Hernia

Overview

Hernia is also known Inguinal hernia, inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. It appears as a bulge in the groin. The bulge can be painful especially while coughing, bending over or lifting a heavy object. The resulting bulge may go all the way down into the scrotum.

Though inguinal hernia is not dangerous, it can lead to life threatening complications if not treated on time. For this reason, a surgical repair is recommended for painful inguinal hernia that’s becoming larger. The surgical procedure is common..

Symptoms

Many times inguinal hernia is asymptomatic. It is usually identified during a regular medical exam. But often one can see and feel the bulge created by the protruding intestine. The bulge is usually more obvious when the person stands upright, especially while cough or strain. The common symptoms include:

• A bulge in the area on either side of the pubic bone
• A burning, gurgling or aching sensation at the bulge
• Pain or discomfort in the groin, especially when bending over, coughing or lifting
• A heavy or dragging sensation in the groin
• Weakness or pressure in the groin
• pain and swelling in the scrotum around the testicles when the protruding intestine descends into the scrotum occasionally in men..

Causes

Mostly inguinal hernias have no apparent cause. But most of them occurs as a result of:

• Increased pressure within the abdomen
• A pre-existing weak spot in the abdominal wall
• A combination of increased pressure within the abdomen and a pre-existing weak spot in the abdominal wall
• Straining during bowel movements or urination
• Heavy lifting
• Fluid in the abdomen
• Pregnancy
• Excess weight
• Chronic coughing or sneezing

In many, the abdominal wall weakness leading to an inguinal hernia that occurs during birth when the abdominal lining (peritoneum) is not close properly. Other inguinal hernia develops later in life due to factors like ageing, strenuous physical activity or coughing accompanied by smoking when muscles weaken or deteriorate.

The weak spot in men is usually along the inguinal canal where the spermatic cord, which contains the vas deferens, enters the scrotum.

In women, the inguinal canal carries a ligament that helps hold the uterus in place, and hernias sometimes occur where connective tissue from the uterus attaches to tissue surrounding the pubic bone.

The way males develop in the womb makes them more vulnerable to have an inherent weakness along the inguinal canal.

Weaknesses can also occur later in life in the abdominal wall, especially after an injury or certain operations in the abdominal cavity..

Risk Factors

Factors that is likely to put at a greater risk of developing inguinal hernia:

• Being male puts you at a higher risk of having the disease. This is the reason; the vast majority of newborns and children with inguinal hernias are boys.
• Family history of inguinal hernia increases your chances of having the same.
• Certain medical conditions like having cystic fibrosis that causes severe lung damage and often a chronic cough, makes it more likely to develop an inguinal hernia
• Chronic cough that occurs from smoking increases the risk of inguinal hernia.
• Chronic constipation leading to straining during bowel movements can be a cause of inguinal hernias.
• Excess weight can put extra pressure on the abdomen.
• Pregnancy can both weaken the abdominal muscles and cause increased pressure inside the abdomen.
• Certain occupations that requires standing for long periods or doing heavy physical labor increases the risk of developing an inguinal hernia.
• Premature birth can be a reason for inguinal hernias.
• History of hernias can result in eventually developing another usually on the opposite side..

Diagnosis

The diagnosing process of inguinal hernia only requires a physical exam. The doctor may ask about the signs and symptoms. He may check for the bulge in the groin area. Because standing and coughing can make a hernia more prominent, the doctor may ask the patient to stand up and cough or strain as part of the exam. The growth may increase in size when the person coughs, bend, lift, or strain..

Tests

Though there are no tests require diagnosing the condition, in infants and children hernia may be diagnose by ultrasound.

X-ray of the abdomen may be needed if the person has blockage in the bowel

CT scans are also very useful for finding some hernias. 

Treatments

The treatment includes wait and watch if the hernia is not causing any symptoms and not bothering he person but if the hernia is painful and enlarging it requires surgical repairs. The treatment options include:

• Herniorrhaphy: Also called "open" hernia repair, the surgeon makes an incision in the patient’s groin and pushes the protruding intestine back into the abdomen. Then the surgeon repairs the weakened or torn muscle by sewing it together. Often the weak area is also reinforced and supported with a synthetic mesh, a procedure called hernioplasty. After the operation, the patient will be encouraged to move about as soon as possible, but it may be as long as four to six weeks before he will be able to fully resume his normal activities.

• Laparoscopy: In laparoscopic surgery, the surgeon uses several small incisions rather than one large one. A fiber-optic tube with a tiny camera is inserted into the abdomen through one incision, and miniature instruments are inserted through the other incisions. Then the surgeon performs the operation using the video camera as a guide. In laparoscopic surgery, synthetic mesh is always used to repair the hernia (hernioplasty)..

Alternative Treatments

Alternatives may include:

• Meditation
• Reiki
• Sungazing
• EFT
• Foot reflex massage
• Infra red massager
• Yoga and other
• Stretching exercises
• Supplements like Aloe Vera, Propolis, Ginseng, Olive leaf tea, Granada peel tea, MSM, minerals, etc.
• Chinese herbal therapy.

Medicine Drugs

Though the treatment process involves surgeries and operations, the doctor may prescribe some drugs to control the symptoms and after effects..

Complications

Inguinal hernia may have some serious complications which include:

• If inguinal hernias are not repaired surgically, they enlarge over time. Large hernias may put pressure on surrounding tissues which in men may extend into the scrotum, causing pain and swelling.
• Incarcerated hernia which can be a result of trapped loop of intestine in the weak point in the abdominal wall. This may obstruct the bowel movement leading to severe pain, nausea, vomiting and the inability to pass gas.
• Strangulation: it is when part of the intestine is trapped in the abdominal wall (incarcerated hernia), blood flow to this portion of the intestine may be diminished, and it may lead to the death of the affected bowel tissues. A strangulated hernia is life-threatening and requires immediate surgery..

 

Prevention

There is no preventive method that can prevent the congenital defect that leads to inguinal hernia; however few steps may be used to help reduce strain on the abdominal muscles and tissues. Some of these are:

• Maintain a healthy weight
• Emphasize high-fiber foods like fresh fruits and vegetables and whole grains.
• Lift heavy objects carefully or avoid heavy lifting altogether. Always bend from the knees to lift heavy objects not from the waist.
• Stop smoking
• Don't rely on a truss, a supportive garment designed to keep hernias in place..