Types of Hernias and Does a Hernia Always Require Surgery?
A hernia is a common condition that is experienced by a number of people. Although the name makes it sound complex, in reality, it is a condition that can often be treated using some simple measures.
What do you mean by hernia?
A hernia is a medical condition wherein one part of the body pushes itself through an opening into muscle or tissue, which essentially contains the organ in a normal circumstance. For instance, the intestines in the body may, due to certain conditions, bulge out through a weak passage into the abdominal area, where they are essentially contained.
Hernias are commonly seen in the abdominal region and can also be found in areas like the upper thigh, belly button or the groin region. Most hernias are not quite life-threatening, but they can not be treated by themselves and in some cases require some form of surgery when it is suspected to become complicated.
What are the types of hernias?
There are various types of hernias found in people, some of the common ones being:
Inguinal hernias
Inguinal hernias are known to be the most common form of a hernia occurring in people. Around 70 percent of hernia cases are known to be inguinal forms of a hernia. The hernia essentially is caused as the intestines bulge out into the lower abdomen wall known as the inguinal canal. The bulge may take place through a weak area or a tear that may occur in the abdominal wall.
The inguinal canal is situated in the groin region of the body. In males, this is the region is where the spermatic cord travels through from the abdomen to the scrotum. This cord is primarily responsible for holding together the male testicles. In females, the inguinal canal has a ligament which is known to hold the uterus in its position.
This form of hernia is more commonly seen in males as compared to females. This is primarily so since the male testicles come down through the inguinal canal almost immediately after their birth. Once this happens, the inguinal canal should ideally shut itself completely. However, in some cases, the inguinal canal fails to close completely leaving behind a weak area that could be prone to hernias in the future.
Hiatal hernias
This form of hernia is caused by the stomach bulging up into the chest cavity or the diaphragm. The diaphragm is a cover of muscles that enables breathing to take place through the contraction and drawing of air into the lungs. It essentially separates the various organs in the abdominal region from the chest organs.
This form of hernia is commonly seen in patients who are over 50 years of age. If a child suffers from this medical condition, it could be caused due to an inherent birth deformity. Hiatal hernias are known to be the main reason behind gastroesophageal reflux that occurs as the contents of the stomach move upwards into the esophagus leading to a severe burning and abiding sensation all the way up.
Umbilical hernias
Umbilical hernias are another type of hernia commonly seen in little children and babies who are below six months of age. It is caused when the intestines protrude through their abdominal cavity walls close to where the belly button is located. One may notice a strange bulge around the belly button of the baby, particularly noticeable as the baby cries. An umbilical hernia is the only type of hernia that is known to correct itself on its own, by the time the baby turns one year old. If by then the hernia does not get corrected on its own, then a surgery may be required to treat the condition.
Incisional hernias
Incisional hernias are a form of hernia that typically takes place after an abdominal surgery takes place. The intestines could bulge through the scar of the incisional cut and can occur after you’ve had abdominal surgery. Your intestines may push through the incision scar or the surrounding, weakened tissue.
What triggers a hernia?
Hernias could be caused due to various reasons, primarily due to a combination of factors like muscular weakness and sudden strains. Depending upon what the trigger is for your hernia, the development of the condition could either occur quickly or suddenly or gradually over a period of time.
Some of the leading causes that could induce muscular weakness include:
- When the abdominal wall fails to shut properly in the womb and causes an inherent birth defect and a perpetual risk of hernia
- With increasing age, the walls of the muscles begin to weaken naturally which is a part of the aging process
- Severe coughing
- Sudden damage occurring from an injury or a surgery
There are several factors that put some strain on the body and could be the leading cause of a hernia, particularly if you are suffering from weakened muscles. Some of these factors include:
- Pregnancy that puts undue pressure on the abdomen with the growing fetus in the womb
- Severe constipation that causes pressure and strain as one passes motions
- Weight lifting, particularly lifting heavier weights than your actual body capacity
- Fluid accumulation in the abdomen
- Sudden weight gain
- Continuous coughing or sneezing
What puts you at risk of a hernia?
There are some factors that could increase one’s chances of developing a hernia, and these include:
- Having a family history or genetic tendency to developing hernias
- Excessive weight or obesity
- Severe coughing
- Severe constipation
- Chain smoking that can lead to severe coughing
- Several other medical conditions like cystic fibrosis, which can trigger severe coughing and eventually cause a hernia
Symptoms that can help identify a hernia
The most visible sign of a hernia includes a bulge or a bump in the area that is affected by the hernia. If it is an inguinal hernia, a lump may be seen on one of the sides of the pubic bone, which is the meeting point for the groin and thighs. In most cases, one can feel a hernia by touch as one stands up.
In case your child is suffering from a hernia, you can see the bulge when the baby cries. The bulging may be seen as a symptom of an umbilical hernia.
There are a few other symptoms of an inguinal hernia which include:
- Severe pain or an uncomfortable feeling in the area that is affected by a hernia, particularly as one cough, bends or lifts heavy weights
- Severe weakness and intense pressure felt in the abdomen region
- Intense feeling of burning or a sensation of aches felt around the region of the bulge
Diagnosis –
The doctor would conduct a physical examination to diagnose incisional or inguinal hernia. The doctor would first feel if there is a bulge in the stomach or groin and whether if it gets larger while standing, coughing or putting any strain. If there is a hiatal hernia, then the doctor would perform its diagnosis with the help of a barium X-ray or perform and endoscopy. The below tests would allow the doctor to have a look at the internal location of the stomach:
Barium X-Ray – This is a series of X-Ray pictures of an individual’s digestive tract. Once the individual finishes drinking a solution of liquid which contained barium then the series of pictures are recorded. These would show up well on the X-ray image.
