Hernia is a protrusion of an organ, usually the small bowel, outside of its natural cavity or position. It occurs through areas of weakness in the abdominal area usually and commonly presents as a bulge, especially on straining. Hernias can be diagnosed based on signs and symptoms, but occasionally radiological imaging may be required.

Common Types of hernia

• Inguinal ( lump or pain in the groin)
• Femoral
• Incisional ( Over any previous operation scar)
• Umbilical/ paraumbilical
• Ventral etc.

Risk factors for hernia

Any activity which increases the intraabdominal pressure or involves straining. Chronic cough, chronic straining to pass urine or pass motion, carrying heavy weights, chronic obstructive lung disease etc.

Symptoms of a hernia

Usually, a bulge, pain or discomfort over the hernia site when straining or walking. It may go away when lying down.

Risk of a hernia

Hernias if left untreated, may stay the same or get progressively bigger and symptoms may worsen. There is no medication to treat hernias, which are treated with surgery. The underlying predisposing causes (i.e. straining, cough etc.) should be treated first to prevent recurrence. The main risk of having a hernia is if the intestines become incarcerated or stuck inside and cannot be reduced. There is a risk of strangulation of the intestines within and this may cause intestine obstruction, gangrene or perforation of the bowel. The signs and symptoms are usually severe pain and tenderness over the hernia site. If this happens it is a life threatening emergency and immediate surgery is required.

Treatment

Hernias are repaired via surgery and a mesh is usually placed to strengthen the defect. This can be done via open method or “keyhole” / minimally invasive technique. Do see a specialist to discuss which method is suitable for you.

Recovery

Most patients are able to return to work within a week or two, but more intense exercise should be avoided for a more prolonged period. The main risk involved in this operation is infection, bleeding, swelling, damage to the surrounding structures, persistent pain( 10 %), mesh rejection and hernia recurrence ( especially if the patient continues to strain).