Hernias: Causes and Treatment Options

What Is a Hernia?

Get it as Amazon.com A hernia occurs when part of a tissue or internal organ bulges through an abnormal opening in the structures normally containing it. This can happen through a rupture, tear, or weakness in the structure. Most often, this bulge is caused by abdominal tissue that has protruded through the wall of muscle and tendon that surrounds the abdomen.

What Causes a Hernia to Develop?

We tend to think of hernias as being the result of lifting very heavy objects. In fact, they can have any number of causes, such as sports activities, overexertion, coughing, or a natural weakness in the abdominal wall that is present at birth.

Who Is Most Susceptible?

Hernias can occur in both men and women of all ages, as well as in children. However, hernias tend to be much more common in men, occurring most often in the groin area where the abdominal folds meet the thighs. These are known as inguinal hernias. This is due in part by the normal descent of the testicles into the scrotum. This creates an unsupported area in the groin where abdominal tissue can protrude.

Women may be more prone to develop hernias at the top of the thigh (the femoral area), very often resulting from the strain of pregnancy and childbirth.

Children are most susceptible to inguinal hernias, with the large majority of these occurring in boys. Infants are also susceptible to umbilical hernias. These generally appear as a protrusion in the naval area. Umbilical hernias in infants tend to be less troublesome than other types of hernias, since they tend to heal without any treatment by the time the child is three or four.

How Do I Know I Have One?

Generally, you will notice a small lump somewhere in the groin or abdominal area. Many hernias are reducible; that is, you can push the tissue gently back into its normal place. If you notice a bulge that does not resolve, or you develop pain at the site, you should seek medical treatment.

Are They Dangerous?

If left unattended, the protrusion through the hole or gap can cause increasing amounts of pain, as more of the abdominal tissue pushes through the gap. As long as the hernia is reducible, it is not considered dangerous, but it can still put pressure on the surrounding tissue. A non-reducible hernia can become life-threatening, though, if a part of the bulging tissue becomes trapped and circulation is cut off to the tissue.

Will It Heal by Itself?

Unfortunately, no. With the exception of umbilical hernias in infants, hernias will not go away on their own. It can take months or even years to worsen. If you suspect that you or your child has a hernia, it should be checked by a doctor because of the possible danger of strangulation.

In the short term, reducing strenuous physical activity, losing weight, and/or wearing a truss can lessen the discomfort caused by a hernia. Ultimately, the only way to fix a hernia is with surgery.

What Are the Various Surgical Options?

Open Hernia Surgery

Open hernia surgery is performed by making an incision over the site of the hernia. The part of the intestine or other tissue bulging through is then placed back into the abdominal cavity. Finally, the abdominal wall is repaired by stitching the surrounding muscle together.

Open Mesh Surgery

This hernia surgery uses a mesh plug. Here, a small incision is made at the hernia site. The bulging tissue is then returned to the abdominal cavity. The repair of this area is completed by using sterile mesh material to strengthen and repair the weak area.

Laparoscopic Surgery

During laparoscopic surgery, a surgeon inserts small instruments, including a tiny video camera, through small holes made in the abdominal wall. The doctor performs the surgery while viewing the hernia on a TV monitor.

Hernias can be successfully treated. If you notice an bulge in your skin, make an appointment with your doctor for an exam.

  • American College of Surgeons

    http://www.facs.org

  • Hernia Resource Center

    http://www.herniainfo.com

  • Canadian Association of General Surgeons

    http://www.cags-accg.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Groin hernia in adults and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 21, 2013. Accessed April 2, 2013.

  • Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003; 362:1561.

  • McIntosh A, Hutchinson A, Roberts A, Withers H. Evidence-based management of groin hernia in primary care—a systematic review. Fam Pract. 2000; 17:442.

  • McCormack K, Scott NW, Go PM, et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;CD001785.

  • Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009;13(4):343-403.

  • Umbilical hernia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 2, 2012. Accessed April 2, 2013.

  • Velanovich V. Laparoscopic vs. open surgery: a preliminary comparison of quality-of-life outcomes. Surg Endosc. 2000; 14:16.