A hernia is an abnormal hole or weakness in a muscle or connective tissue that allows part of an organ to protrude. Four areas of the abdominal wall — around the belly button, upper stomach and inner and outer groins — are prone to hernias. Incisional hernias occur at the site of incompletely healed surgical incisions.
Hernias usually surface as lumps in the abdominal wall or groin area. Painless protrusions that slide back into their natural position when pushed are asymptomatic reducible hernias.
Those that continue to protrude when pushed are irreducible. Swelling, tenderness and extreme pain in an irreducible hernia may indicate strangulation, or cutting off of the blood supply.
Hernia Symptoms: Common Symptoms of Hernia
Common hernia symptoms include:
- Abdominal heaviness when bending
- Pain from lifting heavy objects
- A lump that vanishes when the person lies down and enlarges when the person coughs, stands or strains the abdominal or groin muscles
Hiatus and obturator hernias have additional symptoms. Hiatus hernias mimic acid reflux disease by causing:
Hernia Symptoms : Hiatus
- Pain from drinking hot liquids
- Regurgitation of food
- A sensation of food trapped in the gullet
While obturator hernias don’t create visible pelvic bulges, they may cause nausea, vomiting and potentially fatal bowel obstructions. Strangulated intestinal hernias may also create bowel obstructions with nausea, vomiting and possibly fever.
Even reducible hernias have the potential to enlarge and strangulate. Even a small, painless protrusion in the abdomen or groin merits attention form a doctor. Many hernias are obvious and need no further diagnosis. Less obvious ones may require the doctor to feel the area around the suspected site while the patient coughs or stands to increase the abdominal pressure.
Wearing a truss or supportive garment to treat reducible hernias is appropriate short-term treatment. Strangulation, however, is always a risk for reducible and irreducible hernias. Surgical repair is the only way to prevent it. A strangulated hernia is a medical emergency demanding immediate surgery. About 10 percent of repaired hernias reoccur and require additional operations.
A common technique to repair abdominal hernias is to reinforce the weakened muscle or connective tissue with nylon mesh and surgical stitches. Inguinal hernias don’t require large incisions. They’re treated with laparoscopy, the insertion of a small instrument at the hernia site for repairing from within.
The time it takes to recover from surgery depends on a patient’s general health and the type of hernia repaired. Many patients are back to work and light exercise within a week. Complete incision healing may take up to six weeks. Many patients wait three months before doing any heavy lifting, but every doctor will advise about returning to sports or strenuous exercise on a case-by-case basis.
What Causes Hernias?
All hernias result when weight from an organ pressures the weakened muscle, connective tissue or surgical site. While some babies are born with hernias, most people don’t experience them until adulthood.
Several lifestyle factors increase the likelihood of hernias. Bad diet, smoking and overuse encourage muscular weakness. Pressure on these impaired tissues from lifting, constipation, frequent coughing, an accumulation of fluid in the abdominal cavity, pregnancy or obesity is enough to result in a hernia.
Differences in anatomy have led to an unbalanced distribution of hernias between the sexes. Nearly 75 percent of all hernias are inguinal — or inner groin — hernias. Men are 25 times more likely to develop inguinal hernias than women. An inguinal hernia allows the bladder or intestine to penetrate the abdominal wall or the groin’s inguinal canal. Musculature in this area is naturally weaker in men.
These hernias may be direct or indirect. Direct inguinal hernias are most common in people whose abdominal walls have weakened with age. Indirect inguinal hernias occur in men whose fetal testicular pathways failed to close completely. These hernial sacs may drop into the scrotum.
These rare and dangerous hernias usually occur in women when the femoral canal, a narrow channel containing the femoral nerve, vein and artery, stretches abnormally. Intestines or other abdominal tissue drop into the extra space, causing a bulge in the inguinal crack where the thigh and groin meet.
Between 10 and 30 percent of babies are born with umbilical or belly button hernias. The abdominal wall opening that connected them to their mother’s placenta failed to close properly. Even completely closed umbilical openings can lead to hernias later, because the abdominal wall remains weaker at the site of the opening. Elderly people and middle-aged women who have given birth have the highest risk of delayed umbilical hernias.
While hiatus hernias affect nearly 10 percent of the population, they’re most common during pregnancy, in obese middle-aged women and in the elderly. A hiatus hernia occurs when a portion of the stomach slides into the esophagus though a hole in the diaphragm.
Protruding fatty tissue causes epigastric hernias at the abdominal midline between the lower ribs and navel.
These usually painless hernias develop on the outer edges of the rectus abdominus, two long flat muscles extending down the front of the abdomen from breastbone to pelvis.
Women are most likely to suffer from these rare hernias, caused by tissue protruding from the pelvis through an opening in the obturator foramen, or pelvic bone.
Approximately one in 10 abdominal surgery patients experiences an incisional hernia in the abdominal wall at the site of the operations. Even when surgically repaired, incisional hernias reappear in up to 45 percent of patients.
Treating Hiatus Hernia Symptoms
People suffering form hiatus hernias can eliminate most of their discomfort by changing their behavior while waiting for a surgical repair. Losing excess weight and eating several small meals instead of three large ones each day reduces abdominal pressure.
Staying away from hot or carbonated beverages, spicy foods and cigarettes also minimizes hiatus hernia pain. Antacid can provide relief following a dietary lapse. Elevating the head above the feet at night can make sleeping much more comfortable.