Hernias. The signs, symptoms and surgery
Wednesday 22 November 2017

One in 10 people will get a hernia at some point in their life, and hernia procedures are the world’s most common surgical operation. But what causes hernias, what exactly are they and how are they treated?

Abdominal wall weakness

A hernia happens when there is a weak spot in the layer of muscle in the abdominal wall, which results in an internal part of the body, for example the intestines, poking through. A lump or swelling is seen against the skin, often around the stomach or groin.

The abdominal wall is made up of muscle and tendons, and runs from the ribs to the groin. Its job is to hold the intestines and contents of the abdomen in place.

Causes and complications

There are a number of different types of hernias and various causes. There may be a weak spot because an area didn’t close properly where the umbilical cord was attached at birth, for example, or where there has been previous surgery in that part of the body.

Hernias can also be caused by repeated strain or pressure being put on the abdomen, or can simply be due to ageing.

A hernia can become dangerous when the blood supply to a section of organ or tissue trapped in the hernia becomes cut off. This is called ‘strangulation’.

Signs and symptoms

If you have a hernia, you will notice a swelling or lump along the front of your body, somewhere between your chest and groin. Coughing or straining can make the lump appear, and the lump can then disappear when pushed back in or when you’re lying down.

Some hernias don’t lead to any other symptoms. However, some may result in constipation, discomfort in the stomach or groin, or heartburn.

If the hernia has led to strangulation, there are more serious symptoms such as severe pain and vomiting, and being unable to push the hernia back in. If you have these symptoms, you should go straight to hospital.

Diagnosis and treatment

A doctor will diagnose a hernia by examining the area where there is a lump, and sometimes by doing an ultrasound scan.

A decision will then be made on whether surgery on the hernia is needed. This will depend on the type of hernia you have, what it is that is poking through from the abdomen, what your symptoms are, and your overall health.

Hernias won’t get better without surgery, but some won’t necessarily get worse. However, surgery will mean you no longer have the hernia.

Surgery and recovery

Surgery for a hernia involves pushing the lump back and returning the intestine (or other part of the insides of the body) back to where it should be. It also involves repairing the weak spot in the abdominal wall so that the hernia doesn’t happen again.

The operation is done under general anaesthetic and is done either as open surgery or keyhole surgery. It is a short procedure and you can usually go home the same day as the operation, or the day after. A week of recovery is usually all that is needed.

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