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What are hernias and what causes them?

In the past two weeks, we’ve heard of two people who need hernia surgery. But what exactly is a hernia and what causes them?

A hernia is a condition in which part of an organ protrudes through the wall of the cavity containing. Oftentimes, it involves the intestine at a weak point in the abdominal wall. While some medical conditions can put pressure on the abdominal wall and cause a hernia, like:

  • Straining on the toilet (due to long-term constipation, for example)
  • Straining to urinate
  • Persistent cough
  • Cystic fibrosis
  • Enlarged prostate
  • Childbirth
  • Abdominal fluid
  • Peritoneal dialysis
  • Undescended testicles

Other times, hernias can be caused by our way of life, such as:

  • Being overweight or obese
  • Lifting heavy items
  • Poor nutrition
  • Smoking
  • Physical exertion

There are several types of hernias and some more severe than others.

Inguinal Hernias is the most common type of hernia and more common in childhood and old age. About two-thirds of people who have a hernia have this type, and it’s more common in men than in women. They occur in part of the abdominal wall called the inguinal canal where a man’s testicles must descend before birth. If the opening does not properly heal, the contents of the abdomen, such as intestine, may protrude through this opening just above the leg crease, near or adjacent to the pubic area. However, in older men, these can occur due to a weakness in the groin area.

Ventral Hernias can occur through the scar due to a past abdominal surgery — weeks, months or years after surgery. They can vary in size from small to very large and complex. If you think you have a ventral hernia, see your doctor immediately as it may widen and become very difficult to repair.

Femoral Hernias are more common in women than men and like inguinal hernias, they appear in the groin area. They are usually the result of pregnancy or childbirth.These hernias are more prone to develop strangulation of the intestines as an early complication. Once diagnosed, it’s important to have surgery to repair it sooner rather than later.

Umbilical Hernias are a bulge in the belly button region, which has a natural weakness from the blood vessels of the umbilical cord. These hernias may occur in infants and may resolve themselves by age three of four. In adults, umbilical hernias will not resolve themselves and may worsen over time. They can be caused by being overweight, excessive coughing, or pregnancy.

Epigastric Hernias occur due to a weakness, gap or opening in the muscles or tendons of the upper abdominal wall, between the breastbone and the navel. These types of hernias are more common in men than in women.

Hiatal Hernias are caused by the upper part of the stomach pushing out of the abdominal cavity and into the chest cavity through an opening in the diaphragm.These types of hernias cause acid reflux which can lead to heartburn, pain, and erosion of the esophagus. Surgery is required for this type of hernia and is more complicated.

Oftentimes hernias do not produce troubling symptoms, but abdominal complaints may mean a more serious problem is progressing.

In some cases, a hernia needs immediate surgery, for instance, when part of the gut becomes obstructed or strangulated by an inguinal hernia. A strangulated hernia happens when part of your intestine or other tissue becomes tightly trapped and the blood supply is cut off. Strangulated hernias can result in gangrene. This condition is considered a medical emergency and requires immediate surgery to undo the blockage and repair the hernia. Immediate medical attention should be sought if an inguinal hernia produces acute abdominal complaints such as:

  • Pain
  • Nausea
  • Vomiting

With the exception of an incisional hernia (a complication of abdominal surgery), in most cases, there is no obvious reason for a hernia to occur.

The risk of hernia increases with age and occurs more commonly in men than in women.

If you do think you have a hernia, seek medical attention. They are usually simple to diagnose, simply by feeling and looking for the bulge. Your doctor will advise you on whether you need surgery or if you should watch and wait for symptoms to persist. Just don’t wait too long, as you may make matters worse.

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