A hernia is a common medical condition that affects millions of people every year. Most hernias are not life-threatening; sometimes, hernia symptoms might even come and go. But that doesn’t mean you should ignore a hernia. A hernia can’t heal itself and will only get worse with time, leading to extreme discomfort and, in some cases, serious complications.
June is National Hernia Awareness Month. At The Surgical Clinic, we want to do our part to raise awareness of why you shouldn’t delay treating a hernia and how hernias can be prevented and managed effectively.
Whether you’re worried about your risk of developing a hernia or you’ve already been diagnosed with one, we hope that by reading this guide, you’ll feel equipped with the knowledge you need to better understand the various types of hernias, how to prevent and treat hernias and minimize the risk of hernia-related complications.
What Is a Hernia?
A hernia happens when an organ or fatty tissue pushes through a weak spot in the surrounding muscle or connective tissue. This typically causes pain, pressure, or burning, and an odd bulge in the affected area that worsens during activity and sometimes eases up when lying down. However, some people have a bulge and no pain, and vice versa. Hernia symptoms can be constant or intermittent and vary from patient to patient.
There are many types of hernias, and while most occur in the groin areas or abdomen, they can develop in various parts of the body. Hernias most often occur with age due to regular wear and tear on the muscles, but they can also develop due to a birth disorder, after an injury, following surgery, or from lifting heavy objects, which is exactly why hernias are very common in athletes and bodybuilders.
While hernias can be very painful and typically require surgery, they are rarely life-threatening. But that doesn’t mean you should ignore a hernia or delay seeing a doctor if you believe you have a hernia. Hernias do not go away on their own, almost always worsen with time, and can become very serious if left untreated.
For example, ignoring a hernia could lead to incarceration or strangulation. Incarceration is when the hernia becomes trapped outside the abdominal wall and cannot be pushed back in. Strangulation is more severe and occurs when the blood supply to the trapped hernia is cut off, leading to tissue death and potentially life-threatening complications. Other potential complications of untreated hernias include chronic pain, infection, and bowel obstruction.
Unfortunately, not all hernias are preventable, but there are steps you can take to reduce your risk of developing a hernia. We will discuss the most common hernia risk factors and best practices to prevent a hernia a little further down. But first, it’s important to understand the different types of hernias that can develop throughout the body, as you might be surprised by all the places they can occur.
Types of Hernias
The type of hernia you have depends on where it is. Hernias can occur in various body parts, including the abdomen, groin, upper thigh, belly button, and even the chest or diaphragm.
Here is a comprehensive list of the most common types of hernias and hernias that can occur but are much more rare.
Inguinal hernias are the most common type of hernia, accounting for about 75% of all hernias. They develop in the groin area and happen when part of the intestine or abdominal tissue protrudes through a weak spot in the lower abdominal muscles, causing a bulge in the groin.
There are two types of inguinal hernias: direct and indirect. A direct inguinal hernia happens when abdominal contents push through a weakness in the wall of the inguinal canal. The indirect inguinal hernia is caused by a defect in the abdominal wall present from birth, allowing a portion of the intestine to protrude through the inguinal canal.
Regardless of the type of inguinal hernia, they can cause discomfort, pain, and swelling in the affected area. Surgical treatment is often required to prevent complications.
A ventral hernia is any hernia that occurs through the front wall of your abdomen. This type of hernia can occur at any location on the stomach but most commonly develop along previous incisions or weakened areas of the abdominal wall.
Ventral hernias happen when there’s a weakness or a hole in the abdominal muscles, allowing organs or tissues to protrude through the weakened area. This type of hernia is relatively common, accounting for about 10% of all hernias. Surgical repair is often needed to prevent complications.
Another common type of ventral (abdominal) hernia is an umbilical hernia. Most umbilical hernias are present from birth but can also occur later in life.
In infants, the umbilical opening allows the umbilical cord to pass through the abdominal wall to connect the baby to the mother’s placenta. Typically, this opening should close shortly after birth, but in some cases, it may not close properly, leading to the development of an umbilical hernia. In adults, umbilical hernias can develop due to factors such as obesity, multiple pregnancies, and abdominal surgeries that weaken the abdominal muscles.
Treatment for umbilical hernias depends on the size of the hernia and the severity of the symptoms. In some cases, umbilical hernias may close on their own as the child grows, while in other cases, surgery may be necessary to repair the hernia.
A hiatal hernia is where part of the stomach protrudes into the chest through an opening in the diaphragm. This can occur gradually with age or as a result of injury or surgery.
There are two types of hiatal hernias: sliding and paraesophageal. The sliding hiatal hernia is the most common and occurs when part of the stomach and the place where the stomach and esophagus meet slide up into the chest through the opening (hiatus). On the other hand, the paraesophageal hernia is less common but can be more serious. It happens when part of your stomach pushes up through the opening (hiatus) into your chest and is next to your esophagus.
