All about Hernia

  • Overview
  • Types
  • Cause
  • Symptoms
  • Diagnosis
  • Treatment
  • Precaution
  • Complications
  • Prevention
  • Risks

What Is Hernia?

A hernia is a swelling in groin (area between abdomen & thighs) which you can see or feel ( Inguinal Hernia). At times, it can also be around navel (Umbilical Hernia) or near abdominal scars (Incisional hernia) due to protrusion of an organ or tissue through an abnormal opening in the body. Most hernias occur when a piece of intestine slips through a weakness in the abdominal wall, creating a bulge you can see and feel.

Types of Hernia

The 3 common types of Hernia are:

  • Inguinal: Swelling develops in groin (an area between abdomen & thigh)
    right side, left side or both sides.
  • Umbilical: Swelling occurs around the navel
  • Incisional : Swelling appears at the site of the scar of a previous abdominal surgery. This can happen soon after the operation or many years later.

Causes of Hernia

Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time.

Common causes of muscle weakness include:

  • Failure of the abdominal wall to close properly in the womb, which is a congenital defect
  • Age
  • Chronic coughing
  • Straining during urination & defication
  • Lifting of heavy weight
  • Following injury or surgery

Common Symptoms of Hernia

  • The swelling usually appears on standing or coughing & disappears when you lie down.
  • Swelling increases in size on lifting heavy weight, coughing, sneezing or straining while passing urine/stool and may cause pain.
  • Though pain is not a very common symptom of Hernia, the person suffering may get severe pain if complications like obstruction or strangulation arise, which is very risky and life – threatening.
  • In some cases urinary bladder is a content of Hernial sac and this may cause urinary symptoms like urge to pass urine frequently.
  • Abdominal pain at times is due to descent of intestines/abdominal fat into Hernial sac, in cases where the ring through which it descends is narrow and therefore exerts pressure. In such situation pain may be felt in the middle of the abdomen.

How Is a Hernia Diagnosed?

Hernia is a clinical entity. A swelling which appears and disappears on pressure is a Hernia. Hernia is typically seen at a known site like groin, navel or previous abdominal scar.

In some cases when Hernia is suspected, but cannot be seen or felt high frequency sonography or MRI can be of help.

Complex Hernia and very large Hernia require CT Scan for further details.

Treatment for a Hernia

Though all Hernia may not get complicated but when they get complicated, it can risk the life & hence it is advisable to treat all Hernia.

Hernia cannot be treated with any tablets capsules or injections, in allopathy, ayurveda, homeopathy, unani or natureopathy.

The only treatment of Hernia is surgery.

There are two types of surgeries for Hernia:

  • Open surgery: Which requires a big cut, dissection of muscles and use of MESH to cover the defect

  • Laparoscopic surgery: In this the same surgery is done through key holes. Laparoscopic surgery is less painful, reduces hospital stay, leads to faster recovery and with better cosmetic results.

Precautions for Hernia

If you have a Hernia, then you should:

  • Avoid lifting heavy weights.
  • Avoid straining for urine & stools.
  • Avoid heavy exercises.
  • Treat cough and cold immediately.
  • Stop smoking.
  • Not delay consultation of expert Hernia surgeon.

Complication for Hernia

If left untreated:

  • Hernia grows in size, becomes bigger & may start paining
  • Bigger Hernia require complex procedures and have high chances of re-occurrence.
  • Sometimes a loop of intestine may get trapped in Hernia defect leading to obstructed Hernia.
  • Obstructed Hernia will lead to severe abdominal pain, nausea & vomiting.
  • Increasing pressure on the Intestine can compromise its blood supply leading to Gangrene of Intestine, rupture of Intestine, Sepsis leading to Death.

Prevention for Hernia

You can’t always prevent the muscle weakness that allows a hernia to occur. However, you can reduce the amount of strain you place on your body. This may help you avoid a hernia or keep an existing hernia from getting worse. Prevention tips include:

  • Stop smoking
  • Seeing your doctor when you’re sick to avoid developing a persistent cough
  • Maintaining a healthy body weight
  • Avoiding straining during bowel movements or urination
  • Avoiding lifting heavy weights

Risk Factors

  • Obesity.
  • Smoking.
  • Chronic cough.
  • Straining at urine & stools.
  • Lifting heavy weight.
  • Injury to abdominal wall.
  • Abdominal surgery.

Some FAQ's

What is Hernia?

Hernia is a swelling, which you can see or feel. Commonly it occurs in groin (area between abdomen & thighs) when it is called Inguinal Hernia. It can be on the right side, left side or both sides. At times, it can also be around navel when it is called Umbilical Hernia. When it occurs near previously operated scars on the abdomen, it is called an Incisional hernia. There are other types of Hernia like, Femoral, Obturator, Spigelion, Lumbar etc., but they are rare.

What is characteristic feature of Hernia?

The swelling usually appears on standing or coughing & disappears when you lie down.

When people get Hernia?

Hernia can occur at all ages from birth till old age, though commonly it occurs in childhood & above 40 years.

What is treatment of Hernia?

Only treatment of hernia is surgical repair. The hole in the muscle is repaired with “mesh”, a kind of net made up of artificial material.

How safe is the use of this artificial material?

There are various types of these materials. They are prepared after lot of research & are safe to human body. Lakhs of these meshes have been used by now & are harmless to human body.

What are the types of surgeries for Hernia?

Surgery of Hernia has evolved over the years.

Basically, it can be either

  • open surgery wherein a “cut” of few inches is required, muscles are dissected & the defect is sealed with MESH or
  • “Key hole” surgery through few tiny holes (5mm to 10mm). Laparoscopic surgery, known as “Key hole” technique causes less pain, less stay in hospital, faster recovery and better cosmetic results.

What are the symptoms of Hernia?

Hernia is usually painless, but sometimes there is mild pain. That is the reason, people ignore hernia.

What happens in Hernia?

Hernia is a hole in the muscle, through which abdominal contents like intestine pop out.

Can we ignore hernia, since it is painless?

Every hernia has a potential chance of complication. Sometimes, when more contents slide through, the contents cannot return back. These intestines then get obstructed & can become gangrenous. This complication, if not operated in few hours, can endanger life.

Where should I get my Hernia surgery done?

Hernia surgery is done by all general surgeons. However, surgeons with special interest in Hernia do them better. These are known as “Hernia Clinic”.

What is so special about Hernia Clinic?

Hernia clinic is run by surgeons who have dedicated to hernia surgery. They have latest & most scientific knowledge of hernia. After diagnosing, all options of treatment are explained to the patient at length. The type of surgery etc is then decided by surgeon & well informed patient. Each case is treated individually on its own merit, “tailor made” approach. From the variety of prosthesis, the Best is chosen depending on the type of hernia. Hernia clinic has Operating Rooms with cutting edge technology. All possible equipments & instruments are available from the Best of the companies. Surgeries are standardised & done in most scientific manner under suitable anaesthesia. Most of the patients are discharged on the same day. Obviously, the results of surgery are consistently better. This has been proved by various trials done abroad. Cleveland, Florida, Toronto & Maryland are some of the famous Hernia Clinics in the world.

Does Hernia come back?

Hernia is known to recur. Recurrence rate were very high in past. But with modern advances the recurrence rates have come down from 25% to less than 5%.