WHAT IS A HERNIA?
A hernia is a bulge or tear in the abdominal muscle. When the inside layers of the abdominal walls become weak, a small balloon-like sac will form. A loop of intestine or abdominal tissue may push into the sac.
Hernias are extremely painful and can cause serious harm. Emergency surgery may be necessary to repair damage. A hernia will not get better over time, and it will not heal on its own. Both men and women can develop a hernia. Some people are born with congenital hernias while others develop the condition over time.
COMMON HERNIA SYMPTOMS
Hernias may occur in the groin, belly button, upper abdomen, buttocks, or sites of previous operations. In rare instances, hernias may develop in other areas of the body.
It is usually easy to notice a hernia. You may notice an unusual bulge under the skin, or you may feel pain when you lift heavy objects, or cough. You may feel discomfort while going through the bathroom, and you may have trouble standing or sitting for a long period of time.
Hernia pain tends to vary. Sometimes, it’s sharp and immediate, and other times, it can feel like a dull pain that worsens toward the end of the day. Severe pain, continuous discomfort, redness, and tenderness are signs that the hernia is entrapped or strangulated. If you feel these symptoms, you should contact your Houston hernia surgeon or physician immediately.
Abdominal walls have natural areas of weakness. Hernias may develop at these sites or in other areas due to heavy strain, aging, injury, or congenital weaknesses. You might also develop a hernia at a previous surgical site.
Hernias can affect people at all ages. Among children, hernias tend to be congenital and present at birth. Adult hernias tend to result from abdominal weakness, strain from heavy lifting, coughing, or problems going to the bathroom. Contributing factors include:
- Poor nutrition
- Pulmonary disease
- Family health history
- Cystic fibrosis
- Undescended testicles
- Persistent cough
- Constipation and bowl movement straining
- Enlarged prostate
- Straining while urinating
- Injury or prior surgery
UMBILICAL HERNIA CAUSES
The abdominal wall has natural areas of weakness such as the site where the umbilical cord was attached as a fetus. Hernias may develop due weakness, heavy strain, aging, injury, previous surgery, or birth abnormalities. Among children, umbilical hernias tend to be congenital and will close spontaneously by age two. Among adults, umbilical hernias occur due to weakness or injury.
INCISIONAL HERNIA CAUSES
The wall of the abdomen has natural areas of potential weakness. Hernias can develop at these or other areas due to heavy strain on the abdominal wall, aging, injury, an old incision or a weakness present from birth. Anyone can develop an incisional hernia at any age. A natural weakness or strain from heavy lifting, persistent coughing, difficulty with bowel movements or urination can cause the abdominal wall to weaken or separate. In an old incision, there is a natural weakness as the normal muscle and fascial layers have been disturbed and replaced with scarring that can weaken and thin out over time. Smoking, obesity, malnutrition and pulmonary disease have also been shown to be contributing factors.
EPIGASTRIC (UPPER MIDDLE ABDOMINAL) HERNIA CAUSES
Hernias develop at naturally weak spots in the abdominal wall. Heavy strain, aging, injury, and previous surgical incisions can cause hernias to occur in other areas as well. Epigastric hernias can affect people at any age. In the epigastric region, there is a natural weakness as the linea alba contains no muscle and only a single layer of fascia. As we age, the linea alba widens and becomes thinner.
VENTRAL HERNIA CAUSES
Ventral hernias occur when a piece of the intestine protrudes through an abnormal opening in the abdominal wall. These types of hernias result from holes, tears, or weakened areas in the abdominal wall – usually as a result of previous surgical incisions. The weakness will allow the intestine to protrude through the hole, causing a bulge to form beneath the skin. The condition affects both men and women and will not get better over time.
A person with a ventral hernia has a piece of intestine that protrudes through an abnormal opening in the abdominal wall. In order for an ventral hernia to form, there must be a hole, tear or weakened area in the abdominal wall, usually caused by a previous surgical incision. This abnormal weakness allows the intestine to protrude through the hole or tear, and the intestine forms a bulge underneath the skin. The abnormal opening may be in the umbilicus or in a surgical scar. In rare instances, complications from ventral hernias such as incarcerations, obstructions, and strangulation may occur.
OPTIONS FOR HERNIA REPAIR
Few options are available for hernia patients. These hernias typically become larger over time, causing symptoms to worsen. Inguinal hernia repair is most successful with fewer chances of recurrence early on.
Surgery is the most common solution for hernia repair. The surgery may be performed through an open, laparoscopic, or robotic approach. With the open approach, the surgeon will create an incision over the hernia defect. The incision extends into the skin, subcutaneous fat, and superficial fascial layers. The surgeon will patch the defect with a piece of surgical mesh with no tension. The procedure usually requires a local anesthetic; however, in some cases, general anesthesia is necessary.
The laparoscopic approach is minimally invasive and requires three small incisions. A piece of mesh is placed through one of the incision sites and is held in place with surgical tacks or small hooks. The laparoscopic procedure usually requires general anesthesia.