What happens when you have a Hernia?
What is a Hernia?
A hernia occurs when an internal part of the body pushes through a weakness in the muscle wall.
A hernia usually develops in your abdominal cavity. In most cases, it causes no or very few symptoms, although you may notice a swelling or lump in your abdomen or groin. The lump often occurs during the day and can often be pushed back in or disappears when you lie down. Coughing or straining may make the lump appear. Surgery is the only permanent treatment. Almost hernia surgeries involve the use of a mesh to reinforce the defect.
Common types of Hernia
1. Inguinal Hernias
Inguinal hernias occur when fatty tissue or a part of your bowel protrudes through into your groin above your inner thigh.
This is the most common type of hernia and it mainly affects men. It is often associated with ageing and repeated strain on the tummy. It is further classified into Direct and Indirect inguinal hernias. Direct hernias are less likely to cause complications while Indirect inguinal hernias have a higher risk of bowel complications.
2. Femoral Hernias
Femoral hernias also happen when fatty tissue or part of your bowel protrudes through into your groin above your inner thigh. It is often mistaken as an inguinal hernia. Femoral hernias are much less common than inguinal hernias and tend to affect more women than men. Femoral hernias have the highest risks of bowel complications and should always be surgically repaired.
Like inguinal hernias, femoral hernias are also associated with ageing and repeated strain on the tummy.
3. Umbilical Hernias
Umbilical hernias occur when fatty tissue or part of your bowel pokes through your abdomen near your belly button (umbilicus).
In adults, it is often due to previous umbilical incisions (laparoscopic surgery) and obesity.
Assessing a Hernia
Hernias are assessed by an examination of the lump. Sometimes an ultrasound scan may be required to confirm the diagnosis or assess the extent of the problem.
A number of factors will be considered when deciding whether surgery is appropriate, including:
- The type of hernia – some types of hernia (Femoral > Indirect > Direct) are more likely to become strangulated or cause a bowel obstruction than others
- The content of your hernia – if the hernia contains a part of your bowel or other tissue, there may be a risk of strangulation or obstruction
- Your symptoms and the impact on your daily life – surgery may be recommended if your symptoms are severe or getting worse, or if the hernia is affecting your quality of life
- Your health in general– surgery may be too much of a risk if your general health is poor
When is it an emergency?
You should go your nearest immediately if you have a hernia and you develop any of the following symptoms:
- sudden, severe pain
- difficulty passing motion or gas
- the hernia becomes firm or tender, or cannot be pushed back in
These symptoms could mean that either:
- the blood supply to bowel in the hernia has become cut off (strangulation)
- a piece of bowel has entered the hernia and become blocked (obstruction)
These are medical emergencies and need to be treated immediately.
Surgery for a Hernia
There are 2 main ways surgery for hernias can be carried out:
- Open surgery – where a cut is made to allow the surgeon to push the lump back into the abdomen.
- Laparoscopic surgery – this is a less invasive, but more difficult technique where several smaller cuts are made, allowing the surgeon to use various special instruments to repair the hernia. The risks of hernia recurring is slightly higher compared to open surgery.
Most people will be able to go home the same day or the day after surgery and make a full recovery within a few weeks.
Dr Leong Quor Meng is a Consultant Colorectal and General Surgeon that holds advanced certifications in robotic colorectal surgery. Dr Leong is amongst a handful of local surgeons who practice Single Incision Laparoscopic surgery for colorectal.Read More