Hernia
What is a Hernia?
A hernia occurs when tissue from an organ or growth protrudes outside of its normal location. Normally, strong, connective tissue or muscle called fascia hold organs in place. However, when there’s a weak spot or a hole in the fascia, tissue from other organs in the body can push against it and form sacs (a hernia). They are usually detected during physical exams of the body, and can be detected with radiology scans such as ultrasound or CT scan.
While hernias can form at various locations in the body, the most common hernias occur inside the groin (inguinal hernia), outside the groin (femoral hernia), near post-surgical stitches or scars (incision hernia), near the belly button (umbilical hernia) and at the top of the stomach (hiatal hernia). Gastroenterology deals primarily with hiatal hernias in patients who experience abdominal pain and heartburn that worsens if the hernia grows. A hiatal hernia happens when the stomach pushes up against the diaphragm. Usually, treatment is only necessary if a patient’s pain is severe or if the hernia is causing mechanical issues, such as severe heartburn, chest pain, or difficulty eating.
What Causes a Hernia?
Having weak spots in connective tissue muscle does not always mean that a patient develops a hernia. Sometimes vigorous physical activity such as lifting heavy items can cause certain organs or tissue to shift and push against these vulnerable areas and form a hernia.
A person can also be born with a hernia that just does not manifest and start to produce symptoms until later in life. Usually, hernias that occur in infants result from improper tissue formation, when the lining around certain organs fails to develop fully before birth. About 5 percent of babies are born with an inguinal hernia in their inner groins.
Furthermore, some underlying medical conditions that cause pressure against the abdomen to increase may also trigger the formation of a hernia. Such conditions include:
- Constipation—that forces patients to strain while passing stool
- Long-term, deep coughing—that can irritate and increase pressure in the chest
- Weight gain—which directly increases pressure on bodily organs
- Cystic fibrosis—a mucous-producing lung disease that can cause bloating and coughing
- Swollen prostrate glands—that forces a man to strain while urinating
- Vigorous physical activity—can cause the hernia to expand and worsen symptoms
How is a Hernia Treated?
To treat a hernia completely, surgery must be performed in order to fix the structural problems associated with weak fascia. However, surgery is only resorted to in dire cases when the hernia causes extreme symptoms or poses a serious health threat to a patient. Most of the time, a small hernia that produces little to no symptoms will merely be monitored as a precaution, just in case there’s a complication.
Surgical procedures to repair hernias involve repairing weak muscle tissue and closing up any holes that have formed. This is usually done with stitches and pieces of cloth. Immediate surgery is only necessary if the hernia gets lodged into a hole and can’t pass through, thereby cutting off the body’s natural blood supply (obstruction). Leaving this situation untreated can lead to dead tissue and severe medical complications, including death. Nevertheless, the prognosis looks very good for patients with hernias—after treatment, it is rare that the hernia ever returns. Call your medical doctor if you think you may have a hernia stuck inside your body or if an external hernia has recently changed color.
Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014
