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Hernia

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Considering a hernia surgery? Let’s take you through this article that will help you explore different treatment options for a hernia surgery.

Hernias do not heal on their own. Though they can remain asymptomatic for a long time and cause no trouble, they also have high possibilities of getting worse with time. Usually surgical repair is recommended for treating hernias but your doctor may prescribe OTC (Over-the-Counter) antacid medicines at times to reduce the risk of your hernia or may ask you to wear a supporting truss. It is important to understand that hernias in most cases are not immediately life-threatening but it does require treatment as they normally do not get better on their own. Apart from an umbilical hernia in infants, the nature of treating a hernia normally depends on symptom presence. If an adult has the same, surgery is usually recommended because the complications are most likely to increase with time.

As per available evidence, surgical repair is the only current effective way to treat a hernia. To prevent the hernia surgery is performed to return bulging tissue to its proper place, and then repair the defect in the abdomen with stitches or a mesh patch. There are generally two types of a hernia surgery- open repair and laparoscopic repair.

1) Open Hernia Repair

A single long incision is made in the groin area for this kind of repair. The weak spot in the muscle wall is then fixed by sewing the edges of healthy muscle tissues collectively for the contents to be pushed back into the abdominal cavity. This approach is suitable for more diminutive hernias that may have been present since birth, and for healthy tissues without addressing stress on the tissue. This type of surgery can be performed under general, spinal, and local anesthesia.

What to expect after the open hernia surgery?

  • In most of the cases, patients are able to go home the same day. However, recovery time is usually about 3-4 weeks.
  • You can most likely return to performing light activities after 3 weeks.
  • Strenuous tasks must wait until after 6 months of recovery.
  • Avoid tasks that may cause severe pain.

2) Laparoscopic Hernia Repair

Laparoscopic hernia repair uses a laparoscope, a thin, telescope-like instrument that is inserted through a small incision at the umbilicus (belly button). This procedure is usually performed under general anesthesia and before the surgery, you will have an evaluation of your general state of health and an electrocardiogram (EKG). The laparoscope is connected to a tiny video camera that projects an “inside view” of your body onto television screens in the operating room. After the procedure is completed, the small abdominal incisions are closed with the help of stitches or surgical tapes.

What to expect after a laparoscopic hernia surgery?

  • In most of the cases, patients are able to go home the same day itself however, recovery time is usually about 1-2 weeks.
  • You can most likely return to performing light activities after 1-2 weeks.
  • Strenuous tasks must wait until after 4 months of recovery.
  • Avoid tasks that may cause severe pain.

Recent studies have revealed that in the short term, laparoscopic repair is superior to open repair in terms of less blood loss, fewer operative complications, and shorter hospital stay. Long-term outcomes such as recurrence rates are yet unexplained. However, a hernia can reoccur even after the surgery. And, which is why patients are advised to adapt a healthy lifestyle post a hernia surgery. While not much can be done to prevent muscle weakness, one can reduce pressure on the abdomen, and thus reduce the risk of incurring a hernia. Maintaining a healthy body weight can reduce the risk of getting a hernia as your extra body fat can put pressure on your abdomen. Likewise quitting smoking, avoiding lifting of heavy objects can also help in reducing the risk of getting a hernia. Also, staying aware of any symptoms is the key to identifying and treating a hernia on time. It is important to keep in mind that hernias do not go away on their own and will need medical attention at some point of time.

It is said that anything that causes an increase in pressure in the abdomen can cause a hernia. It is usually innocuous and painless, however, time and again it can bring utmost pain and discomfort especially on doing certain activities which we will discuss further in the blog. Though, anyone can develop a hernia at any age, adults are more likely to have an inguinal hernia. Among adults, the chances of having an inguinal hernia increase with age. Hence, it becomes important to follow certain precautionary measures in order to avoid getting one. Adults who frequently find themselves doing strenuous sports and physical activity, particularly weight-lifting, can develop an inguinal hernia. However, hernias are not just caused by lifting heavy weights, but could be congenital or may also be caused by a bad adult lifestyle i.e. smoker’s cough, and other conditions like COPD that cause heavy coughing, which exerts pressure on the abdominal wall. It is always recommended for both males and females to not ignore any type of hernia and seek immediate medical attention if any discomfort stays for a long period.

Now let’s go deeper in understanding exact reasons that contribute to the causes of hernia in adults.

In simple terms, hernia is a protrusion of the inner organ or part of the organ through a weak muscle area. Although there are multiple reasons for a hernia, below are some common contributing factors of muscular weakness or tension that can cause hernia in adults.

  • A congenital condition – a defect that may be present during infant development but is detected during adulthood.
  • Muscular weakness due to advanced age or as a result of an injury or surgery. Reasons such as obesity, smoking, and an unbalanced diet can lead to the weakening of muscles in the abdominal region which can cause a hernia.
  • Constantly recurring respiratory disease or coughing can put strain on the weak muscles.
  • Performing heavy exercises or frequent lifting of heavy objects.
  • Multiple pregnancies (twins, triplets and more) can cause a hernia. Pregnant women have a higher risk of getting one due to an increased pressure on the abdomen during pregnancy.
  • Longstanding chronic constipation and pushing hard for a bowel movement can be a big cause of hernia in adults.
  • Accumulation of more fluid (>25 ml) in the abdomen area could be a cause of hernia in adults due to the increased pressure of fluids.
  • Obesity/ overweight is another factor because it increases the strain and pressure on the abdominal muscles, therefore making them weaker and more prone.

