What is a Hernia?
A hernia is a broad term that refers to a bulge or protrusion of an organ/tissue through the tissue that usually contains it in its normal anatomical place. Most commonly this is a weakness in the muscle/fascia of the body. This area of weakness then allows organs like the intestines to push through the hole, and cause the herniation.
Symptoms of a Hernia
Symptoms and signs differ depending on the kind of hernia. A lot of times the herniated tissue moves back and forth through the weakness with minimal symptoms. Sometimes you will see a bulging in this area. Symptoms include pain, swelling, pressure. If the hernia gets stuck in the bulge, this is called an “incarceration.” This will produce more pain and can lead to “strangulation” (death of the tissue). This is a serious problem if the tissue is an organ like intestines or colon.
Common types of Hernias
There are many different types and sizes of hernias. Examples include Inguinal hernia ( In the groin region), Incisional hernia (Site of previous abdominal surgery) or Hiatal hernia (Upper Stomach, diaphragm).
Epigastric (midline of the upper abdomen)
Hiatal (upper stomach, diaphragm)
Inguinal (inner groin)
Femoral (outer groin)
Incisional (near a scar of previous surgery)
Umbilicus (at the stomach button.)
An inguinal (groin) hernia happens when the intestine, for example, protrudes through the weak spot in the abdominal muscles at the inguinal canal. Inguinal hernias are more common in men and about 1 in 4 men will develop one in life. There are two kinds of Inguinal hernias:
Indirect Inguinal (groin) hernia is when the internal inguinal canal which should close by the time of birth remains open. This hernia is usually diagnosed in the first year of life.
Direct Inguinal (groin) hernia is when part of the intestine pushes through a weak abdominal muscle by the wall of the inguinal canal. This type occurs in male adults.
Incisional hernia is when part of an organ or tissue bulges through a weakness in the abdominal wall at the site of previous abdominal surgery. This is a common risk/side effect of having abdominal surgery. After surgery the muscle/fascia that is stitched becomes weak. The peritoneum (covering of the abdominal hole) protrudes through, and the defect causes bulging. The bulging is more evident when the abdominal muscles are straining. Any actions that increase intra-abdominal strain may worsen the hernia; examples of such activities are lifting, coughing, or even straining to pee or a bowel movement.
The hiatal hernia occurs when a weak muscle tissue allows the stomach to bulge through the diaphragm. This may result in gastroesophageal reflux illness (GERD) or laryngopharyngeal reflux (LPR). Symptoms of Hiatal hernia are:
Shortness of breath (induced by the hernia's force on the membrane)
Backflow of stomach acid into the esophagus (acid reflux).
There are many different types and sizes of hernias. In general, hernias can lead to organs or other structures moving through the weak tissue into an area they should not be. This can lead to pain/discomfort and more serious complications such as bowel blockages or compromised organs.
Who typically gets Hernias?
Men are more prone to develop hernias more often than females because of their anatomy and higher personal exertions. Smokers are also very likely to develop hernias because of the increased coughing, which increases the pressure in the abdominal wall.
I think I have a Hernia
If you think you have a hernia it is best to be examined by your primary care physician or surgeon. This will help determine the type of hernia, the size and if surgical repair needs to be undertaken. Sometimes we do imaging studies such as CT Scans to help identify the location and size of the hernia. This is important for Operative planning.