What is a hernia. How does it affect the body. What are the common symptoms of hernias. What causes hernias to develop. How are hernias diagnosed and treated. Can hernias be prevented. What are the surgical options for hernia repair.

What is a Hernia: Definition and Overview

A hernia occurs when an internal organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue. This condition results in a visible bulge or protrusion, often causing discomfort and potential complications if left untreated. Hernias can develop in various parts of the body, with the most common locations being the abdomen and groin area.

Hernias are categorized based on their location and specific characteristics. Understanding the different types of hernias is crucial for proper diagnosis and treatment.

Common Types of Hernias

• Inguinal hernia: Occurs in the groin area, more common in men
• Femoral hernia: Appears in the upper thigh near the groin, more prevalent in women
• Ventral hernia: Develops in the midline of the abdomen
• Incisional hernia: Forms at the site of a previous surgical scar
• Umbilical hernia: Associated with the belly button, more common in infants
• Hiatal hernia: Involves part of the stomach protruding through the diaphragm
• Congenital diaphragmatic hernia: A birth defect affecting the diaphragm’s formation

Recognizing Hernia Symptoms: When to Seek Medical Attention

Hernia symptoms can vary depending on the type and severity of the condition. While some hernias may not cause noticeable symptoms initially, it’s essential to be aware of potential warning signs that warrant medical attention.

Common Hernia Symptoms

• Visible bulge or swelling in the affected area
• Pressure or discomfort at the hernia site
• Persistent cough
• Heartburn or acid reflux (especially with hiatal hernias)
• Difficulty swallowing
• Shooting pain
• Nausea and vomiting
• Constipation

How can you determine if your hernia requires immediate medical attention? If you experience severe pain, vomiting, or notice that the hernia bulge becomes soft or cannot be pushed back in, seek emergency medical care. These symptoms may indicate complications such as organ strangulation or infection, which require prompt intervention.

The Root Causes of Hernias: Understanding Risk Factors

Hernias can develop due to various factors, often resulting from a combination of genetic predisposition and lifestyle choices. Identifying the underlying causes can help individuals take preventive measures and manage their risk of developing hernias.

Common Causes and Risk Factors

1. Weakened muscles or connective tissue
2. Increased abdominal pressure
3. Heavy lifting or improper lifting techniques
4. Chronic coughing or sneezing
5. Obesity or poor nutrition
6. Pregnancy and childbirth
7. Aging
8. Smoking
9. Family history of hernias
10. Previous abdominal surgeries

How do these factors contribute to hernia formation? Weakened muscles or connective tissue create vulnerable areas where organs or tissues can protrude. Increased abdominal pressure, whether from pregnancy, obesity, or chronic coughing, can exert force on these weak spots, leading to hernia development.

Diagnosing Hernias: Medical Examinations and Imaging Techniques

Accurate diagnosis is crucial for determining the appropriate treatment plan for hernias. Healthcare providers employ various methods to assess and confirm the presence of a hernia.

Diagnostic Procedures for Hernias

• Physical examination
• Ultrasound
• Barium X-ray
• Computed Tomography (CT) scan
• Endoscopy

How do these diagnostic techniques help in identifying hernias? A physical examination allows the doctor to feel for any bulges or abnormalities. Imaging tests such as ultrasound and CT scans provide detailed pictures of the affected area, helping to determine the size and location of the hernia. Barium X-rays and endoscopies are particularly useful for diagnosing hiatal hernias and assessing the condition of the digestive tract.

Hernia Prevention: Lifestyle Modifications and Best Practices

While some hernias are unavoidable due to genetic factors or congenital conditions, many can be prevented or their risk reduced through lifestyle modifications and healthy habits.