Hiatal hernias are very common and affect about 20% of people in the United States and about 50% of people over 50. Both types of hiatal hernias require medical attention, and treatment may vary depending on the severity of the hernia. Sometimes a hiatal hernia can be managed with lifestyle modifications such as avoiding large meals, losing weight, and avoiding lying down after meals. In more severe cases, medications or surgery may be recommended.
An incisional hernia is a type of hernia that occurs when tissue or organs bulge through a weak spot or scar from previous surgery. This happens because tissues at the incision site only regain about 80% of their original strength after surgery. Incisional hernias are most common after abdominal surgery but can also occur after other types of surgeries.
About 10% of all hernias are incisional hernias. If you have an incisional hernia, your healthcare provider will likely recommend surgery to repair the weakened area in your abdominal wall. Mesh material may be used during the surgery to reinforce the area and prevent the hernia from returning.
A femoral hernia develops just below the groin area. It is caused when a part of the intestine or abdominal tissue pushes through a weak spot in the lower abdominal wall near the inguinal ligament (a band of tissue that runs from the pubic bone to the hip bone).
Femoral hernias are very rare, accounting for only about 5% of all hernias. Treatment typically involves surgical repair to push the bulging tissue back into place and close the weakened area of the abdominal wall.
Congenital Diaphragmatic Hernia (CDH)
Congenital diaphragmatic hernia (CDH) occurs when the diaphragm, a muscle that separates the chest cavity from the abdomen, doesn’t form properly during fetal development, affecting the organs in the chest, causing them to move up into the chest cavity and crowd the lungs.
CDH occurs in about 1 in 2,500 to 5,000 live births and is considered a serious congenital disability that can lead to respiratory failure. Treatment for CDH depends on the severity of the condition and may involve surgery to repair the diaphragm and/or other affected organs.
A perineal hernia is a rare type of hernia that occurs in the pelvic floor that is caused by a weakness in the muscles around the anus, leading to the protrusion of pelvic contents through the perineal region.
Perineal hernias can occur in humans but are more commonly seen in male dogs. Surgical treatment is often necessary to repair the hernia and prevent complications.
Hernia Risk Factors: What Causes a Hernia
Hernias can occur in anyone, but certain risk factors can increase the likelihood of developing a hernia. Some of these risk factors are impossible to avoid, but others can be lessened, decreasing your chances of developing a hernia.
- Age: Aging can weaken the muscles, making them more susceptible to hernias.
- Constipation: Straining during bowel movements can put pressure on the abdomen and increase the risk of developing a hernia.
- Weight Gain: Excess weight puts additional pressure on the muscles, making it easier for a hernia to occur.
- Pregnancy: The added weight and pressure on the abdomen that occurs during pregnancy can strain the muscles.
- Heavy Weight Lifting: Strenuous physical activity, be it in the gym, at work, or even repeatedly picking up heavy objects at home, can increase the risk of developing a hernia, particularly if proper lifting techniques are not used.
- Chronic Coughing: If you are coughing a lot, often caused by smoking or lung conditions, it can increase the risk of developing a hernia by putting pressure on the abdomen.
- Family History of Hernias: A family history of hernias may increase your risk of developing one, as there may be a genetic component to the weakening of abdominal muscles.
How to Prevent a Hernia
Although hernias cannot always be prevented, there are steps you can take to reduce your risk.
Here are eight important preventative measures to help prevent a hernia from developing, worsening, or returning.
Maintain a Healthy Weight
People who are overweight or obese are at a higher risk of developing a hernia due to the increased pressure that excess weight places on the abdominal wall. This constant pressure can weaken the muscles and lead to a hernia.
Maintaining a healthy weight through a balanced diet and regular exercise can help reduce the risk of developing a hernia.
Exercise isn’t only excellent for your overall health and maintaining a healthy weight, it can help strengthen the muscles surrounding your abdomen and groin areas, which can help reduce the likelihood of developing a hernia by keeping your core muscles (all the major muscles of the pelvic and abdominal region) strong and flexible.
Pelvic floor contractions, core twists, pelvic tilts, forward lunges, sit-to-stands, planks, and belly button pulls (stomach vacuums) are all excellent low-impact exercises to strengthen your core muscles. That said, you should always consult with your doctor before starting any exercise regime, and avoid lifting heavier than you can and using poor lifting techniques, as these are major risk factors for developing a hernia.
Do Not Smoke
Individuals who smoke have an increased risk of developing hernias due to the effect of nicotine on the abdominal lining, which can weaken the tissue and result in organ protrusion. Furthermore, smoking can restrict enzyme production and inhibit cell growth.
Smoking also increases your risk of chronic coughing, which puts strain on the muscles. If you are a smoker, you should take the necessary steps to stop.
