Breaking Down Hernias: Understanding Causes, Symptoms, and Treatment Options

It is protrusion of part of intestine or intra abdominal contents through a small hole in the abdominal wall.

Most commonly we come across:

1. Inguinal hernia
2. Femoral hernia
3. Umbilical or ventral hernia
4. Incisional hernia

Inguinal hernia is commonly seen in male patients while femoral hernia & umbilical hernia is commonly seen in females.

Causes of hernia

1. Congenital: hernia is present from birth but patients present with symptoms in teenage or early twenties.
2. Heavy weight lifting at work or lifting heavy weights in gym
3. Smoking
4. Post pregnancy
5. In elderly males enlargement of prostate gland
6. Previous abdominal surgery

Symptoms

Usually patients present with swelling in the abdominal wall which increases on straining ( like coughing, sneezing, passing stools) and the swelling sometimes reduces on pushing or by lying down.
Some patients can present with pain near the swelling(hernia) area.

In case of complications patients can present with abdominal distension, vomiting, redness & pain in hernia site.

Investigations

Usually it is a clinical diagnosis, but some patients may need ultrasound abdomen or a CT scan to measure the defect (hole) size and also to see the contents.

Treatment

It is always surgery and there is no medicine top treat hernia. Surgery can be performed Laparoscopically ( key hole surgery) or by open surgery. in either methods the hernia sac is reduced and the defect is closed with sutures and the surgery is completed after placing a Mesh. Laparoscopic surgery has a better advantage than the open surgery because of small incisions( cuts) which means less pain and easy recovery. Also in laparoscopic surgery bigger size mesh can be placed which means lesser chance of recurrence. However laparoscopic hernia surgery is technically more challenging and has to be performed by a well trained surgeon.

Post surgery recovery

Usually the patient can be discharged within 24 hours of hospitalisation after performing laparoscopic surgery. Patients can resume regular activities from next day itself. Patients can have normal food post surgery. Usually patients are asked not to lift heavy weight for about 3 to 4 weeks post surgery & they are called fro a followup visit 5 days after surgery.
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Chief of Surgical Gastroenterology,
SMC Bangalore
Consultant Minimal Access Surgery, Apollo Hospital, Bangalore
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Dr. Gautham SL

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