Strategies for Hernia Prevention

1. Maintain a healthy weight
2. Practice proper lifting techniques
3. Strengthen core muscles through regular exercise
4. Avoid straining during bowel movements
5. Quit smoking
6. Manage chronic cough
7. Eat a balanced, fiber-rich diet
8. Stay hydrated
9. Avoid heavy lifting when possible
10. Address underlying medical conditions that may increase hernia risk

How effective are these preventive measures? While they cannot guarantee complete prevention, adopting these lifestyle changes can significantly reduce the risk of developing hernias, particularly those related to increased abdominal pressure and weakened muscles.

Treatment Options for Hernias: From Conservative Management to Surgery

The approach to treating hernias depends on various factors, including the type, size, location, and severity of the hernia, as well as the patient’s overall health and symptoms.

Conservative Management

• Monitoring for changes
• Dietary modifications
• Activity restrictions
• Medications for symptom relief

Surgical Interventions

• Laparoscopic surgery (minimally invasive)
• Open repair surgery
• Use of surgical mesh (temporary or permanent)

How do doctors determine the most appropriate treatment plan? For small, asymptomatic hernias, a watchful waiting approach may be recommended. However, if the hernia causes pain, grows larger, or poses a risk of complications, surgical repair is often necessary. The choice between laparoscopic and open surgery depends on factors such as hernia size, location, and the patient’s medical history.

Surgical Mesh in Hernia Repair: Benefits and Considerations

Surgical mesh is a medical device commonly used in hernia repair procedures to provide additional support to weakened tissues. Understanding the types of mesh and their applications can help patients make informed decisions about their treatment options.

Types of Surgical Mesh

• Synthetic mesh
• Biological mesh (derived from animal tissue)
• Absorbable mesh
• Non-absorbable mesh

How does surgical mesh contribute to hernia repair outcomes? Mesh products act as a supportive scaffold, reinforcing the weakened area and reducing the risk of hernia recurrence. Temporary, absorbable mesh works with the body’s natural healing processes, while permanent mesh provides long-term support. The choice of mesh type depends on factors such as hernia size, location, and the patient’s individual needs.

Living with Hernias: Managing Symptoms and Improving Quality of Life

For individuals diagnosed with hernias, understanding how to manage symptoms and maintain a good quality of life is essential, especially if immediate surgical intervention is not required or recommended.

Strategies for Managing Hernia Symptoms

1. Wear supportive garments or hernia belts
2. Avoid activities that exacerbate symptoms
3. Practice good posture
4. Maintain a healthy weight
5. Use ice or heat therapy for discomfort
6. Take over-the-counter pain relievers as advised by a healthcare provider
7. Eat smaller, more frequent meals (especially for hiatal hernias)
8. Elevate the head of the bed for acid reflux relief
9. Stay physically active within recommended limits
10. Attend regular follow-up appointments with your healthcare provider

How can these strategies improve daily life for hernia patients? By adopting these management techniques, individuals can often reduce discomfort, prevent hernia progression, and maintain their ability to perform daily activities. However, it’s crucial to consult with a healthcare provider to develop a personalized management plan tailored to the specific type and severity of the hernia.

Hernia Recurrence: Risk Factors and Prevention Strategies

While hernia repair surgeries are generally successful, there is a risk of recurrence in some cases. Understanding the factors that contribute to hernia recurrence and implementing preventive measures can help reduce this risk.

Factors Contributing to Hernia Recurrence

• Obesity
• Smoking
• Chronic cough
• Heavy lifting
• Poor wound healing
• Inadequate surgical technique
• Infection at the surgical site
• Underlying medical conditions

How can patients minimize the risk of hernia recurrence after surgery? Following post-operative instructions carefully, maintaining a healthy weight, avoiding heavy lifting during the recovery period, and addressing underlying health issues are crucial steps. Additionally, working with an experienced surgeon and using appropriate surgical techniques, including the proper application of mesh when indicated, can significantly reduce the likelihood of recurrence.

