UNDERSTANDING HERNIA

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Hernia is when an organ or tissue breaks through the weak spot or organ encapsulating it. A hernia are most common in the abdomen. For instance, the bowel loop breaks through the muscle or fascia, this hernia bowel loops or fat/omentum could be intermittent, meaning that it occurs at intervals. Sometimes, the patient complains of a bulging mass when they cough or do strenuous exercise. Sometimes, hernia can be harmless and pain-free, but at times it can bring discomfort and pain. The weak muscle or fascia through which the bowel loops herniate may have a wide neck that could measure up to 3cm in diameter.

TYPES OF HERNIAS
Abdominal hernias
An abdominal hernia is the type of a hernia that occurs when there is an opening or weakness in the muscular structure of the wall of the abdomen. Many activities can worsen or increase the pressure of the intra-abdominal content E.g of these activities are lifting heavy objects, coughing, bowel movement, straining to urinate. Serious complications from hernia can result from the trapping of tissues in the hernias which is known as or called incarceration. This trapped tissues may have their blood supply cut off leading to damage or death of the tissue. The treatment of incarceration usually involves surgery. Abdominal hernias may occur in infants, children and adults. Both in males and females. However, the majority of abdominal hernias occur in males and about 10% of the population will have an abdominal hernia during their lifetime. Here are the different types of abdominal hernias

  • inguinal (groin)
  • Epigastric hernia
  • umbilical hernia
  • incisional hernia
  • hiatal hernia
  • Spigelian hernia
  • lumbar hernia
  • internal hernia
  • Inguinal (groin) hernia- an inguinal hernia is the common location for hernias because there is a natural anatomical weakness in the groin region which results from incomplete muscle coverage. This type of hernia is found in the groin. It occurs when the intestines push through a weak spot or tear in the lower abdominal wall often in the inguinal canal. This type of a hernia is more common in males than females. Several different types of a hernia may occur and frequently coexist in the groin area. These include direct, indirect, and femoral hernias.
  •   Epigastric hernia- this is when fat or omentum pushes out through the weak wall of the abdomen between the umbilicus (belly button), sternum and forms a lump.
  •   Umbilical hernia- this is most common in children and babies under 6months old, it usually goes on its own at the age 6. When it persists after this age, medical attention will be needed. This happens when the intestines bulge through the abdominal wall near the belly button.
  •   Incisional hernia- this is the reoccurrence of hernia after surgery.
  •   Hiatal hernia-  this occurs when part of the stomach protrudes up through the diaphragm into the chest cavity.
  •   Spigelian hernia-  this is also known as a lateral ventral hernia. It is when fat or omentum herniate into the weak muscle between rectus abdominis muscle medially, and the semilunar line laterally.
  •   Lumbar hernia- this type of a hernia is very rare. It is the protrusion of the intraperitoneal or extraperitoneal contents through a defect of the posterolateral abdominal wall.
  •   Internal hernia- this is the prolapse of intestinal loops or fat through a congenital or acquired opening within the peritoneal cavity.

CAUSES OF HERNIA
Generally, hernias are caused by a combination of pressure and weakness of muscle or fascia. Things and activities that can cause pressure in the abdomen to include:
* diarrhoea or constipation
*pregnancy
*ascites
*persistent coughing or sneezing
*lifting heavy objects without stability
*age
*damage from injury
*failure of the abdominal wall to close properly in the womb.
However, being overweight or obese, family history of a hernia and smoking which triggers a chronic cough can be a risk factor of developing a hernia.

SIGNS AND SYMPTOMS
The most common signs and symptoms of a hernia is a bulge or a lump which can be felt through touch when standing up. However, you can feel the bulging of a hernia in a baby when they are crying. Other signs and symptoms include:
*feeling heaviness in the abdomen
*burning or aching sensation at the site of the bulge
*pain or discomfort in the affected area.

DIAGNOSIS
Hernias are usually diagnosed through a physical examination. Your doctor may feel a bulge and advise for ultrasound, barium meal, or endoscopy.

TREATMENT
Treatment depends on the size of a hernia and the severity of the symptoms. Treatment options for hernias are surgery, medication, and lifestyle changes. The surgery maybe open or laparoscopic repair.

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