health

Hernia – Causes and Treatments

Dr. Nikhil Eric Saldanha

July 29, 2022

A hernia is a condition in which an internal organ bulges via a weak point present in the muscles or tissues. The growth usually occurs through a delicate area in the abdominal walls.

A hernia usually affects the stomach or intestine causing intense pain and requiring immediate medical examination and treatment. If left untreated, a strangulated hernia can lead to life-threatening conditions such as necrotising enterocolitis (severe inflammation of the intestine) and sepsis. Since hernias can happen to anyone, knowing warning signs of hernias and being aware of them are essential.

Causes

Inguinal and femoral hernias occur in weaker muscles that might be present from birth or develop due to age and frequent pressures on the abdomen and groin regions.

Physical exercise, weight, pregnancy, or regular coughing can all cause strain. It occurs due to the pressure pushing any organ or tissue through an open or weak spot. 

Sometimes weakened muscles are present by birth. However, it is a more typical development taking place later in life. Moreover, adults can develop an umbilical hernia by stressing their abdominal muscles, being overweight, coughing for a long time, or giving birth.

In addition, Hiatal hernias are not entirely understood yet, but it occurs in a person due to a weakened diaphragm because of age or strain on the abdomen.

Some common causes of hernia are:

  • Cystic fibrosis
  • Enlarged prostate
  • Obesity
  • Abdominal fluid
  • Lifting heavy items
  • Peritoneal dialysis
  • Poor nutrition
  • Smoking
  • Physical exertion
  • Undescended testicles

Some Common Symptoms of Hernia

A bulge or lump in the afflicted region is the most prevalent sign of a hernia. In addition, an inguinal hernia can cause a swelling bump on either side of the pubic bone, the meeting spot of your groin and thigh. 

  • On lying down, you can notice the lump disappearing. When you are standing, leaning down, or coughing, you will more likely feel your hernia by touching it. There are chances of discomfort or pain in the region surrounding the swelling. The symptoms vary with different types of hernias.
  • Swelling can also be painful and uncomfortable.
  • Hernias often go undetected because they have no intense symptoms initially. As a result, you may not realise you have a hernia until diagnosed during a physical or a medical test.

Inguinal, femoral, umbilical, and incisional hernias include symptoms like: 

  • A visible swelling underneath the skin of the groin or abdominal region. 
  • Lifting or leaning over causes pain in your abdomen or groin
  • The bulge hurting
  • The groin feels weak and strained
  • Heartburn
  • Trouble swallowing

Some other symptoms that are not too common:

  • Extreme pain
  • Vomiting
  • Constipation
  • Pain and swelling near testicles

Diagnosis

A hernia is usually diagnosed depending on your symptoms, a physical exam, and sometimes imaging testing. External hernias are frequently discovered during a physical examination as they generate a protrusion that is noticeable or palpable in certain instances. 

A physical checkup for males always includes an examination for an inguinal hernia. It includes your physician feeling around the groin region for analysis and asking you to cough.

Coughing puts more strain on the hernia and makes it more prominent to detect. Your doctor can also direct you to undergo an imaging test in case of any confusion.

Ultrasound:

For women, the doctor might suggest an ultrasound to rule out the possibility of other causes of abdominal discomfort like ovarian cysts or fibroids. 

An ultrasound is the best way to check for inguinal or scrotal hernias among men. As in this test, ultrasound captures the pictures of your abdomen and pelvic organs through sound waves. 

CT Scan (Computer Tomography):

Your doctor may order this test to rule out alternative causes of stomach discomfort and swelling. CT scans utilise X-rays to produce pictures of your abdomen and related organs. It involves rotating an X-ray tube and electronic X-ray detector around you while you pass through the machine. 

Magnetic Resonance Imaging (MRI):

Your doctor may prescribe magnetic resonance imaging tests if your discomfort worsens while you work out. For example, physical activity can create a hernia without a protrusion in some people. Even if there is no bulge, an MRI scan might reveal a rupture in your abdominal muscles. This test creates pictures of the abdomen and the organs it contains using radio waves and a magnetic field.

Treatment

Surgical treatment is the only approach to managing a hernia. The size of the hernia and the degree of symptoms will determine whether you require surgery. 