Endoscopy – This process involves threading a small camera which would be attached to a tube down the throat and then into the esophagus into the stomach.
An ultrasound would be performed if the child has an umbilical hernia. High frequency sound waves are used in ultrasound so that an image is created of the structures inside the body.
Treating hernias
The size of your hernia and the intensity of which the symptoms are felt determines your course of hernia treatment. The doctor is likely to check your hernia for complications and recommend one or a combination of the below mentioned treatment options:
Lifestyle alterations
Certain changes in your everyday activity levels and diet can help in treating the symptoms of a hernia. Basic practices like avoiding heavy or large meals, avoiding immediately lying down after a meal, or keeping your body weight under check can help in treating and preventing hernias.
Medicines
Certain over the counter drugs and prescribed medicines can help in reducing symptoms of stomach acid and reflux, which thereby help in reducing discomfort and better your symptoms. Some of these medicines include antacids, PPI drugs and so on.
Surgery
In case your hernia is increasing in size and causing pain, then your doctor may suggest a surgery to treat the condition. The hernia operation includes a procedure whereby the hole in the abdominal wall that is causing the bulge is sewed and closed.
Inguinal Hernia Surgery: Mostly the doctors recommend to perform surgery for those suffering from inguinal hernias. This is done so to avoid any complications, one which is called as strangulation. When a loop of intestine gets tightly trapped in a hernia leading to cutting off the supply of blood to that area of the intestine then it is called as strangulation which is nothing to ignore about. At times the hernia surgery can be pushed back based on the individual’s convenience however if it cannot be done so then the surgery should be done as soon as possible. Surgery may not be needed if the hernia is small and if one does not experience any symptoms. However, consultation with the doctor is a must before one decides on any action plan.
Surgery in children: In many cases, a child suffering from inguinal hernia will need surgery to get it corrected. Those infants who are less than six months of age or younger are at a higher risk of strangulation than the older ones and the adults. Hence when it comes to inguinal hernia surgery for infants then it should not be delayed as it is with adults.
In an infant, synthetic patches are not required to be repair an inguinal hernia. Infants with this cases should be hospitalized for performing the surgery rather than performing the surgery in an outpatient setting. Those would include special cases of kids with certain medical conditions such as heart disease, seizures or lung problems from birth or those who were born preterm.
Choices of surgery:
There are two types of surgery which can be done to repair the inguinal hernia:
- Open inguinal hernia repair
- Laparoscopic inguinal hernia repair
Prevention –
One cannot always prevent the weakness in muscles which are known to create hernia however there are ways to reduce the amount of strain one places on the body. This would help to keep hernia at bay or at least keep the existing hernia from getting more severe. Few of the prevention tips are:
- Avoid smoking
- Avoiding to lift heavy weights
- Maintain a healthy body weight
- During bowel movements or while urinating one should avoid straining
- Visiting a doctor when one is sick to avoid development of persistent cough
- One should life objects by giving support with your knees and not the back.
Natural remedies for Hernia –
When the hernia is large and painful then the doctors usually recommend going through surgery as part of hernia treatment. Surgery helps to make the weak abdominal wall more strong and secure by closing up any existing holes with the cloth patches. In cases of umbilical hernia doctors usually recommend waiting till the child attains the age of five years. Emergency surgery is usually recommended when the bulging sac becomes strangulated and there is a fear of blood supply being cut off. If during such times the medical attention is not received, then the bulging area would lose supply of blood completely leading to death.
Natural remedies are there to offer some kind of relief from the symptoms however they should not be treated as an alternative for the conventional medications. Hence it is advisable to attain consultation from the doctor before going in for any home treatment.
- Ginger root is one well know treatment which is known to protect the esophagus and the stomach from any damage due to buildup of gastric acids and bile. But this may not work well with everybody since ginger is also known to at times causing stomach upset.
- Licorice is an herb which has been used as a healing remedy for various medical conditions such as sore throat and respiratory trouble. Herb licorice is also known to heal the damaged parts of the stomach lining and the esophagus which is caused due to hernia. It also helps to alleviate pain in the chest and throat along with the burning sensation.
- Roots of marshmallow is known to have multiple health benefits. Its aids in digestion along with decreasing the production of digestive acids. It also helps to improve hernia related symptoms.
- Acupuncture can also be used to relive hernia related symptoms. When certain pressure points are stimulated then it helps to reduce pain and discomfort.
- Gentle exercises are known to target the core abdominal muscles. If one maintains regular practice of these exercises, then it would help to shed off excess body weight leading to low pressure on the abdominal muscles. However, one should refrain from carrying out any strenuous exercises or lifting up any heavy weights which can cause damage to abdominal muscles. One should avoid exercising immediately after having a meal and should wait for around two to three hours to carry out any exercises.
- Individual suffering from hernia should avoid applying any heat or pressure on the affected area, it can aggravate the existing problem.
- Soon after eating, one should refrain from lying down on the stomach.
- Refrain from wearing tight clothes as it can cause pressure on the stomach hence it is better to wear loose and comfortable clothes.
- Applying ice packs on the affected area or ice compresses are one of the known best remedies for hernia. It helps to improve the pain and the swelling which his caused due to hernia.
- One should avoid consuming alcohol.
- Include fresh fruits and vegetables in the daily diet, especially those which are filled with nutrients and rich in fiber.
- Always maintain a healthy body weight by practicing a nutritious diet.
