What is a hernia?
A hernia occurs when an organ like the intestine pushes out through a hole in the muscle or tissue that is meant to contain it.
Generally, you’ll find hernias in the abdomen or groin area, and they appear as a bulge or lump. The most effective treatment of hernias is surgery – and it is one of the most common operations in Australia, with about 40,000 Australians having hernias repaired each year.
Some people are born with a weak abdominal wall, making them more susceptible to hernias. Others develop later in life.
There are different types of hernias. The most common include:
- Inguinal – these account for up to 90% of all hernias. Mainly affecting middle-aged men, inguinal hernias occur in the groin area.
- Femoral – more common in women, these occur high on the thigh as a result of intestines forcing their way through the weak muscles of the femoral canal. It is a serious hernia requiring urgent surgery.
- Umbilical – more common in newborns and women who have had multiple pregnancies, the umbilical hernia is where a portion of intestine pushes through the muscle near the navel.
- Incisional – occurring after abdominal surgery, this is where the intestines push through the site of surgery.
- Hiatus – you won’t be able to see a hiatus hernia, as it occurs inside the body (where your oesophagus passes through the diaphragm). Watch out for symptoms like heartburn and difficulty swallowing.
A hernia can be at risk of becoming strangulated – which means it cannot be gently pushed back through the abdominal wall. Another term for this is non-reducible hernia. This can lead to serious complications, including gangrene of the trapped bowel.
Symptoms of hernia
Generally, a hernia can be seen or felt on your body. Other symptoms of hernias include:
- Pain when exercising
- An uncomfortable feeling in the gut
- The lump gets bigger when you cough
- The lump gets smaller when you lie down
If you have a hernia, you can gently press on it to make sure that it is not a non-reducible hernia; and also watch out for these symptoms, which will suggest that yours has become strangulated:
- Severe pain
If you have any of the above symptoms, you should see a doctor straight away. Surgery is needed to remove the hernia and reduce your risk of gangrene.
Causes and treatment of hernia
A hernia can be caused by different things, but is typically a combination of muscle weakness and excessive strain. There are mechanical causes such as heavy lifting, bouts of coughing, a sharp blow to the abdomen, or poor posture. Other physical causes include obesity, constipation (and the resultant straining), pregnancy and smoking.
For the majority of hernias (reducible and non-reducible), surgery is the only treatment option. The good news is that many hernias – particularly inguinal hernias – can be fixed with laparoscopic surgery, which is also known as ‘minimally invasive’ surgery. In this type of surgery, a tiny camera is inserted and, directed to the problem area. The defect is then repaired by pushing back the herniated tissue and repairing the weakened muscle. If you have a laparoscoprocy, you should expect to be able to return to work in a week or two.
Some hernias require a more complicated procedure, in which the surgeon needs to cut a larger opening in the abdomen to reach the affected area. In some cases, a synthetic material (mesh) is placed over the weak muscle area to strengthen against future occurrences of hernia.
If you think you may have a hernia, or have some of the warning signs that make you a likely candidate for one, it’s a good idea to get it checked out by a doctor. Untreated hernias may cause complications that are easily avoided with surgical correction.
Further information and sources