Constipation can increase the risk of hernia. If you experience frequent constipation, it is crucial to address the issue. Eating enough high-fiber foods can help regulate bowel movements and prevent constipation.
If your constipation is more severe, you might need fiber supplements, such as psyllium-based laxatives or other natural bowel-cleansing herbs. Staying hydrated by drinking at least 1.5-2 liters of water daily is also essential to avoid excessive straining during bowel movements.
Use Caution When Lifting Heavy Objects
When lifting a heavy object, be it everyday items or weights in the gym, it is crucial to do so correctly. Heavy lifting puts a lot of pressure on your abdominal muscles, which can cause a weakness or tear. This can lead to a hernia if the pressure causes the intestines or other organs to push through the weakened area.
Never lift more weight than you can, and always maintain a stable stance, tighten your abdomen muscles, and use your leg muscles when lifting something heavy rather than relying solely on your back. Additionally, if you have an existing hernia, avoiding any strenuous activities involving heavy lifting is recommended, as this can exacerbate the condition and cause even more discomfort.
Manage Other Health Problems
The risk of developing a hernia increases with other health issues such as obesity, asthma, COPD, acid reflux, and even diabetes. Research suggests that diabetic patients are at a higher risk of developing hernias, especially if their blood sugar is poorly controlled.
Additionally, studies show that diabetic women have a higher risk of complications following ventral and umbilical hernia repair, especially those who require insulin. Therefore, it is important to manage any underlying health problems that may contribute to the development of a hernia and to discuss any concerns with your healthcare provider.
Carefully Follow Post Surgery Instructions
Proper postoperative care is crucial to reducing the risk of developing an incisional hernia after surgery. While older adults and individuals in poor health are more susceptible, following the doctor’s instructions after surgery can prevent incisional hernia.
It is important to avoid activities that put pressure on the wound, such as heavy lifting, and follow the instructions provided to prevent constipation, limit weight gain, and avoid overexertion.
Be Proactive About Your Risk
Being aware of your personal and family medical history is crucial in preventing hernias. If you or a close family member has had a hernia before, or you are at high risk of developing one due to factors like chronic coughing or a genetic predisposition, taking extra preventative measures is recommended.
This can include wearing supportive garments, avoiding high-impact activities that strain the muscles, and performing gentle exercises that build core strength, like yoga or Pilates. By being proactive, you can reduce your risk of developing a hernia and avoid the need for future surgeries.
What To Do When a Hernia Develops
If you are having common symptoms, such as a visible bulge or swelling in the affected area, discomfort or pain when lifting objects, bending over, or coughing, or a feeling of pressure or heaviness in the abdomen or groin, it is important to schedule an appointment with a hernia repair specialist as soon as possible.
The doctor will perform a physical examination and may order diagnostic tests, such as an ultrasound or MRI, to confirm the diagnosis. If it is determined that you have a hernia, your doctor will discuss the best next steps to treat it.
In the meantime, you can take the following steps to reduce discomfort and prevent the hernia from worsening.
- Avoid heavy lifting and high-impact exercise.
- Make dietary changes to prevent constipation.
- Take over-the-counter pain medications such as acetaminophen or ibuprofen.
- Apply a cold compress to the affected area for 15 to 20 minutes several times daily.
- Consider wearing a hernia belt or truss, but consult your doctor first because sometimes they can do more harm than good.
How to Treat a Hernia
Treatment for hernias can vary depending on the hernia’s type, size, and severity. In some cases, if the hernia is small and not causing any symptoms, your doctor may recommend a watchful waiting approach, especially in patients who are not good candidates for surgical repair. However, treatment may be necessary if the hernia is causing discomfort, pain, or other symptoms.
The most common treatment for a hernia is surgery, which involves pushing the protruding tissue back into place and repairing the weakened area of the abdominal wall. There are two types of hernia surgery: open surgery and laparoscopic surgery.
Open surgery is the traditional method where a larger incision is made in the skin and muscle, and the hernia is repaired. Laparoscopic surgery is a minimally invasive approach that uses small incisions and a tiny camera to guide the surgeon in repairing the hernia.
It is important to note that untreated hernias can lead to serious complications. Therefore, it is essential to book an appointment with a hernia repair specialist if you suspect you have a hernia or experience any symptoms so they can evaluate your condition and recommend the best treatment approach for your case.
See A Hernia Repair Specialist in Middle Tennessee
At The Surgical Clinic, we can’t stress enough the importance of seeking medical attention if you suspect you have a hernia. While, in most cases, a hernia is not a severe medical condition, it is still something you should not brush aside. And with June being Hernia Awareness Month, there’s no better time to take action and prioritize your health.
Our team of board-certified surgeons have extensive experience in hernia repair surgery and are available at multiple locations throughout Nashville and Middle Tennessee, making it convenient for you to access our skilled surgical care.
Click here to find a location and general surgeon near you, and then call to schedule your hernia appointment today.