Definition
A hernia is a weak area in the abdominal wall that allows organs that normally live inside the abdomen to protrude through and form a bulge. Hernias are mostly in the abdominal wall, and groin. They are also common in scars from prior abdominal surgery.
Types of hernias
- Ventral- anterior abdomen
- Umbilical- at the belly button
- Inguinal -in the groin. These can form in a weakness that is there from birth.
- Femoral-outer groin
- Incisional hernia-from prior surgical incision or scar
- Hiatal: Not on the abdominal wall but rather inside the upper abdomen when the stomach or intestines go into the chest
Causes
Increased pressure in the abdomen as caused by:
-Lifting heavy things
-Severe coughing
-Constipation
-Diarrhea
-Obesity
Presentation or symptoms
-A bulge in the area of the hernia either in the groin or abdomen
-The bulge can come in and out.
-Pain over the hernia site, burning or a dull ache
-Hiatal hernias present differently, not with a bulge but with heartburn, shortness of breath, trouble swallowing, or cough.
When to seek medical attention
These can be a sign of an emergency where you need to go to the Emergency room
-Painful bulge
-Bulge that no longer goes in
-Nausea and vomiting
-Constipation
-Difficulty breathing or swallowing
Nonemergent
-Dull ache
-Bulge that goes in and out
-Bulge that’s getting bigger
Diagnosis
A physical exam can be enough to diagnose the hernia
CT scan is very helpful for all types of hernias but not always necessary.
Treatment
-Surgery is the standard of care for hernias
-Most hernias will be repaired with mesh, which is a piece of plastic that reinforces the weakened wall and reduces the chances of the hernia coming back
-Small and asymptomatic hernias can be watched. But if they start getting bigger or symptomatic, then surgical repair should be considered.
-Hernia Truss is a supportive undergarment that can help to hold the hernia in and reduce discomfort.
-Weight loss
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