Each kind of hernia has various causes in adults, which implies that the measures you take to intercept them will also be moderately different. However, consuming a high fiber diet, maintaining a healthy weight, and quitting smoking can help curb a hernia. Please note that not all of them are preventable and it’s always advisable to seek proper medical care to avoid severe consequences as they cannot heal on their own. And, just in case you’re experiencing any discomfort while sitting, walking or performing any routine physical activities then contact your primary care provider as soon as possible and request an appointment.

Hernia? Isn’t that something that happens only to athletes or only bodybuilders and weightlifters?
You may also have such similar questions in mind but the truth isn’t the same. Hernias happen more often than you think. A hernia can happen to men, women, and children. However, overall hernias do tend to be more common in men than women. You may not be born with a Hernia but you may end up getting one. Not many know but Hernias can cause complications that can be life-threatening. It’s important to seek emergency care if you experience symptoms. Though Hernias often show no troublesome symptoms, frequent abdominal complaints may signal a serious problem. Let us now learn more about Hernia and its various types.

What is a Hernia?

A hernia occurs when an internal organ or fatty tissue compresses through the wall of tissue or muscle that contains it which is referred to as the fascia. Most hernias are found within the abdominal cavity which lies between the chest and hips. Usually, an abnormal bulge under the skin of the abdomen near the groin or the navel is observed. Anything that increases the pressure in the abdomen can result in a hernia, this can be by lifting heavy objects, diarrhea or constipation, obesity, persistent coughing or sneezing or even after giving birth.

There are mainly six types of Hernias: Inguinal Hernia, Femoral Hernia, Umbilical Hernia, An incisional hernia, Epigastric Hernia, and Hiatal hernia.

  • Inguinal Hernia: This is one of the most common forms of Hernia which usually affects men more often as compared to women. In an Inguinal Hernia, a part of the intestine penetrates a little into the groin at the top of the inner thigh through the inguinal canal post-birth after which the canal is supposed to close almost completely behind them. This type of Hernia may be painful or touch-sensitive. Some symptoms may include swelling in the groin, burning sensation or pain while coughing and while bending over.
  • Femoral Hernia: A femoral hernia is common in women as compared to men. A part of the intestine or the fatty tissue enters the canal that carries the femoral artery into the upper thigh. Women who are obese or pregnant have a higher chance of having a femoral Hernia. Most femoral hernias cause no symptoms but one may have some groin discomfort. It may get worse while standing, lifting heavy objects, or strain.
  • Umbilical Hernia: Common in infants and sometimes also affects obese women or the ones who have had many children. This is caused when a part of the small intestine protrudes through the abdomen near the navel. Umbilical hernias in children are usually not that painful but if they appeared at an older age then it may cause abdominal discomfort, vomiting, etc.
  • Hiatal Hernia: A hiatal hernia is when your stomach bulges up into your chest through an opening in your diaphragm, the muscle that separates the lungs from the abdominal organs. The opening is called the hiatus, so this condition is also called a hiatus hernia. A lot of people might not notice any symptoms but few might have heartburn, bloating, burping, upset stomach and vomiting.
  • Incisional Hernia: This is more prominent if you’ve had any previous abdominal surgery. The intestine pushes through the abdominal wall where the surgery had occurred. Apart from a prominent bulge, incisional hernias might also cause nausea, vomiting, diarrhea, thin stool, burning sensation and fever.
  • Epigastric Hernia: In Epigastric hernia, a fatty portion of the intestine pushes through the abdominal wall between the belly button and the chest. The bump or bulge caused due to this phenomenon is visible all the time or sometimes only when one coughs, sneezes or laughs. This type of Hernia is often seen more in men than in women. It is said the epigastric hernia may occur due to increasing tension on the abdominal wall near the diaphragm.

Ultimately, the fact is that one can get Hernia either by birth or can develop as they age. The treatment for hernia can be either surgical or non-surgical. However, most of the Hernias need surgical repair. It is always recommended to get yourself checked by an expert as soon as any of the above-mentioned symptoms continue to cause severe pain and discomfort.

With so much debate going around the risk of Hernia and chances of returning to normal life post a Hernia surgery, it becomes very important for people to have a deep understanding of the problem first and some of the most common types of Hernia that are often seen in individuals. For the people who don’t know, a Hernia occurs when an internal organ or fatty tissue compresses through the wall of tissue or muscle that contains it which is referred to as the fascia. There are various types of Hernias e.g  Inguinal Hernia, Femoral Hernia, Umbilical Hernia, an Incisional Hernia, Epigastric Hernia, and Hiatal Hernia but the most commonly found ones are Hiatal and Inguinal. Though many Hernias occur in the abdominal region between your chest and hips, they can also appear in the upper thigh and your groin area.

