Every organ in our body is special
and we do not realize their functioning unless and until there
is a symptom of malfunction. Besides this, organs within a
body cavity can also go out-of-place. What happens then? Let’s
know something about hernias here.
What is a hernia? A hernia is a medical condition that occurs when
the contents of a body cavity bulge out of the area where
they are normally contained. These contents that bulge out
are usually portions of intestine or abdominal fatty tissue
that are enclosed in the thin membrane that naturally lines
the inside of the cavity. Theoretically, hernias can happen
anywhere in our body, but most common place of occurrence
is in the abdomen between the rib cage and the groin.
Types of Hernias:
The most common types of hernia
are inguinal (inner groin), incisional (resulting
from an incision), femoral (outer groin), umbilical
(belly button), and hiatal (upper stomach).
Some rare abdominal-wall hernias
are: the spigelian (occurs along the edge of the
rectus abdominus muscle through the spigelian fascia), obturator
(in women, protrudes from the pelvic cavity through an opening
in the pelvic bone (obturator foramen), epigastric
(occurring between the navel and the lower part of the rib
cage in the midline of the abdomen).
A sports hernia is different.
Unlike the other types, it does not create a hole in abdominal
wall and no bulge is seen. So, it becomes difficult to diagnose.
It is a tear to the oblique abdominal muscles.
Causes of Hernia:
The cause of some hernias cannot be exactly pinpointed, but
mostly result from increased pressure within the abdomen,
a weak spot in the abdominal wall, or a combination of both.
Hiatal hernias commonly develop in pregnant women and overweight
people due to the increased pressure on the abdominal wall.
In men, an inguinal hernia will commonly develop in the groin,
specifically in a region called the inguinal canal. In women,
inguinal hernias are rare, but can develop where the tissue
that binds the uterus exits from the abdomen and joins with
the tissue surrounding the vaginal opening. Umbilical hernias
may be present at birth. In adults, they may develop when
there is a weakness in the tissue in the umbilical area combined
with increased pressure on the abdominal wall.
Symptoms of Hernia:
1. Inguinal Hernia: Discomfort
while bending over or during lifting. A small lump in the
groin region is seen which grows bigger with activities like
coughing. This bulge usually disappears with lying down, but
if this does not happen and if a person experiences nausea,
vomiting or abdominal pain, then it means that the hernia
has become obstructed (no blood flow) or strangulated and
strangulation may lead to a life-threatening condition called
gangrene (decay or death of body tissues) that may account
for an emergent surgery. Strangulation symptoms are pain,
swelling, discolored, bluish or red skin, vomiting, and an
inability to urinate. These hernias may not show themselves
until when the abdominal wall is weakened due to sustained
coughing, lifting, or straining during a bowel movement.
2. Incisional Hernia:
Caused due to stretching of scar tissue that forms after surgery
and occurs due to constant pressure of abdominal contents
on the scar. Not all abdominal surgeries will lead to incisional
hernia, but any full thickness abdominal incision can leave
a weakness and make that area prone to hernia. Usually a proper
closure and adequate post-operative measure avoids the problem.
However, sometimes despite the best care, a person may develop
the hernia or it may be predicted, depending on the patient’s
general condition and the type of surgery performed.
3. Femoral Hernia: Occurs
when the contents of the abdomen (usually part of the small
intestine) push through a weak point or tear the thin muscular
wall of the abdomen, which holds the abdominal organs in place.
Some of this type may be by birth and some noted in old age.
A femoral hernia is a bulge in the upper part of the thigh
near the groin.
4.Umbilical Hernia: pregnancy,
the umbilical cord passes through a small opening in the baby's
abdominal muscles. The opening should normally close just
after birth. If the muscles don't join completely in the midline
of the abdomen, this weakness in the abdominal wall may cause
an umbilical hernia at birth or later in life.
5. Hiatal Hernia: Normally
no symptoms occur initially, but once the sphincter muscle
surrounding the esophagus (food pipe) becomes weak, symptoms
like heartburn, belching, regurgitation, sharp pain or even
bleeding may occur. There may be choking, coughing or breathlessness
while asleep. All these happen because the valve between the
stomach and esophagus (food pipe) does not remain closed and
acid spills into the esophagus from the stomach.
Treatment for Hernia:
Surgery or repair is the best
treatment option for hernia. However, surgery will be avoided
if the hernia has a large opening in the abdominal wall as
it becomes complicated to close this and strangulation (compromised
blood supply leading to gangrene) is almost impossible with
large openings, and if there is risk with surgery or if surgery
needs to be delayed then surgical belts and binders do help
to some extent in some type of hernias. Activities like coughing,
lifting, straining cause increased intra-abdominal pressure
and have to be avoided to prevent further increase of the
hernia size. So, it is up to the surgeon to decide if the
patient requires surgery based on conditions like if the hernia
is reducible (can be pushed back into the abdomen by putting
manual pressure), irreducible, or partly strangulated.
According to the National Center
for Health Statistics, approximately 5 million Americans have
an abdominal hernia. The hernias are 5 times more common in
men than in women, and the most common type in both men and
women is the inguinal or groin type. So, there is nothing
alarming if any hernia is identified. It is wise to seek prompt
medical attention and go for a repair at the earliest when
advised.
“On
my license, it says I'm an organ donor, but the
truth is I'd consider being an organ martyr. I'm
sure I'm worth a lot more dead than alive - the
sum of the parts equal more than the whole. I wonder
who might wind up walking around with my liver,
my lungs, even my eyeballs."
-
Jodi Picoult, My Sister's Keeper
Disclaimer: The above content is provided
for information and awareness purpose only. It is not prescriptive
or suggestive or meant to replaces your qualified physician's
advice or consultation.