By Dr. Atul Mishra, General Surgery
Hernia are bulges protruding form a weak point on belly (abdomen) through which intestine and abdominal fat comes out to lie just below the skin. It can also be found in groin, upper thigh and chest. There are several types of hernia like inguinal hernia (direct and indirect), femoral hernia, umbilical hernia, umbilical hernia, epigastria hernia and incision hernia.
Who get hernia?
Conditions that lead to increased abdominal pressure are at more risk of developing hernia –
- Persistent cough
- Being overweight or pregnant
- Lifting, carrying or pushing heavy loads
- Straining on the toilet
What are the symptoms of hernia?
- Mostly they are asymptomatic/no symptoms.
- People just notice a swelling or bulge which gets bigger while standing or straining and disappear while lying down/sleeping.
- Some might feel a dragging/aching sensation.
- The swelling tends to get bigger with time.
- Symptoms develop when there is a complication like strangulation.
This happens when the content of abdomen (intestine) come out and can not go back. There will be severe pain in the region and vomiting. Overlying skin will become red. Urgent surgery is needed in this situation otherwise the blood supply to intestine gets cut-off and the intestine in hernia might die (gangrene).
How are hernia treated?
Surgery is the only treatment for hernia. Now a days, most of the hernias are operated laparoscopically (key hole or minimally access technique).
Minimally Invasive Hernia Repair - The surgery is done with a laparoscope which has a small tiny camera, hernia mesh and small tool with it. So, the patient can return back to their normal routine earlier as the incision made is smaller.
Advantages of Laparoscopy:
Laparoscopy has clear advantage over open repair in the way of less pain, less complications like wound infection, small and more cosmetic scar, shorter hospital stay, early return to work and daily activities and less chance of recurrence (repeat formation of hernia after surgery). Before undergoing hernia surgery:
• One week before surgery it is much essential to stop taking drugs that are causing the thinning of the blood. Drugs like Clpodogrel and Acitrome or Warfarin should be stopped with the doctor’s advice.
• Stop herbal supplements and check the fitness of your cardio and diabetes.
• Gain adequate knowledge about surgery and be prepared for post surgical care.
After hernia surgery:
• Avoid heavy weight lifting, exercises, and physical works with excessive strain a few weeks after surgery
• Cough or laugh loud only with support to the surgical site until one week after surgery
DO’s & DON’T’s in patients of Hernia:
1. Increased intake of fibers in diet. ( Fruits, vegetables and grains)
2. Drink plenty of water and other fluid to prevent constipation.
3. Exercise regularly: sweat and loose excess weight and toxins.
4. Eat small meals more frequently in place of one or two large meals
1. Stop smoking and drinking
2. Don’t reduce the amount of food you eat
3. Avoid lying down or bending after meal
4. Avoid wearing tight clothes
5. Avoid food difficult to digest
6. Avoid strenuous activities like heavy weight lifting
Types of Hernias:
This happens at the site of previous surgery. This occurs as a result of poor wound healing at the time of previous surgery or as a result of complications like in infection. It is rare after laparoscopic or key hole surgery.
This occurs through or around belly button (umbilicus). It can be present at the time of birth and needs no repair as most of them resolve by the end of one year. If it persists or appears after 5 years of age then operation is required. Inguinal hernia These are most common hernias and occur in groin region. They are more common in men.