Abstract

The protrusion of an internal organ through a weak spot in the muscles or tissues is called a hernia. Read about its types, causes, symptoms, risk factors, and treatment.

What Is a Hernia?

A hernia is the protrusion of an internal organ through a weakened area in the muscles or tissues. Most hernias are seen in the abdomen, but they can be seen in the groin and upper thigh regions also. They do not pose an immediate threat to life but require surgery as they do not go away on their own. Surgery can also help prevent future complications.

What Are the Types of Hernias?

Based on the exact site in the abdomen where the weakness is present, there are different types:

Hiatal Hernia - When a portion of the stomach pushes through the opening in the diaphragm (hiatus) into the chest, it is called hiatal hernia. This is seen more commonly in people over 50. It causes symptoms of GERD. Acid reflux is the most common symptom of an hiatal hernia. Hiatal hernia is further classified into:
1. Sliding hiatal hernia - It is the most common type where the stomach and esophagus slide in and out of the hiatus.
2. Fixed hiatal hernia - This type needs surgery, as the part of the stomach that gets protruded cannot move back and forth the hiatus. It can cut off the blood supply to the stomach if left untreated.

Incisional Hernia - This is a type of a hernia that occurs post-surgery in the area weakened by the incision. Commonly seen when the surgical wound does not heal properly. Doctors commonly refer to this as ventral hernia.
Inguinal Hernia - When the intestines protrude through a weak spot in the lower abdominal canal (groin region), it is called an inguinal hernia. It is more common in men than in women. This hernia can consist of a part of the small intestine or even parts of the female reproductive organs in women. It is sometimes confused with a femoral hernia.
Epigastric Hernia - The epigastric region is the part below the ribcage and above the belly button. Hernia in this region is called an epigastric hernia. An epigastric hernia can be felt when you cough, stress for a bowel movement, laugh, and other activities that cause excess pressure on the abdominal wall.
Femoral Hernia - It occurs when the intestine pushes into the canal of the femoral artery in the upper thigh, which can also possibly block blood flow to the leg. This is common in women who are pregnant or obese. It results in a small or medium lump in the groin region. Around 2 to 4 % of hernias in the groin region are of this type.
Umbilical Hernia - This is a type of a hernia that may be seen in the belly button region of very young babies due to their abdominal walls still being weak. It is especially visible when they cry. With age, the muscles get stronger, and this condition goes away on its own.

What Are the Possible Causes of a Hernia?

Hernias are usually caused due to muscle weakness and strain. The following condition can result in the combination of both these factors and result in a hernia:

A hernia can be present from birth (congenital hernia).
Damage due to surgery.
Abdominal injury.
Ascites (fluid in the abdomen).
Chronic obstructive pulmonary disorder (COPD).
Strenuous exercise.
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Risk Factors:

A positive family history of hernias.
Older adults.
Obesity.
Multiple pregnancy.
Chronic constipation.
Chronic cough.
Smoking.
Premature baby and low birth weight.
Sudden loss or gain of weight.

Malnutrition.

What Are the Signs and Symptoms of a Hernia?

In most cases, hernias do not cause pain. But it can cause pain and discomfort while straining, lifting objects, and/or standing. If you notice a lump, make sure you consult a doctor immediately, as sometimes, hernias can cut off blood supply and cause complications. If you experience the following symptoms, get immediate medical attention for an inguinal hernia:

A sharp, burning pain in the affected area during coughing, sneezing, lifting weights and quick movements.

Pressure and discomfort in the abdomen (in the area of bulge).

Sometimes, no symptoms are felt.

How Does a Doctor Diagnose Hernias?

A hernia is often diagnosed during a routine physical examination. The doctor will feel for an obvious protrusion that gets more visible with coughing.

Based on the suspected location, few tests may be ordered by the doctor to visualize the internal organs better.

Abdominal ultrasound - Here, high-frequency sound waves are used to produce images of the structures in the abdomen.
MRI scan - strong magnets and radio waves are used to produce detailed images of the abdomen.
CT scan - X-rays are used to produce detailed cross-sectional images of the body.
Barium X-ray or Gastrografin - Here, the patient drinks Gastrografin (a combination of Diatrizoate meglumine and Diatrizoate sodium) or liquid barium, and then a series of X-rays are taken of the digestive tract.
Endoscopy - A flexible, thin tube with a camera at one end is inserted through the patient’s mouth to the stomach.

What Are the Treatment Options for Hernias?

1. Lifestyle changes:

Eat fibrous food.
Keep your meals light.
Do not lie down immediately after a meal.
Stay in the healthy weight range.
Strengthen the muscles around the hernia bulge by exercising under the guidance of a qualified physiotherapist.
Avoid spicy foods.
Stop smoking.

2. Medication:

In certain cases (a hiatal hernia), medications such as antacid help relieve symptoms and are prescribed by the doctor.

3. Surgery:

If a hernia causes pain and other complications, your doctor will suggest a surgical correction. This procedure will involve sewing the weakened area closed. Surgery may be via open or keyhole surgery methods.

Preventive Tips:

It is not always possible to prevent a hernia, but these tips can help in preventing some types of hernia: