Hernia repair is one of the most commonly performed surgical procedures. Surgeons make approximately 1 million hernia repairs in the United States annually. Caused by tissue bulging through an opening in abdominal muscles, hernias can be painful.
The only way to correct a hernia is with surgery, although if there are no symptoms, you can put off surgery until later. Experienced surgeons can easily repair a groin hernia, the most common type, and all other hernias with few risks or side effects.
What is a Hernia?
A hernia is a piece of tissue or organ pushing through a gap in muscle, creating a noticeable bulge. Most hernias occur in the abdomen and involve intestines pushing through openings in abdominal muscle, but they can develop in other parts of the body.
Hernias don’t always cause symptoms, so you might not realize you have one until it develops and grows larger. Common symptoms of most types of hernias include:
- Pain or discomfort in the area of the hernia
- Pain that worsens with standing, lifting, or straining
- A visible bulge under the skin
A hernia can become strangulated, which means it gets stuck in the gap in the muscle tissue, reducing blood flow. Symptoms of a strangulated hernia include nausea, vomiting, and bowel obstruction. It should be treated immediately by a specialist surgeon or hernia doctor.
What Causes Hernias?
Anything that creates pressure on the abdominal wall can cause a hernia. A hernia can occur suddenly or slowly over time with repeated pressure. Sudden causes include lifting heavy objects, straining during a bowel movement, or any other activity that involves abrupt straining, pulling, or twisting.
There isn’t always a single or identifiable cause of a hernia, but there are known risk factors:
- Older age: As you get older, your muscles weaken, making it easier for a gap to form.
- Obesity: Extra weight puts pressure on muscles, increasing the risk of an opening.
- Pregnancy: One out of every 2,000 pregnant women develops a hernia.
- Medical conditions: Certain connective tissue disorders make it more likely that a gap will form in the abdominal wall.
- Straining: Chronic straining during bowel movements can lead to a hernia over time.
- Family history: You might be more likely to develop a hernia if a close family member has had one.
Babies can be born with hernias too, but the symptoms usually don’t appear until much later.
Types of Hernias
Abdominal wall hernias are the most common, and these can be divided further:
An umbilical hernia occurs in the area of the belly button. This is a common type in newborns and babies, and it can resolve on its own as the abdominal wall strengthens. Adults can also get umbilical hernias.
A hiatal hernia is when the stomach pushes through the diaphragm and into the chest cavity. It occurs most often in older adults and causes different symptoms from other hernias. These include heartburn, acid reflux, regurgitation of food, chest pains, difficulty swallowing, feeling full, and shortness of breath.
Groin Hernias – Inguinal Hernia vs. Femoral Hernia
A herniated groin occurs lower in the abdomen, in the groin area. An inguinal hernia occurs in the inguinal canal. In men, it carries blood vessels and the spermatic cord and leads to the testicles, while in women it contains a ligament that supports the uterus.
Most of the hernia repairs performed in the U.S. each year are inguinal, and 90% of these occur in men. When the testicles descend through the inguinal canal after birth, the gap behind them doesn’t always close fully. This is why inguinal hernias are much more common in men.
Femoral hernias are groin hernias that do not involve the inguinal canal. They develop in the groin near the top of the thigh and are more common in women. There is a high risk of strangulation, and they are typically repaired immediately.
The only true treatment for a hernia is to repair it surgically. However, for some patients, a wait-and-see approach is appropriate. You might be able to manage symptoms with pressure applied to the hernia site. Trusses and belts can help, but they should be fitted properly to prevent or lower the risk of strangulation.
Surgical treatment for a hernia involves pushing the protruding tissue back into place and strengthening the abdominal wall and muscle tissue. Depending on the location and extent of the hernia, a surgeon might use open or minimally invasive laparoscopic surgery to repair it.
Hernia surgeons have two choices for repairing the damaged muscle tissue. They can stitch the muscle back together using only sutures. Another option is to close the gap using a piece of surgical mesh. They stitch the mesh into stronger muscle tissue. Mesh is usually a better option for large hernias. With sutures alone, the hernia may recur.
After performing the procedure, the surgeon will outline your recovery and what you can and can’t do. You will also have a plan for pain management.
If you have symptoms of a hernia, you need a specialist, a surgeon experienced in repairing hernias. To consult with one of our highly qualified hernia doctors at North Carolina Specialty Hospital, call our office or request an appointment online.