Your physician may choose to monitor your hernia for any potential problems. This method is known as “watchful waiting.” Putting on a truss might help relieve hernia symptoms in certain circumstances. 

Some over-the-counter medicines for a hernia include antacids, H2 receptor blockers, and proton pump inhibitors. However, you should always consult your healthcare professional before taking any over-the-counter medication. 

Surgery for Hernia

Laparoscopic Procedures:

The laparoscopic or minimally invasive procedure includes several tiny incisions of around centimetres to access the hernia. To operate correctly, surgeons use carbon dioxide to expand the abdomen.

Furthermore, surgeons will use a laparoscope. The laparoscopy method is used to return the herniated tissue back into the abdomen surgically, and the weakness in the abdominal wall is repaired and secured with a mesh. It is a piece of small, flexible equipment. It is occasionally necessary to use mesh to secure the abdominal wall’s weakness.

This operation necessitates the assistance of a hernia expert who is familiar with minimally invasive procedures. However, it results in less scarring and surgical discomfort, a lower risk of infection, a short hospitalisation period after surgery, and a quicker return to regular activities. 

However, patients with giant hernias or adhesions through a previous abdominal surgery cannot opt for minimally invasive treatments like open surgery or laparotomy.

Open Surgery:

Open procedures involve repairing the hernia with a mesh by opening the abdomen with a single incision.

Patients with significant or numerous hernias benefit from available treatments. Open surgery is suitable for people with previous abdominal surgeries. 

On the other hand, modern technology makes avoiding major incisions and the associated hazards easier.

Preventing Hernia

1. Healthy Weight:

It’s essential to strengthen the weak abdominal muscles with workouts and yoga postures while keeping a regular flow of oxygenated blood in the body. In addition, maintaining a good posture and doing yoga protect the abdominal organs from being displaced. 

However, lifting big weights should be avoided since it might aggravate the pain. Several yoga positions can help relieve strain on the abdominal opening if done regularly.

2. Diet:

To prevent constipation and pressure during bowel movements, eat a high-fibre diet.

When fighting hernia, focusing on the food quality and eating small amounts of food is beneficial. Moreover, the problem of constipation can also be relieved by eating nutritious meals such as fresh vegetables, non-citrus fruits, whole grains, seeds, and nuts.

In addition, fibre is an indigestible carbohydrate that helps to keep your digestive and cardiovascular systems in excellent condition. 

In addition, as per a study, total constipation score, red meat consumption, chicken consumption, excess bread consumption, low energy intake, and low fibre consumption were significant as independent variables for hernia formation.

Furthermore, smoking, alcohol consumption, total constipation score, low fibre consumption, low egg consumption, and bread consumption were also effective in hernia formation.

3. Lifting Techniques:

Whenever an athlete or someone who does a lot of heavy lifting picks up items, they risk developing an inguinal hernia. Correct lifting practices can help to reduce risk and strain. 

If the weight is too high, seek assistance, utilise a hand truck or forklift, or lighten the weight. Try to bend from the knees rather than the waist. 

In addition, lifting leg muscles with a straight back and sufficient support on your ankles can help in relieving muscle pain. Moreover, you should avoid hurrying and move the weight gently to ensure that your body is in the proper position before lifting.

4. Core Strength:

Improving core strength provides several advantages in terms of preventing hernias. The core comprises major pelvic and abdominal muscles, including the pelvic floor, oblique muscles, and smaller muscles like the gluteus maximus and trapezius. 

Consistent core-strengthening workouts can help you maintain the strength and elasticity of the muscles that surround your abdomen and groin. If you have a hernia, consult your doctor to determine which core workouts are appropriate.

5. Enlarged Prostate:

People with enlarged prostate get the urge to urinate repeatedly and urgently. There can be trouble starting to urinate or feeling your bladder isn’t empty even after urinating. In addition, an enlarged prostate can raise abdominal pressure by putting strain on the bladder during urinating. 

As men become older, they are more likely to acquire an enlarged prostate. To reduce the risk of a hernia, avoid straining during bowel movements or urination. Furthermore, putting pressure on the bladder can increase the likelihood of a hernia. 

