recognized by sharp pains in the area of ​​the hernia, spasticity of the abdominal muscles, traces of blood in the stool, and obvious signs of intoxication. An unreduced hernia of the white line of the abdomen is no less dangerous. This condition is a harbinger of infringement due to the structural features of the hernial sac. Unreduced hernias are often characterized by multi-chamber, which complicates the course of the disease.

The patient’s life is also threatened by sepsis due to infection and inflammation of the contents of the hernial sac.

Causes of hernia of the white line of the abdomen

Hernia of the white line of the abdomen occurs due to weakening or strong stretching of the fibers of the aponeurosis. This disease, which is typical for men aged 20-30 years and for women after 40 years, develops extremely rarely in children.

Among the main causes of a hernia of the white line of the abdomen, there are:

• excessive exercise;
• lifting heavy loads;
• obesity;
• constipation;
• repeated pregnancy;
• pregnancy with a large fetus;
• consequences of trauma or operation in the epigastric region.

Symptoms of a hernia of the white line of the abdomen

At different stages of the disease, a hernia of the white line of the abdomen manifests itself in different ways. In its infancy, a hernia of the white line of the abdomen, as a rule, goes unnoticed until an accidental diagnosis, because. is a tiny wen, practically not extending beyond the peritoneum. At the initial stage, a hernia of the white line of the abdomen is characterized by a protrusion of adipose tissue (lipoma) through the diamond-shaped gaps of the connective fibers in the aponeurosis. With a small size, the lipoma can remain painless, but as the disease progresses, it increases and begins to cause significant discomfort to the patient. A hernia of the white line of the abdomen is characterized by such an obvious symptom already at a later stage of the disease. In the epigastric region, a neoplasm is observed, painful on palpation or with active movement. If the patient is obese, early symptoms may not be noticed and the hernia of the white line of the abdomen may go into an advanced stage, requiring treatment and immediate surgery to remove it.

In addition, a hernia of the white line of the abdomen can also manifest itself with a number of hidden symptoms:

Discomfort and disturbances in the functioning of the organs of the gastrointestinal tract should not be ignored, because a hernia of the white line of the abdomen does not exclude identical symptoms.

During the initial examination, the doctor may make a presumptive diagnosis, but a detailed diagnosis is required for correct treatment. A hernia of the white line of the abdomen for a long time can proceed quite smoothly, but with a diagnosis, it is necessary to undergo follow-up examinations with a surgeon’s consultation in order to prevent the development of complications.

Treatment of a hernia of the white line of the abdomen

Conservative treatment with bandages is considered ineffective and even in the initial stages of the disease shows a negative trend.

A hernia of the linea alba can be successfully treated with surgery if indicated. Modern diagnostics using ultrasound, X-ray with a contrast agent and endoscopic examination allows you to accurately identify the stage of the disease and choose the most appropriate treatment tactics.

Typically, surgeons perform laparoscopic hernia repair using self-locking shape memory mesh implants. In the event that the hernia of the white line of the abdomen is greatly enlarged or a relapse of the disease occurs, a non-absorbable mesh can be used for fixation. If necessary, adhesive and stapler methods are used, which contribute to reliable and durable fixation of the prosthesis, as well as reduce pain after surgery. In most cases, the total period of rehabilitation and adaptation takes up to 2 weeks, and already in the early postoperative period, the patient does not need to comply with strict bed rest. The modern technologies used are aimed at minimizing the recurrence of the disease and speedy recovery after surgery.