HERNIA
A hernia occurs when part of an internal organ bulges through a weak area of muscle. Most hernias occur in the abdomen. There are several types of hernias. Major categories include:
- Inguinal, the most common type, is in the groin
- Umbilical, around the belly button
- Incisional, through a scar
- Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
- Congenital diaphragmatic, a birth defect that needs surgery
Hernias are common. They can affect men, women and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia. The usual treatment for a hernia is surgery to repair the opening in the muscle wall. Untreated hernias can cause pain and health problems. (Source: Medline Plus)
Hernias occur in various locations. Some hernias are present at birth, while others develop during adulthood. Hernias may enlarge due to increased pressure inside the abdomen, such as during straining, lifting, coughing or pregnancy.
Hernia – Epigastric
Occurs when a small bit of fat bulges through a weakness in abdominal muscles between the navel and breastbone. Most people with such hernias are men, usually between ages 20 and 50. These hernias are often so small that they may go unnoticed.
Hernia – Femoral
This is a hernia through the passage that contains the large blood vessels (the femoral artery and vein) between the abdomen and the thigh. This type of hernia causes a bulge in the upper thigh just under the groin and is more common in women than men.
Hernia – Hiatal
This hernia involves the stomach rather than the intestine. The stomach slips upward through the normal opening in the diaphragm and passes into the chest. It is often associated with acid reflux, or "gastroesophageal reflux disease" (GERD), which causes heartburn. Hiatal hernias that are not causing symptoms of acid reflux do not need to be treated. When symptoms occur, medicine may be prescribed to decrease acid reflux. Surgery may be recommended for large hiatal hernias that cause continuing symptoms or for hernias that become stuck inside the chest.
Hernia – Inguinal
Occurs when a portion of intestine or internal fat protrudes through a weakness in the inguinal canal. The inguinal canal is a natural passageway through the abdominal wall in the groin. In males, the inguinal canal contains the blood vessels that go to the testicle and the duct that carries sperm from the testicle. Inguinal hernias account for 75% of all hernias and are five times more common in males than females. They may be present at birth but can develop in adults also.
Hernia – Incisional
Occurs when the intestine bulges through a weakness in the abdominal wall in an area where there has been previous surgery. The skin has healed, but the underlying muscle has pulled apart, resulting in a hernia. These hernias can be small or quite large.
Hernia – Umbilical
Occurs when the intestine or fat bulges through the abdominal wall under the navel. The area of weakness in the abdominal wall can be very small (less than half an inch) or it can be as large as 2 to 3 inches. Umbilical hernias are common in newborns but may disappear gradually over time. They may also occur in adults who are overweight or in women who have been pregnant many times.
Umbilical hernias in infants usually are not treated surgically unless the hernia continues past the child's third or fourth birthday, becomes larger, causes symptoms or strangulates. Umbilical hernias are more likely to need surgery if the opening through which the hernia passes is greater than 2 centimeters in diameter.
Hernia – Ventral or Abdominal
These are general terms that can refer to an epigastric, umbilical or incisional hernia.
Hernias – Complications: Most hernias cause a bulge under the skin. The location of this bulge depends on the specific type of hernia. For example, an inguinal hernia appears as a bulge in the groin, while an umbilical hernia appears as a bulge near the navel. Some hernias can cause twinges of pain or a pulling sensation, but most do not cause pain. Hernias are usually easier to see with coughing or straining. They also tend to be more prominent with standing and often disappear with lying down.
A hernia is considered "incarcerated" if a portion of intestine becomes trapped in the hernia and is unable to slide back into the abdomen. Rarely, the trapped intestine can "strangulate." This means that the contained intestine dies because its blood supply has been cut off by the constriction of the hernia. This causes severe pain and requires urgent surgery.
Hernias that become incarcerated or strangulated require immediate medical attention. Your doctor will try to massage the hernia back through the hole in which it is stuck. If this cannot be done, emergency surgery may be needed. Otherwise, most hernia repairs can be done on an outpatient basis as a non-emergency.