Long-term Outlook for Hernia Patients

What is the prognosis for individuals who have undergone hernia repair? The majority of patients experience a full recovery and return to normal activities following successful hernia repair. However, long-term follow-up and adherence to preventive measures are essential to maintain the repair and prevent future hernias from developing. By staying informed, working closely with healthcare providers, and adopting healthy lifestyle habits, individuals can effectively manage their hernia condition and enjoy an improved quality of life.

What Is A Hernia? – Hernia Symptoms

What is a hernia?

A hernia is a tear in your muscle or tissue that allows part of your insides to bulge out. It can be a bulge of an internal organ or your intestines. Sometimes you can see the hernia, depending on its location and size. Certain activities can worsen the condition, like bending over or lifting heavy objects.

Hernias usually occur in your groin. Inguinal hernias are in the groin and are mostly found in men. Femoral hernias are in the upper thigh near the groin. These are much less common and are mostly found in women. The abdomen is another frequent hernia location. If hernias occur in the midline of the abdomen, they are called ventral hernias. If they occur at the site of a previous surgical scar, they are incisional hernias. Umbilical hernias occur in association with your belly button and are found more commonly in babies.

In a hiatal hernia, part of the upper stomach comes through an opening in your diaphragm, or chest wall. This hernia can cause acid to leak from your stomach into your esophagus. The esophagus is a tube that connects your throat to your stomach. Effects of hiatal hernias include heartburn, indigestion, and acid reflux.

Hernias also can be birth defects. A congenital diaphragmatic hernia occurs when your diaphragm doesn’t form right. This can create space for your stomach to move into your chest. Sometimes doctors find the defect when you’re a baby. Other times, they may not find it until later in life. In severe cases, your stomach can crowd your chest organs, like your lungs and heart. Surgery can help repair your diaphragm so that you don’t develop other problems, such as breathing difficulties.

Symptoms

You might not have symptoms, depending on the type of hernia you have. One common sign of a hernia is the visible bulge in the affected area. Other reported symptoms include pressure, a cough, heartburn, and difficulty swallowing. Severe hernia symptoms are shooting pain, vomiting, and constipation. If your hernia becomes soft or you can’t push it in, go to the emergency room. Hernias can cause your organs or tissue to become infected, blocked, or strangled.

What causes a hernia?

The various types of hernias can have different causes. In general, a hernia starts with pressure on an organ or your intestines. A hernia forms when this pressure 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.

You also can get a hernia, or worsen an existing one, from certain movements and habits. These include:

• Picking up heavy objects (especially lifting them in the wrong way and with weak muscles)
• Overusing the same muscle
• Straining during coughing, sneezing, diarrhea, or constipation
• Being overweight or having poor nutrition
• Using tobacco

Diagnosis

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.

Prevention Tips

You can’t always prevent hernias. Some are caused by genetics that you can’t avoid. A congenital diaphragmatic hernia is a birth defect. You also can be born with weak muscles that make it easier to get a hernia later in life.

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

Treatment

Treatment options depend on the type of hernia you have and your state of health. At first, your doctor may suggest monitoring your condition for changes. This may also include making changes to your diet, activity, and habits. Medicines may help lessen hernia symptoms.

If the hernia doesn’t improve or worsens, your doctor will discuss surgery. There are two types of surgical treatment. Laparoscopic surgery is less invasive. Your doctor or a surgeon will make small cuts in the affected area to fix the hernia. Open repair surgery requires a larger cut to make the repair.

As part of surgery, your doctor might use surgical mesh. This is considered a medical device. The purpose of surgical mesh is to act as a support for your weakened muscle or tissue. Mesh products can be synthetic or made from animal tissue. Surgical mesh comes in two forms. Temporary mesh is one that your body will absorb. It works with your muscles and tissue to strengthen over time. Permanent mesh is meant to provide long-term muscle support.

Living with a hernia

Most types of hernias can be treated and corrected. However, it’s common for hernias to come back. In some cases, surgical mesh can help reduce this chance. Talk to your doctor or surgeon about the best treatment option for you and how to prevent recurring hernias.

