Hernia

Hiatal Hernia:

A hiatal hernia occurs when a portion of the stomach protrudes through the diaphragm into the chest cavity. This type is prevalent among individuals over 50; in children, it's often due to congenital anomalies. Hiatal hernias commonly trigger gastroesophageal reflux disease (GERD), resulting in backward leakage of stomach contents into the oesophagus.

Umbilical Hernia:

Primarily affecting children and babies, umbilical hernias manifest when the intestines bulge through the abdominal wall near the belly button. Although most umbilical hernias resolve spontaneously as abdominal muscles strengthen by ages 1 or 2, surgical intervention may be necessary if the hernia persists beyond 5 years. Adults can also develop umbilical hernias due to factors like obesity, ascites, or pregnancy.

Ventral Hernia:

This type occurs when tissue protrudes through an opening in the abdominal muscles, often diminishing in size when lying down. While ventral hernias can be congenital, they're frequently acquired later in life due to factors such as obesity, pregnancy, strenuous activity, or surgical incisions, leading to incisional hernias.

What are the causes of hernia?

Apart from incisional hernias, which are a complication arising from abdominal surgery, the exact cause of a hernia often remains elusive. Nonetheless, the risk of herniation escalates with age and is more prevalent in men than in women.

Hernias can either be congenital, present at birth, or develop in children with a weakened abdominal wall. Certain activities and medical conditions that exert pressure on the abdominal wall can precipitate hernias, including:

• Straining during bowel movements, often due to chronic constipation.
• Persistent coughing.
• Conditions like cystic fibrosis.
• Enlargement of the prostate gland.
• Straining while urinating.
• Excessive body weight or obesity.
• Accumulation of abdominal fluid.
• Lifting heavy objects.
• Undergoing peritoneal dialysis.
• Need for adequate nutrition.
• Smoking.
• Strenuous physical exertion.
• Undescended testicles.

What are some of the common locations for hernia?

Hernias can develop in various locations, including:

• Passing through your diaphragm in the lower chest area.
• Emerging in your groin through the lower abdominal wall.
• Occurring along the front midline of your abdomen.
• Forming at the site of a previous abdominal surgery incision.

What are the risk factors for hernia?

The risk factors vary depending on the type of hernia:

Risk Factors for Incisional Hernia:

An incisional hernia typically occurs as a consequence of prior abdominal surgery, making recent surgical procedures the most apparent risk factor. Individuals are most vulnerable within 3-6 months following the surgery, particularly if:

• Engaging in strenuous physical activity.
• Experiencing weight gain.
• Undergoing pregnancy.

These factors exert additional stress on the healing tissue, increasing the likelihood of herniation.

Risk factors for inguinal hernias include:

• Advanced age
• Family history of inguinal hernias
• Previous history of inguinal hernias
• Male gender
• Smoking, due to the weakening effects of tobacco chemicals on tissues
• Chronic constipation
• Premature birth and low birth weight
• Pregnancy

Risk factors for umbilical hernias:

In infants, umbilical hernias are frequently observed in those with low birth weight and premature birth.

In adults, the risk factors encompass:

• Obesity
• Multiple pregnancies
• Female gender

Risk factors for hiatal hernias:

• Age 50 years or older
• Obesity

What are the symptoms of hernia?

In numerous instances, a hernia manifests as a painless swelling that poses no immediate concerns and requires no urgent medical intervention.

However, a hernia can cause discomfort and pain, particularly worsening symptoms when standing, straining, or lifting heavy objects. Individuals noticing escalating swelling or soreness often seek medical evaluation.

In specific scenarios, prompt surgical intervention may be necessary, such as when a segment of the intestine becomes obstructed or strangulated by an inguinal hernia.

Immediate medical attention is warranted if an inguinal hernia triggers acute abdominal symptoms, including:

• Pain
• Nausea
• Vomiting
• Inability to reduce the bulge back into the abdomen

In such instances, the swelling typically feels firm and tender and cannot be manually reduced.

A hiatal hernia may elicit symptoms of acid reflux, such as heartburn, stemming from stomach acid refluxing into the oesophagus.

When to see the doctor

If a hernia bulge exhibits redness, purple discoloration, or darkening, or if you detect any indications of a strangulated hernia, it is imperative to seek prompt medical attention.

Consult your doctor if you experience a painful or conspicuous bulge in your groin on either side of your pubic bone. The bulge tends to be more evident when standing, and you can typically palpate it by placing your hand directly over the affected region.