When To Call A Professional
Call your doctor right away if there is significant pain at the site of a hernia. This can be the first sign that a hernia is incarcerated or strangulated. See your doctor if you notice a new, painless lump or swelling in a location where hernias typically occur.
HERNIAS – types of: A hernia occurs when part of an internal organ bulges through a weak area of muscle. Most hernias occur in the abdomen. There are several types of hernias, including
- Inguinal, the most common type, is in the groin
- Umbilical, around the belly button
- Incisional, through a scar
- Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
- Congenital diaphragmatic, a birth defect that needs surgery
Hernias are common. They can affect men, women and children. A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia
HERNIAS – Inguinal:
An Inguinal Hernia is a condition in which part of the intestine bulges through a tear in muscles in the floor of the abdomen wall. An inguinal hernia occurs in the groin (the area between the abdomen and thigh). It is called "inguinal" because the intestines push through a weak spot in the inguinal canal, which is a triangle-shaped opening between layers of abdominal muscle near the groin. Obesity, pregnancy, heavy lifting, and straining to pass stool can cause the intestine to push against the inguinal canal.
Symptoms of inguinal hernia may include a lump in the groin near the thigh; pain in the groin; and, in severe cases, partial or complete blockage of the intestine. The doctor diagnoses hernia by doing a physical exam and by taking x-rays and blood tests to check for blockage in the intestine.
The main treatment for inguinal hernia is surgery to repair the opening in the muscle wall. This surgery is called herniorrhaphy. Sometimes the weak area is reinforced with steel mesh or wire. This operation is called hernioplasty. If the protruding intestine becomes twisted or traps stool, part of the intestine might need to be removed. This surgery is called bowel resection. (Bowel is another word for intestine.)
HERNIAS (Inguinal) - Symptoms of:
Answer: A hiatus hernia occurs when the upper part of the stomach, which is joined to the esophagus (gullet), moves up into the chest through the hole (called a hiatus) in the diaphragm. It is common and occurs in about 10 per cent of people.
Most people are not troubled by their hiatus hernia, but if reflux of the acid contents of the stomach occurs (called gastro-esophageal reflux), you get heartburn. This is a painful burning sensation in the chest, which can sometimes be felt in the throat. Sudden regurgitation of acid fluid into the mouth can occur, especially when you lie down or bend forward. These symptoms are a problem when you go to bed and can wake you up. Other symptoms include belching, pain on swallowing hot fluids and a feeling of food sticking in the esophagus.
HERNIAS – Hiatal Self treatment measures:
There are many self-help measures for Hiatal Hernia:
- Elevate the head of your bed about 6 to 8 inches (place wood blocks or pillows between the Mattress and Bedsprings)
- Maintain your ideal weight and lose weight if necessary
- Avoid stooping, bending and heavy lifting, especially after meals
- Avoid smoking
- Reduce alcohol and coffee
- Avoid corsets and tight clothing
- Take antacid at bedtime if not contra-indicated
- Have small meals
- Avoid spicy food.
- Avoid hot drinks.
- Avoid having late supper. Do not eat heavy meals after 7 p.m.
- Avoid gassy (carbonated) drinks.
Losing weight nearly always cures it. Eating small meals each day instead of 2 or 3 large ones helps. You must have a light evening meal without alcohol and avoid supper so that your stomach is empty on retiring. It takes about 1 hour for the stomach to empty.
Smoking certainly aggravates it, as do coffee and alcohol, especially spirits. If symptoms occur at night, you are advised to use extra pillows to prop up you head and shoulders. If this fails, you should raise the head of your bed about 10 cm (4 inches) to prevent acid reflux at night.
HERNIAS – Hiatal Medical and Surgical Treatment
If over-the-counter antacids and other measures do not help, your doctor may prescribe a special mixture or tablets to reduce reflux. If your problem persists, an operation called Fundoplication may be necessary. This operation generally has good results and can now be performed with “laser surgery” (laparoscopy or minimally invasive sugery). The key to coping with a hiatus hernia is to maintain an ideal body weight.