People who have a congenital diaphragmatic hernia may have other health issues. Talk to your doctor about how to treat and manage these.

Questions for your doctor

• Are there exercises I can do to strengthen my muscles and prevent a hernia?
• What’s the chance of my hernia coming back?
• My hernia only bothers me from time to time. Do I even need to see a doctor?

Resources

National Institutes of Health, MedlinePlus: Hernia

U.S. Food and Drug Administration: Hernia Surgical Mesh Implants

Hernia: MedlinePlus Medical Encyclopedia

A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac comes through a hole or weak area in the strong layer of the belly wall that surrounds the muscle. This layer is called the fascia.

Which type of hernia you have depends on where it is:

• Femoral hernia is a bulge in the upper thigh, just below the groin. This type is more common in women than men.
• Hiatal hernia occurs in the diaphragm muscle that separates the chest and abdomen. Part of the upper stomach pushes into the chest.
• Incisional hernia can occur through a scar if you have had abdominal surgery in the past.
• Umbilical hernia is a bulge around the belly button. It occurs when the muscle around the belly button does not close completely after birth.
• Inguinal hernia is a bulge in the groin. It is more common in men. It may go all the way down into the scrotum.

Usually, there is no clear cause of a hernia. Sometimes, hernias can occur due to:

• Heavy lifting
• Straining while using the toilet
• Any activity that raises the pressure inside the belly

Hernias may be present at birth, but the bulge may not be evident until later in life. Some people have a family history of hernias.

Babies and children can get hernias. It happens when there is weakness in the belly wall. Inguinal hernias are common in boys. Some children do not have symptoms until they are adults.

Any activity or medical problem that increases pressure on the tissue in the belly wall and muscles may lead to a hernia, including:

• Long-term (chronic) constipation and pushing hard (straining) to have a bowel movement
• Chronic coughing or sneezing
• Cystic fibrosis
• Enlarged prostate, straining to urinate
• Extra weight
• Fluid in the abdomen (ascites)
• Peritoneal dialysis
• Poor nutrition
• Smoking
• Overexertion
• Undescended testicles

There are usually no symptoms other than a visible bulge. Some people have discomfort or pain. The discomfort may be worse when standing, straining, or lifting heavy objects. In time, the most common complaint is a bump that is sore and growing.

When a hernia gets bigger, it may get stuck inside the hole and lose its blood supply. This is called strangulation. This causes pain and swelling at the site of strangulation. Symptoms may include:

• Nausea and vomiting
• Not being able to pass gas or have bowel movements

When this occurs, surgery is needed right away.

The health care provider can usually see or feel a hernia when you are examined. You may be asked to cough, bend, push, or lift. The hernia may get bigger when you do this.

The hernia (bulge) may not be easily seen in infants and children, except when the child is crying or coughing.

Ultrasound or CT scan may be done to look for a hernia.

If there is a blockage in the bowel, an x-ray of the abdomen will likely be done.

Surgery is the only treatment that can permanently fix a hernia. Surgery may be more risky for people with serious medical problems.

Surgery repairs the weakened abdominal wall tissue (fascia) and closes any holes. Most hernias are closed with stitches and sometimes with mesh patches to plug the hole.

An umbilical hernia that does not heal on its own by the time a child is 5 years old will likely be repaired.

The outcome for most hernias is usually good with treatment. It is rare for a hernia to come back. Incisional hernias are more likely to return.

In rare cases, inguinal hernia repair can damage structures involved in the function of a man’s testicles.

Another risk of hernia surgery is nerve damage, which can lead to numbness in the groin area.

If a part of the bowel was trapped or strangulated before surgery, bowel perforation or dead bowel may result.

Contact your provider right away if you have:

• A painful hernia and the contents cannot be pushed back into the abdomen by lying down and using gentle pressure
• Nausea, vomiting, or a fever along with a painful hernia
• A hernia that becomes red, purple, dark, or discolored

Contact your provider if you have:

• Groin pain, swelling, or a bulge.
• A bulge or swelling in the groin or belly button, or that is associated with a previous surgical cut.

