What Is a Hernia?

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The term hernia refers to a defect in the muscle or connective tissue layer of the abdominal wall that allows part of an internal organ, such as the intestine or fat, to push through, usually forming a lump under the skin. The lump may come and go and may or may not be painful.

Abdominal hernias usually occur at natural weak spots like the navel or groin area. Hernias can also be caused from a previous surgery, where the abdominal wall is typically not as strong after it heals.

Common symptoms of a hernia include a bulge or lump, pain when lifting, coughing, or sneezing, or pressure in the abdominal or groin area.   

Hernias are very common. It’s estimated that over one million surgeries are performed each year to repair abdominal wall hernias.* Not all hernias need to be fixed unless they become problematic. The decision to repair a hernia can be made in consultation with your surgeon at U of U Health.  

Hernia Causes

A hernia is caused by weakening or straining muscles. Although some types of hernias are more common in men, both men and women can be affected. Muscles become strained or weakened from:

  • age,
  • chronic coughing,
  • congenital defects,
  • injury,
  • previous operations or surgery

You can put additional strain on your muscles through these common causes:

  1. Obesity—Those extra pounds increase the strain and weaken your abdominal muscles, making them more likely to developing a hernia.
  2. Family History—Although family history may not guarantee a hernia, research shows it is a reliable predictor of one occurring.
  3. Pregnancy—The risk is small, but studies show that pregnancy is associated with the increase of risk of a hernia reoccurring.
  4. Constipation—The constant strain caused by constipation may cause a portion of your intestine to get trapped in the abdominal wall. This can lead to some painful problems with the bowel. If bowel movements are a struggle, see a doctor.
  5. Chronic Cough—Often associated with the effects of smoking, constant coughing weakens your abdominal wall.
  6. Injury—Most sports-related hernias occur in the groin and don’t appear as a bulge. But if you leave them untreated, it can evolve into an inguinal hernia.
  7. Heavy Lifting – If your abdominal muscles are already weak, you can strain them further through lifting heavy objects or weights.

Types of Hernias

There are five common types of hernias. Some affect men and women differently.

1. Inguinal hernia is the most common type of hernia. These types of hernias occur when the intestines push through a tear in the abdominal wall. Inguinal hernias are more common in men than in women because the inguinal canal is bigger. With an inguinal hernia, you’ll typically notice a small lump or bulge where your thigh and groin meet.   

2. Femoral hernias are more common in women. Femoral hernias occur when part of the intestine pushes through the femoral canal towards the top of the thigh. The femoral canal is the main blood supply to the legs. 

3. Umbilical hernias are the second most common type of hernia. They’re most common in newborns but adults can also get umbilical hernias. This happens when fat or part of the intestine squeezes through muscle near the belly button. For newborns, the umbilical hernia usually goes away on its own. Usually you only need surgery if you are in pain or the lump has enlarged significantly.

4. Incisional hernias are caused from a previous operation or surgery. If you’ve had a surgery where the doctor needs to make an incision through the muscle lining around your stomach or abdomen than it’s more likely that a hernia will occur. Tissue or other organs can poke through the surgical wound that isn’t completely healed yet.

5. Hiatal hernias are most common in pregnant women and people over the age of 50. Unlike the other types of hernias in your intestines or abdominal muscles, a hiatal hernia is in the diaphragm. A hiatal hernia happens when part of the stomach pushes up through an opening (esophagus) in the diaphragm and into your chest. Instead of a lump or bulge, you may notice heartburn or chest pain instead. Frequently, symptoms do not occur with hiatal hernias. Surgery is only recommended if symptoms occur and cannot be treated with alternative options.

Hernia Symptoms

The most common hernia symptoms include:

  • A bulge or lump in the affected area. This may become more apparent when you cough or are strained.
  • Pain or discomfort in the area, especially when coughing, lifting, or bending over
  • Pressure or a feeling of heaviness in the abdomen.
  • Burning or aching sensation near the bulge or lump area.
  • For hiatal hernias, symptoms include acid reflux, heartburn, chest pain, and difficulty swallowing.

Strangulated Hernia Symptoms 

If you are experiencing more severe symptoms such as nausea, vomiting, and a swollen or discolored bulge, get medical help immediately. This may be a sign that you have a strangulated hernia. A strangulated hernia is caused when blood supply to the intestine is cut off causing part of the organ to die. 

Hernia Symptoms in Men

Men may experience additional symptoms depending on the type of hernia. In inguinal hernias, men may notice pain and swelling around the testicles. This occurs when the intestine descends into the scrotum.

Hernia Symptoms in Women

Sometimes it’s harder to detect hernias in women because these hernias are deeper in the body and less likely to produce a bulge or lump. Symptoms for women often include chronic pelvic pain or acute, stabbing pain that comes quickly.

Hernia Treatment & Procedures

Hernias usually do not go away on their own and surgery may be needed to repair them. 

Surgeons at U of U Health offer two different types of surgery:

  • Open Surgery – The surgeon will make an incision at the location of the hernia and will set the protruding tissue back into place. The weakened muscle that caused the hernia will be stitched back together and a mesh patch will be used to help the area heal fully. Open hernia surgery can be done under general, spinal, or local anesthesia.
  • Laparoscopic Surgery – The surgeon makes small incisions near the location of the hernia and surgical tools are used to complete the repair. A mesh patch is used to strengthen the repair. Laparoscopic hernia surgery can be done with general anesthesia.

Hernia Surgery Recovery

Most people that have hernia surgery will go home the same day. Hernia surgery recovery time depends on the type of hernia you have. To reduce pain and swelling immediately after surgery use an ice pack for 10–20 minutes every one to two hours. Make sure to follow any directions or advice given to you by your provider.

How to Prevent a Hernia

Utilize these guidelines to lower your risk of hernias:

  • Maintain a healthy weight
  • Exercise regularly to strengthen abdominal wall tissue
  • Quit smoking
  • Avoid constipation or straining

 

*https://www.fda.gov/medicaldevices/productsandmedicalprocedures/implantsandprosthetics/herniasurgicalmesh/default.htm