Carolinas Equation for Quality of Life - CeQOL
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Hernias in General
Hernias are generally considered as a weakness, defect, or “hole” in the abdominal wall or other structure through which tissue or organs can move outside their normal location. Each hernia and its treatment should be individualized according to its location, contents, the age and medical status of the patient, symptoms it may be causing (including pain or intestinal issues), and a physician’s assessment of the hernia’s risk to the patient and the risk of surgery to repair it. The key reasons to repair a hernia in an adult is that they do not heal or repair themselves, they tend to get larger with time, they often become painful or develop other problems, and tissue or organs pushed through the hernia can become trapped and require an emergency operation. All of these considerations, especially the latter one, should be assessed by and discussed with your doctor or surgeon.
Abdominal Ventral Hernia
Ventral or abdominal hernias occur when the intestine or other abdominal contents push through a weakness or “hole” in the abdominal wall. If the bulge occurs in the area of a previous surgical incision, these hernias are referred to as incisional hernias. The area of any surgical opening will always remain somewhat weakened throughout a person’s lifetime. Hernias can develop in these incisions during the weeks, months or even years after the initial operation. There are many factors that can affect the formation of an incisional hernia including smoking, being overweight, other medical problems, and a person’s genetics which dictates the type of healing tissue the patient naturally forms after a surgical incision.
An umbilical hernia occurs in the naturally weakened area of the navel or belly button where the umbilical cord was attached as an infant. When seen in babies or small children, these hernias frequently get smaller close on their own as the child ages. In adults these hernia do not close on their own and the only way to treat them is through surgery.
An inguinal hernia is the most common type of hernia - about two percent of all men will develop this type of hernia during their lifetime. They occur in woman as well, just not as often. These hernias tend to form in the area where the blood vessels to the testicle move through the abdominal wall in men or where a small ligament to the uterus attaches in women. This area is a persistent area of potential weakness throughout someone’s life. Inguinal hernias can also arise right beside this area, in the floor of the groin. The exact location of the hernia does not impact how the repair is initiated. The operation to repair both types is very similar.
Femoral hernias are often categorized with and compared to inguinal hernias, but they occur just under the groin. They are most common in women, but men do develop them as well. They occur when there is a weakness near the blood vessels travelling from the abdomen to the upper thigh. They are hard to distinguish from inguinal hernias on physical exam.
Hiatal hernias occur when the stomach slides up through the diaphragm into the chest. Common symptoms are heartburn or Gastroesophageal Reflux Disease, which is sometimes called GERD. Paraesophageal hernias are considered to be more dangerous and occur when part of the stomach is free enough to move up into the chest beside the esophagus. The stomach can be floppy enough to twist on it self. This can lead to significant symptoms and even to strangulation, which would require emergency medical care and surgical correction. These hernias are not abdominal wall hernias and are treated in a very different way from inguinal and ventral or incisional hernias. These hernias are not part of the study or application we have developed.
Hernia Frequently Asked Questions (FAQ)
What is a Hernia?
A hernia is a weakness or tear in the abdominal muscles or diaphragm that allows organs, such as intestines or fatty tissue, to extend through the weakened area. This can cause a noticeable bulge under the skin or symptoms of pain or discomfort, cosmetic concerns, and intestinal issues. Symptoms can worsen when standing for long periods or straining the abdominal muscles, such as when lifting heavy objects.
What Causes a Hernia?
Many hernias are the result of a defect or weakness in the abdominal wall that was present at birth. The area can be further weakened by age, injury, pregnancy, weight gain and especially by a previous surgical incision. Although some hernias are more common in men, they can develop in anyone. Risk factors for a hernia include:
- Chronic cough
- Family history
- Premature birth
- Straining while lifting heavy objects
- Straining during bowel movements or urination
- Certain medications such as steroids
How can I tell if I have a Hernia?
Think of a hernia as a bulge in a tire. The outer wall of the tire is like your abdominal wall. The inner tube of the tire is like your intestines. Most of the time, the outer wall of the tire is strong enough to hold the inner tube, but if the wall weakens, a bulge may occur. This is similar to the way a hernia might form in the abdominal wall or groin. Many hernias will present with symptoms. Often, however, a hernia may not be noticed until your doctor discovers it during a medical exam. Symptoms that people often report include:
- A clear bulge or bump in the groin area or abdomen or at the belly button
- Groin or abdominal discomfort, anytime or especially after working, straining, lifting or bending over – any activity that increases pressure in the abdomen
- Burning, aching or gurgling sensation in the groin or abdominal wall
- Pressure in the abdominal wall or groin
What should I do if I think I have a hernia?
If you have any symptoms of a hernia or are concerned you might have one, see your primary care doctor. After listening to your history and symptoms, he or she can decide if you need to have any tests done or if you need to see a surgeon. Symptoms from a hernia usually get worse over time, but sometimes the hernia has no symptoms until it becomes trapped. A trapped or “incarcerated” hernia could become an emergency and should not be ignored.
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