What is it?
A hernia is a section of intestine or fatty tissue poking through a weak spot between the muscles of the abdomen. Hernias can occur in a number of places: the umbilicus (umbilical hernia), the groin (inguinal hernia) and on the inside of the upper thighs (femoral hernia). The inguinal hernia is one of the commonest.
What could cause it?
Hernias happen in one of two ways:
• There could be weak spots in between the muscles from birth.
• Some other condition may have damaged initially intact muscles.
Things like lifting heavy load, having a cough for a long time, or straining to pass stool can make hernias worse, but they don’t cause them in the first place.
What are the symptoms?
A bulge is usually felt around the groin on either or both sides. It may not be felt easily on sitting or lying down, but coughing or straining makes the bulge get bigger. Some people have hernias that don’t cause them any problems. But in others, hernias can cause discomfort or pain especially when they bend over or strain.
Hernias can be described as “reducible” or “non-reducible”. This means the ability or inability to push it back respectively. Hernias are often able to come out after being pushed back. In men, the lump can move into the scrotum and cause pain.
Sometimes, an initially painless hernia can suddenly become very painful when it becomes trapped and its blood supply cut off. This is called a strangulated hernia. It’s very dangerous and needs emergency attention. A fever can also occur, and the surface of the hernia may change colour. If any of these happens, it’s important to see a doctor right away.
What is the treatment?
If the hernia is not causing any problems, one may just decide to manage it while watching out for any complications.
However, surgery can be done to give a lasting solution. It is called a herniorrhaphy (“rhapphy” for “repair”). It can have complications just like every other surgery. They include infection and bleeding.
In addition, the conditions that can make hernias worse are taken care of so that the operation site doesn’t become weak again. This involves treating the chronic cough, and taking enough water and stool softeners to prevent constipation.
What will happen to me?
Choosing not to have surgery right away does not increase your chance of having problems or of having a worse outcome from surgery in the future.
Most people recover well after surgery and only need one follow-up appointment to check that they are healing and recovering well. But you should go back to hospital right away if you are in a lot of pain or if you vomit.