The word “hernia” is derived from Latin, and means “rupture”. While a hernia doesn’t indicate that an organ has itself ruptured or torn, it refers to how a hernia occurs; when an internal part of the body pushes through a weakness in the surrounding muscle or tissue wall. Commonly affecting areas like the abdomen and groin, hernias can vary in severity, from being mildly uncomfortable to significantly painful. They come in various forms, like hiatus hernia (also called hiatal hernia), and may have no symptoms or require surgical intervention. This guide will explore the causes, types, symptoms, and treatments of hernias, while providing insights for those experiencing symptoms or recovering from hernia surgery.
What Is a Hernia?
A hernia happens when part of an organ or fatty tissue squeezes through its normal boundaries or a weak spot in a surrounding muscle or connective tissue. Think of it as kind of a gap in the muscle where other organs or tissue can push through given the circumstances, and then gets trapped or squeezed and starts to swell. Sometimes it’s only fatty tissue, but it can also include parts of the bowels and in rare cases the bladder. A reducible hernia is when the swelling goes down, and if it doesn’t go down it is an irreducible hernia.
So, what is the reason for a hernia? Hernias can develop due to many factors, so the answer lies in a combination of genetic predispositions, situations and lifestyle factors. Some physical factors that can lead to a hernia are; obesity, chronic cough, heavy lifting, pregnancy, chronic constipation, abnormal abdominal fluid, multiple births, peritoneal dialysis, or previous abdominal surgeries.
Some hernias can become quite serious if left untreated, including conditions like strangulated hernia or incarcerated hernia, where the blood supply to the herniated tissue is compromised. Inguinal hernias are the most common type, accounting for about 75% of all cases, especially in men.
Types of Hernias
Hernias can manifest in various forms, each with unique characteristics and treatment considerations:
- Inguinal Hernia: The most common – occurs in the groin area, is more prevalent in men and is often associated with ageing and strain. An Inguinal Hernia occurs when abdominal contents protrude through a hole in the muscles of the groin at the top of your inner thigh.
Learn more about Inguinal Hernia. - Umbilical Hernia: The belly button (umbilicus) is a naturally weak spot in the abdominal wall, containing fibrous tissue rather than muscle. This makes it susceptible to hernias, where abdominal contents like fatty tissue (omentum) or, occasionally, parts of the bowel can protrude through the surrounding muscle, causing a noticeable bulge. Umbilical hernias are particularly common in women, especially before and after pregnancy, due to increased pressure on the abdominal area.
Learn more about Umbilical Hernia. - Hiatal Hernia: Part of the stomach pushes through the diaphragm into the chest cavity, often leading to acid reflux. Hiatal hernias are particularly common in people over 50, affecting around 20% of adults in this age group.
Learn more about Hiatal Hernia. - Epigastric Hernia: An epigastric hernia develops above the belly button when a weak spot forms in the abdominal wall where the muscles join in the center (called the linea alba). This allows abdominal contents, such as fatty tissue (omentum) or, less commonly, parts of the bowel, to push through, creating a bulge..
Learn more about Epigastric Hernia. - Femoral Hernia: A femoral hernia occurs when tissue pushes through a space called the femoral canal, located next to the main blood vessels in the groin. This opening is naturally wider in women, making femoral hernias more common among them. The protrusion often involves fatty tissue but can sometimes include parts of the bowel or even the bladder.
Learn more about Femoral Hernia. - Incisional Hernia: This can occur after abdominal surgery at the site of an incision if the wound doesn’t heal fully.
Learn more about Incisional Hernia.
What Causes A Hernia?
Many people ask, how can you get a hernia? Hernias can develop due to various factors, from your diet, lifestyle, age or a condition from birth. In order to form, a hernia requires a combination of pressure and a weakness in the muscle. The following things all lead to the weakening of muscles, which increases the risk of a hernia.
Lifting Heavy Weights: Straining during activities like weightlifting or manual labour can increase the risk.
Obesity: Excess body weight puts additional pressure on the abdominal wall, leading to hernias.
Chronic Coughing: Persistent coughing, such as from chronic obstructive pulmonary disease (COPD), can strain the abdomen.
Ageing: The natural weakening of muscles over time can make older adults more susceptible.
Genetic Factors: Certain conditions, such as collagen vascular disease, can weaken connective tissues, increasing hernia risk.
Previous Surgery: Surgeries, especially in the abdomen, can leave weakened areas prone to incisional hernias.
Constipation or Straining: Repeated straining during bowel movements can contribute to the development of hernias.
What Are The Symptoms of Hernias?
