A complete guide to hernias

A hernia is a prevalent medical condition where an organ or fatty tissue protrudes through a weak area or tear in the surrounding muscle or connective tissue. Although often harmless, hernias can lead to discomfort and may need medical attention if not addressed.

We speak to an experienced colorectal surgeon who delves into the nature of hernias, their causes, symptoms, and the treatment options available.

What causes a hernia?

Hernias occur when there is an opening or weakness in the muscles or tissues that normally hold internal organs in place. This allows a portion of the intestine, fat, or another organ to protrude through that weakened area. There are various types of hernias, each with its own causes and risk factors.

The most common type is an inguinal hernia, where tissue pushes through the abdominal wall in the groin area. Other types include femoral hernias, which occur in the upper thigh, and hiatal hernias, where part of the stomach protrudes into the chest through the diaphragm.

In some cases, hernias can develop from congenital defects, while others are the result of increased pressure on the abdominal muscles due to factors such as obesity, heavy lifting, pregnancy, or chronic coughing.

What are the symptoms of a hernia?

The symptoms of a hernia can vary depending on its size and location. Common symptoms may include:

• A visible lump or bulge, particularly noticeable when standing or straining.
• Pain or discomfort in the affected area.
• A sensation of heaviness or dragging in the abdomen or groin.
• Pain that intensifies with activities like movement, lifting, or bending.

In some cases, hernias may be asymptomatic and only discovered during routine medical examinations. However, if the hernia becomes incarcerated or strangulated—where the blood supply is cut off—it can become a medical emergency requiring immediate surgical intervention.

How is a hernia diagnosed?

Diagnosis of a hernia typically begins with a physical examination by a doctor. In some cases, additional imaging tests, such as ultrasound or MRI, may be required for a more accurate assessment. These tests help to determine the severity and exact location of the hernia.

What are the treatment options for a hernia?

The primary treatment for most hernias is surgical repair. In many cases, the goal of surgery is to return the protruding tissue or organ back into its proper place and strengthen the weakened muscles to prevent recurrence.

For smaller, non-complicated hernias, a watchful waiting approach may be appropriate, especially in cases where surgery carries higher risk, such as in elderly patients or those with other health conditions. Non-surgical options like hernia trusses or supportive garments may offer temporary relief, but these are not a cure.

Surgical techniques for hernia repair vary depending on the type and location. Common methods include open hernia repair and laparoscopic surgery. Laparoscopic procedures often lead to faster recovery times and less post-operative discomfort, though they may not be suitable for all cases.

Are there any risks associated with hernia surgery?

As with any surgical procedure, hernia repair carries some risks, including infection, bleeding, and recurrence of the hernia. However, with advances in medical techniques and post-operative care, the success rates are generally high, and complications are uncommon.

If you suspect a hernia, it is important to consult with a doctor promptly for diagnosis and to discuss the most appropriate treatment options tailored to your specific needs.