Jennifer Robb

CONSUMER HEALTH INTERACTIVE

What's a hernia?
A hernia is a protrusion of tissue resulting from torn or weakened abdominal
muscles. The muscle tear allows tissue like intestine, muscle, or fat to bulge through
the weakened area of abdomen. Hernias can develop painlessly over time, or occur
suddenly -- all it takes is increased pressure in the abdominal cavity. They
commonly result from age-related wear and tear, heavy lifting, a congenital defect,
sustained coughing, or obesity, but many hernias have no apparent cause.
Different kinds of hernias show up in various areas of the body. An inguinal hernia,
by far the most common, is a protrusion of tissue in the groin region. (This is usually
the one people mean when they refer to a hernia.) Other types include a femoral
hernia, which occurs at the spot where the abdomen meets the top of the thigh; an
incisional hernia, which results when muscles are weakened by surgery; and a hiatal
hernia, which occurs internally when part of the stomach pushes through the
diaphragm into the chest cavity.
How can I tell if I have a hernia?
If you have a hernia, you'll probably notice a soft bump under the skin near your
groin or abdomen. This bump might feel tender and squishy to the touch, and it
may (or may not) disappear when you lie down. Hernias can be either relatively
painless or almost excruciating. They're frequently the cause of a dull, aching
sensation that gets worse when you cough, strain your bowels, or lift something
heavy. This discomfort may increase over time as more tissue pushes through the
tear. Hernias that worsen quickly can cause sharp, intense pain.
Do only men get hernias?
Although nearly 80 percent of people who experience hernias are men, anyone can
get them. Women whose abdominal muscles have been weakened from childbirth
are particularly susceptible. Even a newborn can have a hernia if his abdominal
muscles haven't developed properly.
Are hernias dangerous?
Most are not. Doctors can usually push the protruding tissue back into the
abdominal cavity and close the weakened muscles surgically. However, in some
cases, a protruding section of intestine can become "strangulated," or pinched
between the ruptured muscles (Imagine a kink in a garden hose.) Strangulation is
agonizingly painful and can be life threatening: It requires immediate surgery to
prevent serious consequences like blood loss to the tissue or a blockage in the
digestive tract.
What's the treatment for a hernia?
A common myth is that limiting activities and getting plenty of rest can cure a
hernia. While this will certainly alleviate symptoms, surgery is the only way to repair
a hernia. Since neglecting a hernia can have serious consequences, consult with
your doctor about the best course of treatment.
About 700,000 people undergo inguinal surgery in the United States each year,
making it one of the most common operations performed. In the traditional method
of hernia repair, herniorrhaphy, the surgeon makes a small incision over the hernia,
pushes the protruding tissue back into place, and sews the torn muscles back
together. You can usually resume normal activities four to six weeks after the
procedure.
Another surgical method, hernioplasty, uses synthetic mesh screens or "plugs" to
fortify the damaged muscles. After several weeks, new tissue grows on and through
the screen, creating a stronger bond that is less likely to weaken again.
Hernioplastic procedures can be done under a local anesthetic, and recovery time is
usually shorter than after a herniorrhaphy. Your doctor will let you know what
activities you can do based on how you feel afterwards.
Laparoscopic surgery, the newest form of hernioplasty, has received a lot of
favorable attention because it's minimally invasive with a recovery period of just a
few days. In this method, the surgeon makes a few tiny incisions in the abdominal
wall and inserts the necessary surgical instruments. These include the mesh patch
and laparoscope, which is like a little video camera that magnifies the internal
organs and enables the surgeon to view the hernia on a video monitor as he repairs
it.
Several studies have found that patients who had laparoscopic surgery to repair
hernias recovered more rapidly and had less persistent pain than patients who
opted for traditional surgery. However, a 2004 study by the Department of Veterans
Affairs found that open (traditional) surgery resulted in fewer complications and a
lower rate of recurrence. In that study, the surgeon's level of experience was an
important factor in determining the outcomes of laparoscopic surgery.
Regardless of what method you and your doctor decide is best for you, be sure to
choose a board-certified surgeon to perform the procedure, and make sure the
hospital or outpatient surgery center is accredited. The American College of
Surgeons has a searchable database to help you find a general surgeon or specialist
in your area. Your family doctor should be able to help you with a referral as well.
Is there any way to prevent a hernia?
There are definitely a few precautions you can take:
•Be careful when lifting heavy objects. Lift with your knees rather than your back,
and don't attempt to move anything too heavy for one person to manage.
•Quit smoking. Smokers often have a violent and persistent cough, which can
increase the risk of hernia.
•Exercise. Getting regular exercise is an important safeguard, since strong muscles
are less likely to rupture.
•Maintain a healthy weight. Being overweight strains your body and can also
dangerously stretch the peritoneum, or abdominal lining.
•Get plenty of fiber. Regular bowel movements will prevent
undue straining.
•Don't strain your muscles. Weight lifters, football players, and golfers frequently
strain or tear the muscles prone to hernia. Be sure to warm up enough before such
activities, and watch out for that telltale bulge.
-- Jennifer Robb is a senior editor at Consumer Health Interactive.
References

Digestive Diseases Statistics, National Digestive Diseases Information Clearinghouse

The Causes and Surgical Treatment of Abdominal Hernia, American Medical Association

Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia

repair, Liem MS et al. New England Journal of Medicine 1997 May 29; 336 (22):1541-7

Hernia Repair, What You Should Know, The PDR Family Guide Encyclopedia of Medical Care

US Department of Veterans Affairs. Open Surgery Better for Most Hernias - Laparoscopic
Fixes More likely to Fail, Especially with Newer Surgeons. June 2006.
http://www.research.va.gov/news/press_releases/hernia-042504.cfm

McCormack K, Scott NW, Go PM, Ross S, Grant AM. Laparoscopic techniques versus open
techniques for inguinal hernia repair.

Cochrane systematic database of reviews. 2003.

Reviewed by C.E. McLaughlin, MD, a professor of sports medicine at the University of

California at Berkeley.

http://www.principalhealthnews.com/topic/hernia

Last updated September 30, 2008

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