6 Facts About Hernias
If you’ve never had a hernia before, you may not know exactly what they are or think of it as just another type of muscle pull. But they’re a bit more serious than that.
“In simplest terms, a hernia is a hole in the muscle layer. Through that hole, tissue that belongs in the abdomen can bulge through,” said Dr. William Bothwell, a board-certified general surgeon who specializes in hernia repairs at Abington-Lansdale Hospital.
Here’s everything else you need to know about hernias.
1. There’s more than one type of hernia
“There are several types of hernias, but the most common are groin hernias, or inguinal hernias,” Dr. Bothwell said.
Another common type of hernia is congenital hernias, which he explained is a weakness someone is born with. Abdominal wall weakness that leads to a hernia can also develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity or coughing.
2. Hernias are more common in males
Simply based on their anatomy, it’s more common for men to develop hernias.
“As the testicles develop in the abdomen, it creates a small area of weakness that 20 percent of men don't feel,” Dr. Bothwell said. When a baby is in the womb, after the testicles form in the abdomen, they then move down the inguinal canal into the scrotum. The inguinal canal closes almost completely shortly after birth, leaving just enough space for the spermatic cord to pass through the abdomen, but not enough room for testicles to move back into the abdomen. However, this canal may not close properly, which can leave a weakened area prone to hernias.
3. Simply lifting something heavy can cause one
Heavy lifting or any activity or medical issue that increases the pressure on the tissue in the belly wall and muscles may cause or aggravate a hernia, including straining during urination or bowel movements, excess weight and chronic coughing or sneezing.
4. The more severe the hernia, the more serious the complications can be
“Hernias can be quite small and of no major concern or they can be very large, extending into the scrotum, obstructing the bowel, or disrupting the bowel,” Dr. Bothwell said.
Large, unrepaired hernias can put pressure on surrounding tissues and, in men, can extend into the scrotum causing pain and swelling. If a loop of intestine gets trapped in a weak spot in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting and being unable to have bowel movements or pass gas – this is referred to as an incarcerated hernia.
“In serious cases, you can develop gangrene in your intestines, which can be life threatening,” he said. This severe complication is the result of a condition called strangulation – a hernia may cut off blood flow to part of your intestine, causing the death of the impacted bowel tissue.
5. Surgery is the only way to repair hernias
“The only way to repair a hernia is surgically. There are different techniques, including open and laparoscopic techniques,” Dr. Bothwell said.
However, just because you have a muscle weakness in your abdomen or have a hernia doesn’t necessarily mean you have to have surgery now.
“For small hernias that aren't causing much discomfort or symptoms and are at a low risk of [it becoming an incarcerated hernia], we’ll advise the patient to watch it, look for bulging or pain,” Dr. Bothwell said. “But if it's symptomatic, it really should be fixed.”
6. Obesity plays a big role in the development and treatment of hernias
“Obesity is a big risk for hernias. When you’re overweight, your abdominal pressure is already high,” Dr. Bothwell said. But being obese doesn’t just put you at risk of developing a hernia; it can complicate repairing a hernia and make it likely you’ll develop another one later.
“Typically, the ideal weight for fixing a hernia is under 200 pounds, depending on [the patient’s height]. If a patient is obese, we’ll put them on a weight reduction plan because their risk of recurrence and infection is much higher,” he explained.
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