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Hernia

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  3. Hernia

Overview of Hernia

Every organ, bone, muscle, blood vessel, nerve fibre, and muscle are held in their position by a thin casing of connective tissue known as fascia. It is located just below the skin. When fascia is pushed outwards, an obtrusion appears.

A hernia (Fataq / فتق) occurs when organs are pushed outwards on the skin surface through the opening in the fascia. This creates an obtrusion on the skin that can be seen by the naked eye.

Most of the hernia occurs in the abdominal cavity, inguinal region, between the chest and the hips. It can be caused by a weak muscle or tissue, allowing the organ to push through.

Prevalence of Hernia

The most widely occurring hernia is inguinal which makes up to 75-80 percent of it. 2 percent of hernias are incisional, 3-10 percent umbilical, and 1-3 percent are other types.

Signs and Symptoms of Hernia

Signs and symptoms of a hernia include:

  • Swelling in the groin or scrotum
  • The appearance of a bulge
  • Increased pain at the site of the bulge
  • Signs of bowel obstruction
  • Sensation of fullness
  • A dull aching throughout the area
  • Pain while lifting things
  • Discomfort and feeling of heaviness
  • Pain while bending

Types of Hernia

There are many different types of hernia. Some of them are as follows:

  • Inguinal Hernia

This type of hernia is caused by the protrusion of the intestine or the bladder in the inguinal region. 96 percent of groin hernias are inguinal because of a natural weakness in the area in men.

  • Umbilical Hernia

This is caused by part of the small intestine that pushes through the abdominal wall near the navel. Obese women and newborns are at risk of developing an umbilical hernia.

  • Femoral Hernia

The part of the intestine pushing into the canal carrying the femoral artery in the inner upper thigh causes femoral hernia.  They are common in obese and pregnant women.

  • Incisional Hernia

A hernia produced at the site of the previous abdominal or pelvic surgery is an incisional hernia. It can occur in elderly people or overweight people who are inactive after surgery.

  • Hiatal Hernia

Hiatal a hernia is caused by the pushing of the upper stomach through a hiatus (opening in the diaphragm) into the chest cavity.

  • Diaphragmatic Hernia

Protrusion into the chest through an opening in the diaphragm causes this type of hernia.

  • Spigelian Hernia

Spigelian hernia is caused by the protrusion of the intestine below the navel.

  • Epigastric Hernia

Protrusion through the abdominal area between the navel and breastbone (lower part of the sternum) causes epigastric hernia.

Causes of Hernia

Causes of hernia are as following:

  • Heavy lifting
  • Weakened muscles
  • Strain from physical exertion
  • Chronic constipation
  • Overweight
  • Frequent coughing
  • Pregnancy or multiple pregnancies
  • COPD
  • Congenital conditions
  • Cystic fibrosis
  • Ageing
  • Family history of hernia
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Risk Factors of Hernia

Some of the risk factors that play an important role in hernia formation are discussed below;

  • Heavy lifting can disturb the intra-abdominal pressure and can cause a hernia.
  • Chronic coughing can increase the risk of strain on the abdominal wall resulting in a hernia. 
  • Abdominal walls get stretched when weight is gained on the abdominal side. This leads to the formation of a hernia.

However, some people are generally more prone to hernia. It's because their connective tissue/fascia is comparatively weaker than the rest of the population. 

Health Complications Due to Hernia

Most of the hernias are reducible. However, certain types of hernias are irreducible, which means they can't go back to their original location. This can lead to the following complications:

Bowel Obstruction: It gets very difficult for the bowel contents to pass through when a part of the gut is herniated. So, this ends up causing vomiting, cramps and absence of defecation.

Strangulation: The pressure that is built on the hernial contents may restrict the blood from flowing into different organs and tissues. This can lead to ischemia, gangrene and even cell death.

These complications can be life-threatening if not treated on time.

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Prevention

A few steps you can take in order to prevent hernia include:

  • Eat healthy in order to maintain a healthy weight.
  • Consume fruits, vegetables and whole-grain to avoid constipation.
  • Avoid lifting stuff that is beyond your ability. Be careful while lifting weights at the gym too. 
  • Avoid smoking as it leads to coughing which triggers hernia. 
  • Visit your doctor if you constantly cough or sneeze.
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Diagnosis

A physical exam is performed and the doctor looks for a bulge and narrows the location of the pain. Imaging such as MRI, CT Scan, or ultrasound is performed to get a clear view of the inside of the body.

An endoscopy or barium x-ray can be used to assess a hiatal hernia.

Treatment of Hernia | When to Consult a Doctor

Usually, surgery is chosen as the best treatment method for a hernia.

  • Open Surgery

The protruding tissue is pushed back into the place and the muscle wall is stitched together. A mesh can be used for extra support.

  • Laparoscopic Surgery

Tiny incisions are made instead of one single insertion and the same repairs as the open surgery are performed. 

If the hernia is not treated properly it can cause intestinal obstruction or strangulation of the intestines.

As soon as pain is felt and a bulge appears on the body, a doctor needs to be consulted. After the consultation, surgery is usually the best way to go.

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