Examining the Treatment and Prevention of Hernias
Often the result of excessive coughing, weight gain or heavy lifting, a hernia is an easily treatable condition that could become life-threatening if left neglected.
Hernias occur when an organ protrudes through a weak spot in a nearby muscle. They most commonly develop in the groin, stomach and belly button areas. Incisional hernias are a type of hernia that can occur at the site of a surgical incision.
Symptoms remain relatively standard across all types of hernias, or may not appear at all.
“It’s common to have a hernia without symptoms, but they should still be checked by a doctor,” said John Phu, MD, a general surgeon at Abington - Jefferson Health who sees patients with hernia conditions on a regular basis. “With symptomatic hernias, if the hernia is repairable, it should be surgically repaired on an outpatient basis.”
Typically, a symptomatic hernia will be marked by a lump in the abdomen or groin that can be pushed back in, or may go away when lying down. Exerting pressure in the abdominal region by strained coughing, hearty laughing or even crying can push the hernia back out. Oftentimes, a doctor can diagnose a hernia in a physical exam, but an ultrasound or CT scan may sometimes be necessary.
Treatment and Recovery
“In non-emergent surgeries, the repair can be done with different approaches, including open or minimally-invasive,” said Dr. Phu. “The approach should be discussed with the surgeon to determine what is appropriate for an individual’s situation.”
The majority of the time, repairs are mesh-based to reinforce abdominal layers and increase strength of repair. Recurrence rates for open mesh-based repair are less than one percent, says Dr. Phu.
Surgery, if done electively, is an outpatient procedure. Recovery is relatively quick, with patients getting back on their feet within a few days. Typical restrictions include no heavy lifting for a given period of time which would be decided by the surgeon. After that, patients find themselves going back to their normal habits relatively quickly.
If left untreated, hernias can cause a bowel obstruction, where part of the intestine is lodged in the inguinal canal. This can cause nausea, vomiting and stomach pain. It is also possible for part of the intestine to become trapped in a position where blood supply is cut off. This is known as strangulation. When strangulation occurs, emergency surgery is required to repair the hernia, which is why Dr. Phu recommends that the surgery be done electively, before complications arise.
Those at a higher risk for developing a hernia include people who have recently gained weight, smokers, people whose work requires heavy lifting and straining and individuals living with COPD. Smokers are at a higher risk because the tissues in their bodies are weakened, leaving them easier to protrude through.
Another common hernia type is an incisional hernia, which develops at the site of a previous surgery. Typically, patients have the most risk for developing an incisional hernia three to six months after their procedure. This risk becomes amplified if the individual becomes pregnant, gains weight or takes part in strenuous activity.
To avoid developing a hernia, Dr. Phu recommends that patients work to lower their preventable risk factors. This includes maintaining a healthy diet, exercising frequently and quitting smoking.