The key to accurately diagnosing hernia is anatomy

Hernia is a condition where an organ pushes through the muscle or tissue that holds it. Hernia is seen to occur in the upper thigh, belly and groin areas. To prevent the dangerous complications of hernias medications and surgery are usually recommended.

Hernia is of three types. Inguinal Hernia occurs in majority of patients, where the intestines push through the weak spot or tear out of lower abdominal wall (inguinal canal).

In Hiatal Hernia, a part of the stomach pushes the diaphragm and moves into the chest. It leads to a condition called gastroesophageal reflux, where the stomach contents leak backward into esophagus. Gastroesophageal reflux causes burning sensation.

Umbilical Hernia is seen in children and babies less than 6 months to 1 year old. Incisional Hernia is seen in those who had abdominal surgery, when the intestines push through the weakened abdominal tissues.

CAUSES

Hernia may occur due to several factors viz. weak abdominal wall (a congenital defect), age, chronic cough and damage to abdominal muscles after injury or surgery. Weakening of the abdominal muscles may happen due to pregnancy, constipation, heavy weight lifting, abdominal fluid (ascites), gaining weight and persistent cough or sneezing.

SYMPTOMS

For each type of hernia, the symptoms are different. The most common symptom of hernia is the presence of a bulge or lump in the affected area. Other symptoms may be pain or discomfort in the affected area, heaviness in the abdomen, burning or aching sensation at the site of the bulge, acid reflux, chest pain and difficult in swallowing.

RISKS AND COMPLICATIONS

Some of the prominent risk factors of hernia are gender of the person (male), family history of hernia, medical conditions including chronic cough and constipation, excess weight, pregnancy, premature birth and others. Hernia may not have an immediate threat to life; however the complications, if neglected may cause death. The complications of hernia are seen as pressure on surrounding tissues causing severe pain, swelling and nausea, vomiting, inability to have a bowel movement, and ultimately strangulation leading to the death of the affected bowel tissue.

TESTS AND DIAGNOSIS

The doctor usually examines different parts of the body for bulge or lump. Questions are posed regarding cough, pain, nausea and bowel movement. Patients are made to cough, stand or strain so that the doctor can feel the bulge in the abdomen.

Barium X-ray or endoscopy is suggested for patients with hiatal hernia. This test helps the doctor to know the internal condition of the stomach and diaphragm. For umbilical hernia (in children below 6 months to 1 year) the doctor may advise for an ultrasound.

TREATMENTS AND DRUGS

Lifestyle changes are advised for patients with hiatal hernia. These include, avoiding heavy meals, not to bend after a meal, and keep the body weight under control. Spicy and tomato-based foods should be avoided as they may cause acid reflux or heartburn.

When hernia becomes large and causes pain, the doctor may advise for immediate surgery. The hole in the abdominal wall is closed with a surgical mesh. Laparoscopic surgery is most preferred over open surgery, as it causes less damage to the surrounding tissues. However, laparoscopic surgeries come with few limitations. When the intestine has moved into the scrotum only open surgery is advised.