How to recognize – and treat – a hernia

July 22, 2019
Doctor Ashley Marek, MD

Ouch! Is it a hernia? Surgeon Ashley Marek, MD explains:

A hernia is caused by weakening or tear in the abdominal wall that lets the intestines or other tissue bulge out. The abdomen is covered by tight connective tissue that’s like an envelope that surrounds the muscles and holds the organs in place. Some spots where that tissue is naturally weak – around the bellybutton, and in the groin – are more prone to hernias. Past surgeries can cause weak spots too, where the muscles have healed but aren’t as strong as they originally were.

Sometimes hernias are just bad luck. But there are some risk factors:

Smoking. Smokers don’t heal as well after surgery. Over time, smoking also makes tissues weak; plus, smoking causes coughing, which increases intra-abdominal pressure and raises the risk of hernia.  Obesity. Extra weight increases pressure inside your abdomen. Heavy lifting. This is especially true for men, who are more prone to hernias than women.

See your doctor or surgeon if you:

have pain in abdomen or groin notice a bulge in abdominal wall or groin (with or without pain)

 Kids can get hernias too. If you notice a bulge in your child’s abdomen, see your pediatrician or family doctor; they may refer you to a surgeon.

There’s no way for a hernia to go away without surgery, though not everyone needs to have surgery right away. If there’s no pain, or you can push the bulge back in easily, you might decide to wait and see if it begins to bother you – gets more tender, sticks out more and won’t push back in, or if it causes you anxiety.

If it’s causing pain or discomfort, it should be repaired. There are a few uncommon types of hernia that require repair when they are diagnosed. It’s a good idea to at least meet with a surgeon to discuss before deciding not to fix yours.

If the hernia becomes very painful, that can mean the intestine is trapped inside the hernia, cutting off blood flow to the intestine. This is uncommon, but it can be life-threatening and should be repaired immediately. If you develop significant pain, go to the Emergency Department.

Almost all hernias are repaired with mesh. It’s the current standard of care for hernia repair as mesh significantly reduces risk of hernia recurrence.

Surgical methods are laparoscopic, robotic, and open surgery. The best option depends on the size and location of hernia, plus individual patient factors.

Hernia repair is most often an outpatient surgery. The patient is sore for a few days to a week, then usually back to work at in two weeks with no heavy lifting for four weeks after surgery. After four weeks, it’s usually back to their regular routine.

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