Hernia: Definition, Causes, Symptoms & Treatment

Definition

Hernia is an abnormal protruding bulge caused by organs or fatty tissues squeezing out from a weak point or hole in the peritoneum.  Peritoneum is a tissue lining the abdominal wall and covers most of the abdominal organs and also keeps them in place. These organs and tissues push out and occupy space under the skin causing a localized bulge. 

Hernias may occur anywhere in the abdomen from chest to hips and also in areas of the upper thigh and groin. 

There are many types of hernias like-

  1. Inguinal Hernia
  2.  Incisional Hernia
  3.  Femoral Hernia
  4.  Umbilical Hernia 
  5.  Hiatal Hernia 
  6. Epigastric hernia
  7. Spigelian hernia
  8. Diaphragmatic hernia

Among these inguinal or femoral are the most common ones.

Causes

A combination of weakened muscles, pressure, or strain is what causes a hernia. Some commonly known causes responsible for weak muscles and strain leading to hernia are:

  • Damage caused by any injury or even surgery
  •  Birth conditions like premature birth or low weight at the time of birth.
  • It could be hereditary
  • Age factors as aging could lead to muscle weakness
  • Pregnancy, particularly multiple pregnancies
  • Heavy weight lifting or strenuous exercises 
  • Chronic coughing
  • Chronic constipation or diarrhea 
  • Being obese or overweight
  • Smoking habit as it weakens the connective tissues
  • Poor eating habits leading to poor nutrition.
  • Fluid built up in the abdomen due to any underlying health problem.

Symptoms

In most cases, the hernia is just a painless bulge or swelling causing no significant problem and does not require any special medical attention. But in some cases due to worsening symptoms, it requires immediate medical diagnosis and attention. Symptoms that calls for immediate medical attention are:

  • Discomfort or pain
  • Increasing soreness or swelling at the site 
  • Nausea and vomiting
  • The bulge becomes firm and tender, making push it back into the abdomen difficult.
  • Bowel obstruction signs

There are no outside bulges in hiatal hernias but it shows symptoms like

  •  Indigestion
  • Chest pain
  • Heartburn
  • Difficulty in swallowing and
  •  Frequent regurgitation 

Treatment

Usually, doctors diagnose a hernia through a physical examination of the bulge. They might go for an abdominal ultrasound, MRI, or CT scan. In the case of hiatal hernia, other tests like Gastrografin or barium X-ray or Endoscopy might be required. As hernias do not go on their own, so if there is any chance of complication your doctor will recommend a hernia surgeon for further treatment as hernia surgery is the only way out. Hernias without any symptoms usually just need a watchful wait. However, in cases where symptoms start worsening or in cases like an umbilical hernia in an adult or inguinal hernia or femoral hernias leading to obstruction or strangulation of the gut, your hernia surgeon will suggest the best repair method or hernia surgery as per your needs. Any one of the hernia surgery out of the three mentioned below can be performed as per the case

  1. Open surgery
  2. Laparoscopic surgery
  3. Robotic hernia repair

After hernia surgery, one needs to follow the instructions given by the hernia surgeon. They are related to diet, care of the incision site, and how to avoid further physical strains. Hernias could be recurring even after the repair operation because of the weakness of inherent tissue, obesity, or smoking habits.