Many people suffer from hernias and they are particularly common among men. Find out what hernias are and the best ways to treat them.
A hernia is a common problem, particularly among men, and it occurs when an internal part of your body pushes through a weak spot in the muscle or tissue wall. Your organs are usually held in place by tight, strong muscles but if there are any weaknesses then part of the bowel or stomach can protrude. You can usually feel this as a bulge or swelling under your skin and you may experience pain and a feeling of pressure1
Types of hernia
There are many types of hernia and all of them occur in the abdomen, between your chest and hips. The four main types of hernia are:
- Femoral – this tends to affect women more and happens when part of the bowel pokes through into the groin;
- Umbilical – this can occur in babies when the umbilical opening doesn’t seal properly;
- Hiatus – this happens when part of the stomach pushes through an opening in the diaphragm and can cause heartburn; and
- Inguinal – this occurs when part of the bowel pokes through into the groin and mainly affects men.
Inguinal hernias are by far the most common, making up around 70% of all hernia cases2. Inguinal hernias occur when part of the bowel or the surrounding fatty tissue pokes through into the groin. This form of hernia mainly affects men, which is why most hernia patients are male. Femoral, umbilical and hiatus hernias can also affect women but they are much less common1.
There are several risk factors associated with hernias. Although you can make certain lifestyle changes to reduce the chance of a hernia you can’t prevent them completely. The main risk factors for hernias are:
Most hernias occur in older people, although it’s possible to have a hernia at any age. This is because your tummy muscles get weaker as you get older3.
2. Repeated strain on the abdomen
If you are inadvertently placing a large strain on your abdomen where your muscles may be weakened, this can cause a hernia to develop. Common causes of strain include chronic coughing, straining during bowel movements due to constipation and lifting heavy weights4.
3. Damage from injury or surgery
Hernias may occur in the area when you have previously had a surgical incision or sustained an injury, as this creates a weakness in the abdominal wall5.
4. Lifestyle factors
There is some evidence that smoking and being overweight increase your likelihood of developing a hernia. In addition, gaining a lot of weight very quickly can put additional strain on the abdomen and be the direct cause of a hernia5.
Treating a hernia
Your doctor may be able to diagnose your hernia with a simple assessment or you may need to have an ultrasound scan to confirm the diagnosis. A hernia will not get better without surgery but in some cases the risks of surgery will outweigh the benefits, and your doctor will decide whether surgery is the right option for you based on a number of factors1.
If your hernia is causing you pain or if your symptoms have a significant impact on your daily life you are likely to be recommended for an operation. You will also have surgery to remove your hernia if any serious complications develop, and this is more likely with inguinal hernias. The most common complications are:
- Obstruction – in an inguinal hernia a section of the bowel can become stuck in the inguinal canal and cause stomach pain, nausea and vomiting.
- Strangulation – if a section of the bowel becomes trapped and the blood supply is cut off then emergency surgery is required within hours to restore blood supply and ensure the tissue doesn’t die3.
Hernias can be repaired with an operation to push the protruding tissue back into place and strengthen the weak muscles which allowed the hernia to occur in the first place. Hernia operations may be carried out as open surgery or keyhole surgery, depending on what type of hernia you have and where it is1.
Whichever type of operation you have you should be able to go home the same day or the day after. You will get detailed instructions on how to take care of yourself, including any adjustments you should make to your diet and how to avoid strain on the area. Most people can return to work and perform activities such as driving within two weeks and make a full recovery after six weeks3.
A hernia operation is a safe, routine operation but there is a small risk of complications. These include:
- A build-up of blood or fluid in the space left by the hernia, which resolves itself without treatment
- Pain or swelling in the testicles, base of the penis or the groin area (in inguinal hernias)
- Damage to the nerves or blood supply or to the vas deferens, the tube which carries sperm to the testicles3 (in inguinal hernias).
There is also a chance that your hernia could come back after surgery, with around one in 10 hernias returning at some point during the patient’s life. However, only between 2 and 4% of hernias return within three years of surgery.
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