Haaibo! I think I have a Hernia!

By: Bailey Cockerill

Hernia’s are caused when there is a weak area of muscle, tissue or membrane allowing the underlying internal organs to protrude through…ouch!!

The most common types are;

• Inguinal, found in the groin
• Umbilical, around the belly button
• Incisional, through a scar
• Hiatus, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.
• Congenital diaphragmatic, a birth defect that needs surgery 

But these are only a few of the many various types of hernias that can occur, due to our vast anatomy.

“So, basically if I have weak muscles then I’ll get a hernia?”

No, we’d be seeing a lot of people walking with funny bulges all over the place if that were the case. Only if those weak tissue area’s are combined with an increased pressure due to something like the following, could you possibly develop a hernia;

• obesity or sudden weight gain
• lifting heavy objects
• diarrhea or constipation
• persistent coughing or sneezing
• pregnancy

Regardless of where the hernia is, it will be classified or graded into one of the following categories;

• Reducible hernia: This term refers to the ability to return the contents of the hernia into the abdominal cavity, either spontaneously or manually.
• Incarcerated hernia: An incarcerated hernia is no longer reducible. The vascular supply of the bowel is not compromised. Bowel obstruction is common.
• Strangulated hernia: A strangulated hernia occurs when the vascular supply of the bowel is compromised secondary to incarceration of hernia contents.

Symptoms?

• Asymptomatic hernia
• Presents as a swelling or fullness at the hernia site
• Aching sensation (radiates into the area of the hernia)
• No true pain or tenderness upon examination
• Enlarges with increasing intra-abdominal pressure and/or standing
  
• Incarcerated hernia
• Painful enlargement of a previous hernia or defect
• Cannot be manipulated (either spontaneously or manually) through the fascial defect
• Nausea, vomiting, and symptoms of bowel obstruction (possible)
  
• Strangulated hernia
• Symptoms of an incarcerated hernia present combined with a toxic appearance
• Systemic toxicity secondary to ischemic bowel is possible
• Strangulation is probable if pain and tenderness of an incarcerated hernia persist after reduction
• Suspect an alternative diagnosis in patients who have a substantial amount of pain without evidence of incarceration or strangulation

Can it be fixed?

Yes, but most likely it needs to be done surgically as hernia’s are structural defects. Basically, a reinforcing mesh needs to be place over the weakened tissue, to ensure that the protrusion through that area can be prevented from getting worse.

Post operatively, muscular strengthening needs to take place gradually, in order to help with structural support.

Ensure that your rehabilitation specialist/physical therapist and doctor have good lines of communication to fully understand the type of hernia and how the repair was done to give you the best possible treatment!

Happy healing J