Common symptoms of hernias include:
- Pain or Discomfort: Hernias often cause a dull ache or sharp pain, especially when lifting, coughing, or bending. This discomfort can worsen with activity and may improve with rest.
- Visible Lump or Bulge: A common sign of hernias is a bulge that becomes more noticeable when standing or straining and might reduce when lying down.
- Digestive Issues: A hernia can cause bloating, constipation, or even diarrhea.
- Nausea and Vomiting: In severe cases like a strangulated hernia, symptoms may include sudden, severe pain, nausea, and vomiting, which require immediate medical attention.
Can a Hernia Cause Back Pain?
Yes, a hernia can lead to back pain, especially if it causes tension in the surrounding muscles or nerves. In cases where the hernia creates pressure in the abdominal area, the strain can extend to the back muscles, leading to discomfort.
Can a Hiatus Hernia Cause Breathlessness?
Yes, a hiatus hernia can cause breathlessness because it pushes the stomach through the diaphragm, the muscle that helps with breathing. When the stomach presses against the diaphragm, it can make breathing more difficult, especially during physical activities.
Can a Hernia Cause Bloating, Constipation, or Diarrhea?
Yes, hernias can cause digestive issues. When a hernia pushes against the intestines, it can interfere with bowel movements, leading to symptoms like bloating, constipation, or even diarrhea. These issues often arise if the hernia partially obstructs the intestines.
Differences in Symptoms Between Men and Women:
Women: Femoral hernias are more common in women due to a wider femoral canal. These may be harder to detect and can cause groin pain, especially during activities. Women are also prone to umbilical hernias, especially during or after pregnancy.
Men: Inguinal hernias are more prevalent in men and are typically associated with a noticeable bulge in the groin area that can be tender or painful. Men might experience more discomfort with physical activity due to the strain on the groin area..
What Does a Hernia Feel Like?
A hernia can feel like a dull ache or a sharp pain, often made worse by physical activity. Some hernias may not cause any pain at all, raising the question, do hernias hurt? While many are painful, others may only present a visible bulge.
How to Treat a Hernia
Hernia Treatment Options
Can a hernia heal itself, and do hernias go away on their own? Smaller hernias may not need surgery, but most hernias do not heal on their own. However, symptoms can be managed with lifestyle changes or a hernia belt – a device worn around the groin that prevents tissue from bulging out – to provide temporary relief.
Managing a hernia can start with lifestyle changes like eating smaller meals, avoiding trigger or very spicy foods, elevating the head during sleep, and maintaining a healthy weight. In severe cases, surgery such as laparoscopic fundoplication may be needed to reposition the stomach and tighten the diaphragm opening.
Over-the-counter pain relievers like NSAIDs can help, along with antacids for acid-related discomfort. Adjusting positions, such as avoiding bending or elevating the head during sleep, can also alleviate symptoms.
Hernia Surgery Options
Surgical intervention is often required for larger or symptomatic hernias, which is determined after an initial consultation with a doctor. Here are the primary surgical methods:
- Open Surgery: Traditional approach, suitable for larger hernias, involving a single incision to push the lump back into place.
- Laparoscopic Surgery: Minimally invasive, offering faster recovery times through smaller incisions.
Is hernia surgery dangerous? Like any procedure, hernia surgery has risks, but it is generally safe when performed by experienced surgeons. Complications can include infection, bleeding, or recurrence, but these risks are very low with proper care. Discuss the potential benefits and risks of the procedure with your healthcare provider before proceeding. Visit our hernia surgery page for more details.
Recovery After Hernia Surgery
Hernia Treatment Recovery Time:
Recovery time varies depending on the type of surgery. On average, patients can expect a recovery period of:
- 2-4 weeks for laparoscopic procedures.
- 4-6 weeks for open surgery.
What to wear after inguinal hernia surgery? Loose, comfortable clothing is recommended to reduce strain and promote healing. Most patients can resume normal activities gradually but should avoid heavy lifting for at least 6 weeks post-surgery.
Preventing Hernias
While not all hernias can be prevented, certain lifestyle changes can reduce the risk:
- Maintain a Healthy Weight: Reduces pressure on the abdomen.
- Strengthen Core Muscles: Core exercises can provide better support for internal organs.
- Avoid Heavy Lifting: Use proper techniques or seek assistance when lifting heavy objects.
- Quit Smoking: Smoking can lead to chronic coughing, which increases the risk of developing a hernia.
A hernia may sound like a frightening matter, but in the right hands, you can heal and recover with dignity and limited pain. For more information on hernias and hernia surgery, please reach out to our experienced team.