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Muscles perform more tasks than those involving movement of the human body. They also keep your organs in their proper place. Hernias occur when fatty tissues or organs slip through a weakened spot in the connective tissue known as fascia or surrounding muscle. Two of the most common hernias are hiatal and inguinal. With a hernia, you’ll notice a lump in your abdomen or groin. The most common ones occur in the abdomen.
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When the bladder or intestines squeeze through the inguinal canal of the groin or the abdominal wall near the groin area, it’s called an inguinal hernia. The inguinal canal is the space where the spermatic cord runs from the scrotum to the abdomen in men. In women, the inguinal canal holds the ligament that keeps the uterus in the correct place.
Ninety-six percent of hernias in the groin are inguinal and happen with men because there is a natural weakness in the muscle walls in this area. This is because the testicles drop down through the canal not long after birth, and then the canal closes up behind them. Sometimes the inguinal canal does not close correctly. This leaves a weak spot wear hernias can develop.
There are two types of inguinal hernias; direct or indirect. Direct hernias do not enter the inguinal canal while an indirect one protrudes into the canal. These hernias commonly occur when someone lifts a heavy object. They can also happen in women and children. It is actually a common surgery in teenagers and kids.
If you have an inguinal hernia, you’ll probably see a bulge where your groin and thigh meet. It will appear when you stand, strain, or cough but disappears when you lay down. Pain may increase with activity like lifting, bending, and coughing.
These hernias usually are not dangerous, but they can lead to serious issues if left untreated. One of the most threatening complications occurs when part of the intestine bulges through, and the blood supply is cut off. This is a life-threatening situation, and you must call the doctor immediately if:
- You cannot pass feces or gas
- Have a fever
- The pain increases rapidly
- You feel nausea and like you might vomit
- The hernia lumps turn dark, purple, or red
These hernias occur when the stomach protrudes through the diaphragm into your chest. The diaphragm is the muscle that separates your chest from your abdomen. There is a small opening known as the hiatus in your diaphragm that the esophagus passes through to connect to the stomach. When children are diagnosed with hernias, they are usually caused by a congenital birth defect.
They vary in size, and often small ones cause few problems. Many times, hiatal hernias are found when a physician checks for other issues. If a hernia is large, it allows acid and food to flow up into the esophagus. You won’t see any lumps, but you may experience chest pain or a sour taste in your mouth in addition to heartburn. Sometimes these hernias require surgery. Hiatal hernias are common in pregnant women but are usually found in people 50 and over.
If symptoms occur, they include:
- Shortness of breath
- Passing bloody or black stools
- Abdominal or chest pain
- Difficulty swallowing
- Acid Reflux
- Regurgitation of liquids or fluids into the mouth
Risk Factors of Hiatal Hernia
- People 50 and over
Causes of Hiatal Hernia
- Being born with a hiatus that is abnormally large
- Diaphragm changes that are age-related
- Injury to the area from some surgeries or trauma
- Intense and continual pressure placed on the muscles surrounding the area such as pressure that occurs while lifting heavy objects, straining while having a bowel movement, coughing, or vomiting
- Poor nutrition
- Ascites or fluid in the abdomen
Risks in General for Hernias
Some factors impact your risk of having a hernia are:
- Family or personal history
- A chronic cough
- Obesity or being overweight
- Chronic constipation
A disease like cystic fibrosis also affects your chance of getting a hernia as it impairs lung function causing a persistent cough.
Inguinal hernias are commonly diagnosed when a doctor performs a physical examination. Your physician may use an endoscopy or barium X-ray to diagnose a hiatal hernia.
For a barium X-ray, the patient swallows a liquid solution with barium, and then a series of X-rays are taken of your digestive system. An endoscopy allows the doctor to run a small camera on a tube into your stomach and esophagus to see the inside of these areas. An ultrasound may be used on a child with a hernia.
Treatment for Hernias
Treatment depends on the location of the hernia, the severity of your symptoms, and the size of the hernia. Your doctor will likely monitor to watch for any complications that may develop. There are a few treatment options.
Changes to Lifestyle for a Hernia
Often dietary changes are implemented to treat hiatal hernias. It's best to avoid heavy or large meals and don’t bend over or lie down after eating. Maintaining a healthy body weight also helps.
Certain exercises help build-up the muscles near the site of the hernia, but exercise done incorrectly may increase pressure in the area causing more harm than good. Always discuss with your physical therapist or physician what exercises are best and how to do them correctly. Avoid foods that cause heartburn and acid reflux such as anything tomato-based or spicy.
Some over-the-counter products can reduce stomach acid and relieve some of the symptoms and discomfort. There are also prescription medicines that provide the same relief. These medications are H-2 blockers, proton pump inhibitors, and antacids.
Unfortunately, sometimes surgery is necessary. If the hernia causes significant pain or grows larger, your physician may recommend operating on the hernia. Hernias are fixed by sewing the hole in the muscle wall closed. Usually, this is done by repairing the hole using surgical mesh.
The hernia is fixed utilizing laparoscopic surgery or open surgery. Some hernias are repairable using laparoscopic surgery which is minimally invasive. Hernias, where part of the intestines have moved into the scrotum, require open surgery. Recovery time is longer for open surgery, and you will not be able to move normally for approximately six weeks.