To prevent a hernia:

• Use proper lifting techniques.
• Lose weight if you are overweight.
• Relieve or avoid constipation by eating plenty of fiber, drinking lots of fluid, going to the bathroom as soon as you have the urge, and exercising regularly.
• Men should see their provider if they strain with urination. This may be a symptom of an enlarged prostate.

Hernia – inguinal; Inguinal hernia; Direct and indirect hernia; Rupture; Strangulation; Incarceration

• Inguinal hernia repair – discharge

• Inguinal hernia
• Inguinal hernia repair – series

Aiken JJ. Inguinal hernias. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 373.

Poulose BK, Carbonell AM, Rosen MJ. Hernias. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 45.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Hernia – cause and treatment – health articles

11/10/2022

Hernia — protrusion of the viscera along with the parietal sheet of the peritoneum through a defect in the muscle layer of the abdominal wall under the skin.

A disease may be classified according to its location. Hence the name of the hernia: umbilical, inguinal, intervertebral, dorsal, lumbar, hernia of the white line of the abdomen, subumbilical.

There are also other forms of hernia, more rare – postoperative, lateral, ischial, obturator, perineal, hernia of the obvious process of the sternum.

Causes of hernia

There can be several reasons for this disease:

• weakening of the anterior abdominal wall that occurs during pregnancy, after childbirth in women or in people leading an inactive life;
• a sharp increase in pressure in the abdomen, for example, when a person lifts weights or when straining while going to the toilet;
• overweight;
• features in the structure of the body;
• Chronic cough or allergy with frequent cough.

A hernia can be caused by a person’s age, recent trauma, or surgery that weakens the muscles. Of course, a hernia can also be hereditary, then the cause is varicose veins, scoliosis, and even flat feet.

Symptoms of a hernia

The most sure sign of the manifestation of the disease is unusual protrusions in the abdominal region. Bulging may appear in the groin, in the navel, or in the scar area if you have recently had surgery. It all depends on the type of hernia.

But not only outwardly it is possible to suspect a disease, symptoms are also such indicators as pain in the abdomen and groin during prolonged standing, during physical exertion, and when lifting weights. A person observes pain when sneezing, coughing, straining.

Umbilical hernia is most common in babies. Usually it passes by half a year, when the child begins to sit and move actively, thereby straining and strengthening the abdominal walls. But if it occurs in children much later, then you need to see a doctor. The disease can appear with frequent constipation, lack of activity, or with a constant cough. If a child complains of pain in the navel and he has protrusions in the same place in a standing position, then this is a sure sign of the appearance of an umbilical hernia. Also, the child may become lethargic, his appetite decreases and apathy occurs.

Inguinal hernia is more common in men and also in boys, especially in infancy. Symptoms are protrusions in the corresponding area, an increase in the scrotum, pain in the lower back, genitals, and when urinating.

A herniated disc causes pain in the legs or in the area of ​​the spine after physical exertion, heavy lifting, bending over, or as a result of an uncomfortable position during sleep or work. There are protrusions in the side of the spinal cord or in the lower back.

Spinal hernia occurs in the lumbar region, neck and chest. Symptoms of such a disease are pain in the corresponding area, weakness in the arms and legs, and sensitivity disorders.

In lumbar hernia, bulges appear on the side or back of the abdomen. This type of disease can be found in a supine position on a sore side – protrusions are visible, but when a person turns over to a healthy side, it disappears.

A hernia of the linea alba is a disease in which preperitoneal fat passes through cracks and holes. With such a hernia, a person may not complain of pain or have it in the epigastric region.

How to identify a hernia

Instrumental methods of examination include a method such as diaphanoscopy, used to distinguish between scrotal hernia and dropsy. It involves examining the scrotum area with a light element.

