Hernia FAQs

What is a hernia?

A hernia is the protrusion which occurs when part of an abdominal organ protrudes through a weak spot in the abdominal wall. Hernias are common and usually not a particularly serious matter. If the protruding tissue becomes obstructed, however, which is referred to as an incarcerated hernia, or if the blood flow to the tissue is impeded, which is called a strangulated hernia, the situation may become dire. Since incarcerated hernias are very serious and may be life-threatening, the presence of a hernia should never be ignored.

What causes a hernia?

Hernias may be congenital, meaning that the abdominal lining has not closed properly during gestation. They may also result later from a weakness in the abdominal wall present at birth which worsens as time passes. Other causative or precipitating factors for hernias include:

  • Family history of hernias
  • Obesity
  • Chronic cough due smoking or disease
  • Pregnancy
  • Constipation
  • Straining to urinate
  • Enlarged prostate
  • Undescended testicles
  • Ascites, the buildup of abdominal fluid
  • Certain medical conditions, such as Marfan syndrome
  • Weakened abdominal muscles due to poor nutrition or heavy lifting

What are the different types of hernias?

There are several types of hernia, differentiated by their locations in the body. They are:

  • Inguinal hernia
  • Femoral hernia
  • Umbilical hernia
  • Incisional hernia
  • Epigastric hernia
  • Hiatal hernia

What are the symptoms of a hernia?

Most hernias present as visible, palpable bulges in the groin or abdomen. They may be tender or painful, especially during heavy lifting, coughing, or straining during urination or bowel movements. A hernia may seem to disappear at times when the protruding tissue is pushed back inside the abdominal wall, but once the weakness exists, the hernia will inevitably reappear. In the case of hiatal hernias, the protrusion on gastric tissue into the chest cavity is not visible. The symptoms of a hiatal hernia include heartburn; regurgitation, difficulty swallowing, bloating or shortness of breath.

How are hernias diagnosed?

A doctor can usually confirm the presence of a hernia during a physical exam. The mass may increase in size when the patient coughs, bends, lifts or strains the abdominal muscles. The telltale bulge of a hernia may not be obvious in infants or children except when they are crying or coughing. Hernias may also be difficult to locate upon the physical examination of an obese person. In such cases, diagnostic imaging may be employed to verify the existence of a hernia.

How are hernias repaired?

While hernias can occasionally be pushed back into place temporarily, surgery is the only method to permanently correct them. Hernia surgery is one of the most common surgical procedures performed in the United States. Physicians usually recommend surgery when hernias are large, painful, or interfering with everyday activities. Such surgical procedures are often undertaken prophylactically to prevent the development of a dangerous, incarcerated hernia in the future. In hernia surgery of whatever type, the surgeon usually covers the affected area with surgical mesh after the incision is made to prevent further weakness or tearing of the abdominal wall. Although repairs may be made using the patient's own tissue without surgical mesh, such repairs have a lower rate of success over time.

How is hernia surgery performed?

There are two major types of hernia surgery, both performed under general anesthesia:

Laparoscopy

Most hernia repairs are now done laparoscopically unless there is a strong reason that this type of surgery is deemed inadvisable. Laparoscopic hernia surgery is minimally invasive and results in little scarring, minimal pain after surgery, and rapid healing. It is usually performed under general anesthetic. While some soreness is to be expected for a few days after the procedure, the patient should be able to resume normal activities within a week or so.

Open Surgery

Reasons that necessitate open, rather than, laparoscopic, surgery may include obesity or the presence of extensive scar tissue from previous surgery. Open surgery in performed with the patient under general anesthesia. In open surgery, a large, deep incision is made through the muscle. The tissue is pushed back behind the muscle, which is then stitched closed. In the case of open surgery, full recovery takes a month to 6weeks.

What are the risks of hernia surgery?

While hernia surgery is one of the most common surgeries performed, and while the success rate for this procedure is extremely high, there are always risks with any surgery. Some of the possible complications are listed below:

  • Allergic reaction to anesthesia
  • Excessive bleeding
  • Abscess formation
  • Puncture of an intestinal organ
  • Infection at the site of the surgery

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