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All you need to know about HERNIA | 05th April, 2017

 
What is a hernia?
A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall.
 
Hernias are most common in the abdomen, but they can also appear in the upper thigh, belly button, and groin areas. Most hernias are not immediately life threatening, but they don’t go away on their own and can require surgery to prevent potentially dangerous complications.
 
Common hernia types
 
Inguinal hernia
Inguinal hernias are the most common type of hernia. They make up about 70 percent of all hernias, according to the British Hernia Centre (BHC). These hernias occur when the intestines push through a weak spot or tear in the lower abdominal wall, often in the inguinal canal.
 
The inguinal canal is found in your groin. In men, it is the area where the spermatic cord passes from the abdomen to the scrotum. This cord holds up the testicles. In women, the inguinal canal contains a ligament that helps hold the uterus in place.
 
This type of hernia is more common in men than in women. This is because a man’s testicles descend through the inguinal canal shortly after birth, and the canal is supposed to close almost completely behind them. Sometimes, the canal does not close properly and leaves a weakened area prone to hernias.
 
Hiatal hernia
A hiatal hernia occurs when part of your stomach protrudes up through the diaphragm into your chest. The diaphragm is a sheet of muscle that helps you breathe by contracting and drawing air into the lungs. It separates the organs in your abdomen from those in your chest.
 
This type of hernia is most common in patients over 50 years old. If a child has the condition, it’s typically caused by a congenital (birth) defect. Hiatal hernias almost always cause gastroesophageal reflux, which is when the stomach contents leak backward into the esophagus, causing a burning sensation.
 
Umbilical hernia
Umbilical hernias can occur in children and babies under 6 months old. This happens when their intestines bulge through their abdominal wall near their bellybutton. You may notice a bulge in or near your child’s bellybutton, especially when they’re crying.
 
An umbilical hernia is the only kind that often goes away on its own, typically by the time the child is 1 year old. If the hernia has not gone away by this point, surgery may be used to correct it.
 
Incisional hernia
Incisional hernias can occur after you’ve had abdominal surgery. Your intestines may push through the incision scar or the surrounding, weakened tissue.
 
CAUSES
 
What causes a hernia?
Hernias are caused by a combination of muscle weakness and strain. Depending on its cause, a hernia can develop quickly or over a long period of time.
 
Common causes of muscle weakness include:
 
failure of the abdominal wall to close properly in the womb, which is a congenital defect
age
chronic coughing
damage from injury or surgery
Factors that strain your body and may cause a hernia, especially if your muscles are weak, include:
 
being pregnant, which puts pressure on your abdomen
being constipated, which causes you to strain when having a bowel movement
heavy weight lifting
fluid in the abdomen, or ascites
suddenly gaining weight
persistent coughing or sneezing
 
Am I at risk for a hernia?
The factors that increase your risk of developing a hernia include:
 
a personal or family history of hernias
being overweight or obese
a chronic cough
chronic constipation
smoking, which can trigger a chronic cough
Conditions such as cystic fibrosis can also indirectly increase your risk of developing a hernia. Cystic fibrosis impairs the function of the lungs, causing a chronic cough.
 
SYMPTOMS
 
What are the symptoms of a hernia?
The most common symptom of a hernia is a bulge or lump in the affected area. In the case of an inguinal hernia, you may notice a lump on either side of your pubic bone where your groin and thigh meet. You’re more likely to feel your hernia through touch when you’re standing up.
 
If your baby has a hernia, you may only be able to feel the bulge when he or she is crying. A bulge is typically the only symptom of an umbilical hernia.
 
Other common symptoms of an inguinal hernia include:
 
pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting
weakness, pressure, or a feeling of heaviness in the abdomen
a burning, gurgling, or aching sensation at the site of the bulge
Other symptoms of a hiatal hernia include:
 
acid reflux, which is when stomach acid moves backward into the esophagus causing a burning sensation
chest pain
difficulty swallowing
In some cases, hernias have no symptoms. You may not know you have a hernia unless it shows up during a routine physical or a medical exam for an unrelated problem.
 
DIAGNOSIS
 
How is a hernia diagnosed?
Inguinal or incisional hernias are usually diagnosed through a physical examination. Your doctor may feel for a bulge in your abdomen or groin that gets larger when you stand, cough, or strain.
 
If you have a hiatal hernia, your doctor may diagnosed it with a barium X-ray or endoscopy. These tests allow your doctor to see the internal location of your stomach:
 
A barium X-ray is a series of X-ray pictures of your digestive tract. The pictures are recorded after you’ve finished drinking a liquid solution containing barium, which shows up well on the X-ray images.
An endoscopy involves threading a small camera attached to a tube down your throat and into your esophagus and stomach.
If your child has an umbilical hernia, your doctor may perform an ultrasound. An ultrasound uses high-frequency sound waves to create an image of the structures inside the body.

     
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