Although anyone of any age can get a Hernia, a child, the elderly, smokers, and the obese stand a much higher chance of developing one. People who have already had Hernia surgery are also vulnerable to getting Hernias again. But, nothing to stress about, it is crucial to treat Hernia just like any other health problem in life which tends to worsen if not addressed on time. Mild symptoms can later be turned into serious ones and hence, early detection and treatment become very important in the case of Hernia too. Let us now learn more about the most common types of Hernia and its symptoms.

1) Hiatal Hernia

A Hiatal Hernia occurs when the upper stomach squeezes through the Hiatus through which the esophagus passes. A lot of people might not notice any symptoms of Hiatal Hernia but in some cases, patients have raised issues like heartburn, a feeling of burning in the lower chest area. It mainly happens when the patient is lying down or is in a bending position, preferably after meals. This heartburn may get worse after consuming citrus fruits, spicy food, raw onions, carbonated drinks and even alcohol. Below are a few other symptoms of Hiatal Hernia:

  • Feeling bloated
  • Bad taste in the throat region, or belching
  • Acid Reflux
  • Difficulty in swallowing
  • Abdominal pain
  • Breathing problems
  • Vomiting
  • Black stools which reflect Gastrointestinal bleeding

2) Inguinal Hernia

In an Inguinal Hernia, the intestine or the bladder get extended beyond the abdominal wall or into the inguinal canal in the abdomen. 96% of all groin Hernias are Inguinal by nature, and the majority of them occur in men because of a natural weakness in this area. Here are some of the common symptoms of an Inguinal Hernia:

  • Swelling/lump in the pubic region
  • Burn or pain in the swollen area
  • Groin pain, especially during bending or coughing
  • Heaviness in the groin or Pain
  • Swelling in the testicular region

Though there’s not a lot that one can do to avoid getting Hernia from developing, there are a few steps you can follow to reduce the pressure on your abdominal muscles like avoiding heavy lifting or doing it in a right manner, maintaining a balanced diet, maintain healthy body weight,  etc.

Remember, it is very important to not take any stress as it can be effectively treated with surgery. You can get back to living a normal life a few months after the surgery. 

Life after a hernia surgery could be a little tricky. Though with the help of a hernia repair surgery you manage to get the problem fixed and are hoping to get back to your normal life, it is important to ensure that all the necessary instructions suggested by the doctor are followed. Most people do not face any long term problems after a hernia repair but a brief recovery period is necessary for all hernia cases. Children might face a lot of pain and would require extra attention in the initial days after a hernia surgery but this is considered normal and is expected to pass with time. Most children and adults are discharged within a few hours after a hernia surgery depending upon the severity but usually, an overnight stay is recommended for people with a medical history.

One of the major risks associated with hernia repair surgery is that the hernia can return. And, If there is a hernia repair failure and the hernia somehow reappears, then it is called as a recurrent hernia. Hence, it becomes even more important for you to take all the precautionary steps to avoid the recurrence of a hernia. The recovery period post a hernia surgery completely depends on the type of hernia and surgery performed. A laparoscopic surgery that uses minimally invasive procedures has been proved to be highly safe and effective. Also, the overall recovery time has reduced and lesser post-operative trouble is seen.

Let us now look deeper into some of the most common precautionary measures to follow irrespective of the patients or the surgeries performed. Below are a few points to keep in mind post a hernia surgery:

  • Regular walking: As per your doctor’s instructions, try to stay active as much as you can. Take a walk indoors to boost your blood flow and to prevent constipation. Take sufficient rest as you are more prone to unrelenting tiredness. Although your doctor’s advice will depend on your surgery type, most patients post a hernia surgery are recommended to stay away from lifting heavy objects for the initial two weeks.
  • Adequate rest: Though the laparoscopic hernia surgery patients can return to their routine much earlier, it is still favored to follow a complete bed rest for the entire first-week post-surgery, preferably in complex patient subsets.
  • Avoid lifting heavy objects: Tasks that put strain to the groin must be avoided at all costs and if your job involves manual labor, you may need a prolonged resting period before resuming your work but you can return to your desk jobs by the second week after surgery.
  • Healthy Diet: You should focus more on your diet especially after a hernia repair surgery by consuming plenty of fluids and fiber-rich foods like fruits, vegetables, whole grains, oatmeal, bran, etc.  to prevent constipation and strenuous bowel movement. Additionally, avoid consumption of citrus fruits such as lemon, orange, smoking, and alcohol as it can prolong your recovery process or even lead to complications.
  • Avoid sex after any hernia surgery: Usually, it is advised to avoid having sex immediately after the hernia surgery that may add extra pressure near the groin area. You can get back to a precaution-free and active lifestyle, 4-6 weeks post-surgery and may resume your regular gym sessions as per your doctor’s instructions.

Keep these tips in mind and follow them religiously for a better recovery post-surgery. In case, you start bleeding or show any symptoms of an infection, immediately consult your doctor. Also, don’t forget to miss out on your regular appointment for a safe recovery.