Everything You Want To Know About A Hernia | Gastroenterology

hernia

What is a hernia?

A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall.

Most of these occur in the abdomen between the chest and hips, but they also appear in the upper thigh and groin. Most of these are not immediately fatal, but they do not go away on their own. Sometimes they require surgery to prevent dangerous complications.

The most common forms are:

  • Femoral hernia: fatty tissue or part of the intestine that protrudes into the groin on the upper part of the inner thigh. These are much less common than inguinal type and mainly affect older women.
  • Umbilical hernia: fatty tissue or part of the intestine that pushes through the abdomen near the navel (belly button).
  • Hiatal (intermittent) hernia: a part of the abdomen pushed into the chest cavity by the diaphragm (the horizontal sheet of muscle that separates the chest from the abdomen).

Types

These are generally found in the following areas:

  • Groin – A femoral hernia creates a slight bulge under the groin. It is more common in women. It is swollen in the groin, which reaches the testicles.
  • Upper abdomen: Hital or hiatal hernia is caused by the opening of the diaphragm that pushes the upper abdomen out of the abdominal cavity and into the chest cavity.
  • Surgical scar: An incision made for an anterior abdominal surgical scar can lead to this.

Symptoms

The most common symptom is a bulge or lump in the affected area. For example, in the case of an inguinal hernia, you may notice a lump on either side of your pubic bone where your groin and thigh meet.

You may find that the lump disappears when you’re lying down. You’re more likely to feel your hernia through touch when you’re standing up, bending down, or coughing. Discomfort or pain in the area around the lump may also be present.

In some cases, It may require immediate surgery, for example, when part of the intestine is obstructed by the throat is constricted. If it causes severe abdominal discomfort, seek immediate medical attention:

  • Pain
  • Nausea
  • Vomiting

The swelling is not pushed into the abdomen.

In these cases, the swelling is usually firm and smooth and cannot be pushed into the abdomen. A hyaline hernia produces acid reflux symptoms like heartburn, which is caused by acid from the stomach entering the esophagus.

Causes of hernia

These are caused by muscle weakness and tension. Depending on the cause, it can develop quickly or over a long period of time. Some common causes of muscle weakness are:

  • A congenital condition that develops during pregnancy and from birth.
  • Ageing
  • Damage from injury or surgery
  • Chronic cough or chronic obstructive pulmonary disorder (COPD)
  • Exercising hard or lifting heavyweights.
  • Pregnancy, especially multiple pregnancies.
  • Constipation, which causes you stress when you have a bowel movement.
  • Fluid in the abdomen or ascites

Risk factors

Factors that contribute to the development of an inguinal hernia:

  • Men are eight times more likely to have an inguinal hernia than women.
  • Family history. You have a close relative such as parents or siblings who have this condition.
  • Chronic coughs like smoking.
  • Chronic constipation. Constipation causes diarrhoea during bowel movements.
  • Pregnancy. Pregnant weakens your abdominal muscles and increases the pressure inside your abdomen.
  • Premature birth and low birth weight.

Previous inguinal hernia. Even if your previous hernia occurred in childhood, you are at risk of developing another.

Treatment

The usual course of action is to watch and wait, but this can be risky for certain types, such as femoral hernias.

Within 2 years of a femoral hernia is diagnosed, 40 per cent result in bowel strangulation.

It remains unclear whether non-emergency surgery is worthwhile for hernia repair in cases of an inguinal hernia without symptoms that can be pushed back into the abdomen.

The American College of Surgeons and some other medical institutions consider elementary surgery unnecessary in such cases and instead recommend careful waiting.

Others recommend surgical repair to eliminate the risk of gingivitis of the intestine, which cuts off the blood supply to the area of ​​tissue that requires an emergency procedure. These health officials prioritize prior routine operations over riskier emergencies.

Types of surgeries

Although the surgical options depend on individual circumstances, including the location, there are two main types of surgical intervention for a hernia:

  • Open surgery
  • Laparoscopic operation (keyhole surgery)

Open surgical repair closes the hernia with stitches, mesh, or both and closes the surgical wound on the skin with stitches, staples, or surgical glue. Laparoscopic repair is used for repetitive operations to prevent the previous scarring, and although it is generally expensive, it is less likely to cause complications such as infection.

Laparoscope-guided surgical repair of a hernia allows the use of small incisions, allowing for faster recovery from the operation. This can be repaired in the same way as to open surgery, but it is guided through a small camera, and light is inserted through a tube. Surgical instruments are inserted through another small incision. The abdomen is inflated with gas so the surgeon has room to look better and work. The entire operation is performed under general anaesthesia.

Home remedy for hernia

There are a few things you can do to ease your symptoms. Increasing your fibre intake can relieve constipation that causes straining during bowel movements, which can aggravate the hernia. Some examples of foods high in fibre are whole grains, fruits, and vegetables.

Diet changes can also help with the symptoms. Try to avoid large or heavy meals, do not lie down or bend after meals, and keep your body weight in a healthy range.

To prevent acid reflux, avoid foods that cause spicy foods and things like tomato-based foods. Plus, quitting smoking can help too.

Complications

  • Pressure on surrounding tissues. Most inguinal hernias expand over time if not surgically repaired. In men, large hernias extend into the scrotum and cause pain and swelling.
  • The hernia was arrested. If the contents of the hernia get stuck in a weak spot in the abdominal wall, it obstructs the intestine, causing severe pain, nausea, vomiting, and the inability to hold stools or pass gas.
  • Sore throat. A blocked hernia can reduce blood flow to some part of your intestine. A sore throat can lead to the death of affected intestinal tissue. A throat hernia is fatal and requires immediate surgery.

Prevention

You cannot prevent a birth defect that can lead to a congenital hernia. However, it can reduce stress on abdominal muscles and tissues. For example:

  • Keep a healthy weight. Talk to your doctor about the best exercise and diet plan for you.
  • Prefers foods rich in fibre. Fruits, vegetables, and whole grains contain fibre that helps prevent constipation and diarrhoea.
  • Lift heavy objects carefully or avoid lifting heavy objects. If you must lift something heavy, always bend your knees, not your waist.
  • Smoking. In addition to its role in many serious diseases, smoking often causes a chronic cough, which can lead to or exacerbate an inguinal hernia.

Recovery

After surgery, you may feel pain around the surgery site. Your surgeon will prescribe medications to reduce this discomfort as you recover.

Be sure to carefully follow your surgeon’s instructions regarding wound care. Contact them immediately if you notice signs of infection such as fever, redness or discharge, or a sudden exacerbation of pain at the site. After repaired, you may not be able to rotate normally for several weeks. You should avoid any strenuous activity. Also, you should avoid lifting heavy objects over 10 pounds during this period.

Open surgery often requires a longer recovery procedure than laparoscopic surgery. Your surgeon will tell you when you can return to your normal routine.

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