Hernia

What is a hernia?

A hernia happens when an internal part of the body (like an organ or fatty tissue) pushes through a weak spot in the surrounding muscle or tissue wall. This may cause a lump or swelling around the abdomen or groin area.

Types of hernia

The most common types of hernia are:

• Inguinal hernia – When the intestine or bladder pokes through into your groin. This is the most common type of hernia, and it mostly affects men.

• Incisional hernia – When the intestine pushes through an incision where surgery took place that hasn’t properly healed.

• Femoral hernia – Fatty tissue or part of the bowel that pokes through into the groin. These are more likely to affect women.

• Umbilical hernia – When fatty tissue or part of the bowel passes through the abdominal wall near the belly button.

• Hiatus hernia – The upper stomach squeezes through an opening in the diaphragm called the hiatus.

Hernia causes

Hernias are caused by an increase in pressure on an organ or tissue, combined with a weakness or opening in the muscle or tissue. This increase in pressure in the abdomen might be caused by:

• Lifting heavy objects

• Persistent coughing or sneezing

• Strenuous activity

• Pregnancy

• Constipation or diarrhoea

The following things can also contribute to weakened muscles and increase your risk of a hernia:

• Poor diet that’s low in fibre (like fruit, vegetables, and whole grains)

• Obesity

• Smoking

Hernia symptoms

A lump or swelling, usually around the tummy or groin area, is often the most obvious symptom. You may be able to push the lump back in, or it may disappear when you lie down, only for it to pop out again if you strain.

Often, the lump isn’t painful, but it may cause an aching sensation that’s worse when you exercise.

You may experience other symptoms, depending on the type of hernia you have, like heartburn if it’s a hiatus hernia.

Hernia complications

Hernias are not usually serious, but it’s a good idea to get medical advice straight away if you think you have one as they can cause complications, including:

• Strangulated hernia – When blood supply gets cut off to the part of the organ or tissue in the hernia.

• Obstructed bowel – When a piece of bowel gets into the hernia and becomes blocked.

Both complications can cause severe pain and are medical emergencies. Contact the emergency services immediately if you have a hernia and you experience sudden, intense pain, difficulty pooing, or the hernia starts to feel tender or is difficult to push back in.

Hernia diagnosis

A doctor will usually be able to identify if you have a hernia through a physical examination. If they aren’t sure, or they want to investigate further, you may be referred for an ultrasound scan, which uses high-frequency sound waves to produce an image of the inside of your body.

Hernia treatment

Hernias can be repaired with different surgical procedures, but not all hernias need to be treated. Without treatment, the hernia won’t get better, but it might not get worse either.

The following factors will be taken into consideration before surgery is recommended:

• Type of hernia – Some hernias have a higher risk of strangulation or bowel obstruction

• The content of the hernia – There may be a higher risk of strangulation or obstruction if it contains part of your bowel, muscle or other tissue

• How severe your symptoms are

• Your overall health and if you are well enough to cope with surgery

Types of surgery

The two main types of surgery for hernia are:

• Open surgery – One long incision (cut) is made in the groin and the hernia is either pushed back into place or tied off and removed.

• Keyhole (laparoscopic) surgery – Several smaller incisions are made, and a tiny camera called a laparoscope is inserted into one of them to guide the surgeon. They use the other cuts to insert tiny instruments and repair the hernia.

Keyhole surgery is generally less invasive, but most people can leave the hospital within a day or two of the operation and usually recover within a few weeks.