Physical examination methods: after examining the protrusion, the doctor feels it, determines its density, whether it is reduced into the cavity, and also notes the condition of the natural canals and openings (whether they are enlarged, for example, by inserting a fingertip into the inguinal canal, it is noted that it is not enlarged whether he).

Another examination method is an ultrasound examination.

Treatment

Hernia is treated by two methods – conservative and surgical. Conservative treatment includes:

• motor technique, exercise therapy;
• a manual technique that helps to change the tension of the muscles of the spine, is used when a person has a herniated disc;
• physiotherapy technique – massage, reflexology, mechanical traction, magnetic and ultrasonic treatment.

But all these methods are rarely used, very often they cannot save a person from a hernia, if only in isolated, unique cases. Conservative treatment is designed to reduce pain and reduce protrusions. The most commonly used surgical method of treatment is the removal of a hernia permanently.

Hernia surgery can be performed under local anesthesia, the procedure takes from 30 minutes to several hours, depending on the severity and type of disease.

What is a hernia | Clinic “Hernia Center”

Hernia is a pathological protrusion of internal organs into the subcutaneous fat through physiological (congenital) or pathological (acquired) holes or defects in the muscular-aponeurotic layer of the anterior abdominal wall, and visually manifested by the appearance of a tumor protrusion uncharacteristic for this area of ​​the abdomen.

Hernias may be congenital and acquired that appeared during life, including against the background of constant regular physical exertion or in the area of ​​damage to the layers of the anterior abdominal wall (for example, after previous operations or stab wounds).

According to the localization of the hernia, it can be conditionally divided into “ external” and “ internal” .

Of the hernias of external localization, the most common are inguinal hernias, umbilical hernias, femoral hernias, hernias of the white line of the abdomen and hernias after previous open surgical interventions on the abdominal organs (postoperative hernias – ventral).

Less common are Spiegel’s line hernia, lumbar hernias (Petit’s triangle and Greenfelt-Lesgaft gap) and pelvic hernias. These types of hernias are very rare and difficult to diagnose, so we will not dwell in detail and describe the anatomical structures through which these hernial protrusions prolapse under the skin. The latter, in general, rarely appear on their own and are more often the result of surgical interventions on the pelvic region and perineum.

internal hernias include hernias of the esophageal opening of the diaphragm, hernia of the obturator canal. The latter is extremely rare.

Hernias can also be divided into primary and recurrent , i.e. hernias that reappeared in the same place after a previous hernioplasty (surgery to “suture” the hernia).

Organs located in the hernial protrusion are covered with peritoneum (sheath), which is a continuation (pocket) of the peritoneum lining the entire abdominal cavity. The latter forms the so-called hernial sac. You can visualize this in the form of a rubber glove, in which the palm is the abdominal cavity, and the finger is the hernia.

It is important to note that all types of hernias of external localization are of two types – reducible and irreducible .

With a reducible hernia, the hernial protrusion disappears when pressed on it or when the muscles of the anterior abdominal wall relax, in particular, the patient is transferred to the prone position.

In an irreducible hernia, even active attempts to push the hernia contents into the abdominal cavity do not give results, but only lead to pain.

Complications of a hernia

In addition to the fact that an existing hernia leads to a decrease in the quality of life, disability and limitation of an active lifestyle and physical activity, it is important to know and remember the presence of the so-called infringement of hernia content. This is a formidable and life-threatening complication of a hernia. At the same time, the hernial protrusion ceases to retract into the abdominal cavity, pain appears in the hernia, sometimes reddening of the skin, and other inflammatory changes up to the development of phlegmon (purulent fusion) of the hernial sac. This condition is acute and requires emergency surgery

Causes of hernias

1. presence of congenital anatomical weaknesses and holes on the anterior abdominal wall and in the abdominal cavity (inguinal and femoral canals, navel, esophageal opening of the diaphragm …)
2. acquired damage to the elements of the abdominal wall (wounds, surgeries .