The Bottom Line

It’s not always possible to prevent a hernia from forming. For example, a hernia might develop due to a pre-existing genetic problem or a prior operation. Nevertheless, you can reduce your chance of a hernia by making some easy lifestyle changes.

Furthermore, if you detect a hernia forming in your body or your hernia getting worse, contact your doctor soon. They are well-versed in the best treatment choices for your disease and will advise you on how to avoid problems in the future.

Frequently Asked Questions (FAQs)

Q. What causes a hernia?

A. Pressure on any organ or the intestines causes a hernia to develop. In other words, a hernia occurs when there is prolonged pressure in the region surrounding a  weak muscle or tissue. Some people have weakened muscles or underdeveloped tissue by birth. Most people, however, get hernias as a result of an ageing body and sagging muscles.

Q. What are the warning signs of a hernia?

A. There are different signs and symptoms related to the hernia. However, some of the most common signs include swollen groyne or scrotum, increased discomfort at the bulge’s location, pain while lifting, lump becoming more prominent over time, painful sensation that lasts for a long time, constipation or prolonged feeling of being full. 

Q. Do hernias go away?

A. Hernias do not heal by themselves. A hernia can be treated only by surgery. However, a minor hernia may not necessitate surgery for some people. Under any circumstance, it’s essential to get the advice of a medical professional first. 

Q. Is having a hernia serious?

A. Hernias, if not treated, become larger and more painful. In certain circumstances, they may pose a significant health concern. A strangulated hernia occurs when the wall by which the intestine protrudes shuts, cutting off blood supply to the bowel. It can cause necrotising enterocolitis (intestinal inflammation) and sepsis. 

Q. Where does a hernia hurt?

A. Hernia includes abdominal discomfort, particularly in the groyne region. The pain worsens when you sneeze, cough, lift anything heavy, or strain. There is also a burning sensation during bowel movements. 

Q. Is it OK to ignore a hernia?

A. Ignoring a hernia or failing to get treatment can lead to more severe consequences such as blockage in the intestines, hernia incarceration, or strangulation. In addition, untreated hernias can grow bigger and become more challenging to control and painful if ignored.

Q. What to avoid if you have a hernia?

A. When possible, limit heavy lifting. The groin is put under a lot of strain when you lift weights. If you have to lift something, don’t lean over. Lift something with your legs rather than your back. Additionally, Foods rich in saturated or trans fats, including red meat, processed foods, high-fat dairy products, and hydrogenated vegetable oil, need to be avoided since they produce inflammation and weight gain and exacerbate hernia problems.

Q. What is a male hernia?

A. Men have a particular space in their inguinal canal due to the development of the testes. Which exit the abdominal cavity and pass through the inguinal canal to the scrotal sac (the ball sack). So this creates a weakness that remains for the rest of their life. Male hernia or Groin hernia includes the bulging of soft tissue through a weak spot in the abdominal muscles. The intestine usually combines soft tissue. The bulge is easy to spot except in a few cases of patients with obesity. Pain is one of the most common symptoms, particularly during coughs, bends, or heavy weight lifting.

Q. What to do if you think you have a hernia?

A. Contact your doctor immediately if you think you have a hernia. Hernias require medical surgeries as you cannot treat them at home. In most cases, hernias develop worse over time. The more you wait, the fewer surgical alternatives available to you.

Q. How do I know if my hernia is getting worse?

A. A bulging hernia turning red, purple, or dark in colour. The inability to defecate or pass gas. If you experience painful or visible swelling in your groin on either side of your pubic bone, visit your physician.

About the Author

Dr. Nikhil did Medicine (MBBS) at St. John’s Medical College and then decided to step away to do a Master’s in Health Psychology at the University of Stirling. On the way to that, he has worked with an NGO, Enfold, on teaching sexual health education in schools and colleges to create a healthy foundation for better sexual health in the nation. He has also worked as a medical content editor with Vinformax. He has now been working with HealthifyMe to bring in a renewed user-centric perspective concerning the users' medical conditions and to support the company with more effective digital tools and devices. He hopes to help improve the healthcare scenario in India.


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