A hernia happens when an organ or tissue pushes through a weak spot in the muscle or connective tissue that holds it in place. The Indian Hernia Society estimates that about 5 million Indians are diagnosed with hernias each year. Hernias occur when the intra-abdominal pressure exceeds the structural integrity of the musculature surrounding the defect, with resultant extrusion of intra-abdominal contents through the weakened musculature.
What Causes Hernias
Inside the human body, layers of muscle and connective tissue keep internal organs in place. Hernias happen when these barriers are weak, or when there is a big increase in pressure in the body. All have the potential weak spots of their abdominal wall.
Types of Hernia Commonly
Classification of Hernias Hernias are classified according to the place of hernia. Inguinal hernias are hernias of the groin and account for roughly 70% of all abdominal wall hernias. In hiatal hernia, part of the stomach protrudes through the diaphragm into the chest. About 60% of people over age 50 have this condition. An umbilical hernia is a common condition of infants that occurs near the belly button. Ventral hernias develop along the abdominal wall, often after surgery or trauma.
Identifying Symptoms
Symptoms vary according to the type and severity of the hernia. The most common sign is a bulge or swelling which can be seen in the hernia area, especially when standing. Many patients feel discomfort ranging from mild pressure sensation to significant pain. According to the National Institutes of Health, the severity of symptoms can vary quite a bit. Some patients with large hernias may be completely asymptomatic, while others with small hernias may be in significant pain.
Risk Factors
There are a number of things that make hernia more likely. Age matters muscles tend to weaken with advancing years, so hernias are more common after age 50. Family history indicates a genetic predisposition. Chronic coughing caused by COPD or smoking increases abdominal pressure. Pregnancy results in important but transient pressure changes. Obesity exerts chronic pressure on abdominal structures. Heavy lifting and constipation are also helpful.
Warning Signs in an Emergency
Some symptoms may need emergency medical attention. Strangulation is a serious condition where blood flow to the herniated tissue is compromised. Signs of strangulation include sudden severe pain, inability to push the hernia back into the abdomen, persistent nausea and vomiting, fever and redness of the overlying skin. Strangulated hernias need emergency surgery within hours.
Preliminary Diagnosis
Most hernias are diagnosed by a physical exam. Physicians may ask the patient to stand during the exam and may ask them to cough or bear down to make the bulge more apparent. If the diagnosis is not certain, imaging tests such as ultrasound, CT scans or MRI may be ordered. The initial assessment is to determine if the hernia is reducible (pushes back in) or irreducible (permanently stuck).
Important Realization
A hernia will not usually heal or become stronger on its own because the weakened tissue remains. However, if it is small and asymptomatic, immediate surgery may not always be required, and watchful waiting with medical monitoring may be appropriate. Treatment is generally recommended when the hernia causes pain, discomfort, swelling, or affects daily activities. If the bulge becomes painful, firm, or cannot be pushed back, or if you develop vomiting, seek prompt medical attention. For proper evaluation and hernia treatment in Indore, consult a qualified surgeon.
