Hernia - Definition, Symptoms, Causes, Types & Treatment

A hernia develops when an organ or fatty tissue pushes through a weak spot in the surrounding muscle. This often happens in areas where the muscle wall is thinner, such as the abdomen or groyne.

Hernias can cause a visible bulge in the affected area, which may become more noticeable when standing, coughing, or straining. Although they may not cause severe symptoms at times, it is better to seek prompt help to avoid complications.

Hernias can be easily classified based on their location and the tissues involved. The primary types of hernia include:

1. Inguinal Hernia: The most common type, occurring in the groyne area and more frequently affecting men. It results in a protrusion or lump.
2. Femoral Hernia: This condition develops in the upper thigh and is more common in women. A noticeable swelling or bulge appears close to the groyne.
3. Umbilical Hernia: Commonly seen in infants, it forms in the area surrounding the belly button and grows as a visible bump near the navel.
4. Hiatal Hernia: Unlike other hernias, it involves a part of the stomach pushing right through the diaphragm and into the chest cavity. It does not present with any external visible signs or lumps.
5. Incisional Hernia: This category of hernia can surface from a previous surgical incision. Generally identified as a bulging or protruding area near the surgical scar.

Grades of Hernia

Hernias are graded based on their severity and the risk of complications. The common classification includes:

1. Grade I: Small, reducible hernias with minimal symptoms.
2. Grade II: Larger, reducible hernias causing discomfort.
3. Grade III: Irreducible hernias with significant symptoms.
4. Grade IV: Strangulated hernias requiring emergency surgery.

Indications of a hernia vary significantly based on the type of the condition. The most common hernia symptoms include:

• A visible bulge in the affected area, such as the abdomen, groyne, or upper thigh
• Pain or discomfort in the area around the lump, which may worsen during physical activities or when lifting heavy objects
  
  
• A feeling of heaviness, pressure, or a dragging sensation in the affected area
• Burning, gurgling, or aching sensations at the affected site
• Constipation or difficulty passing gas in some instances

I frequently encounter hernia cases among labourers who often ignore early symptoms due to their demanding work schedules. One memorable patient was a farmer who endured pain for months before seeking help.

After performing a successful hernia repair, he was relieved of pain, emphasising how timely treatment can prevent complications and improve quality of life.

- Dr Rishabh Prakash Jain

Gastroenterologist

One might wonder what are the hernia causes and whether it affects the patient's quality of life. The most significant reason for the protrusion of internal organs is the weakening of the muscular wall.

Subsequently, it can be due to birth defects or external lifestyle changes. Curious about what these factors are? Then, let’s look at the potential risk factors associated with herniation situations.

Risk Factors of Hernia

While anyone can suffer a hernia, certain factors add to the possibility of experiencing this condition. These include:

1. Age: As people grow older, the muscles and tissues naturally weaken over time, increasing the chances of hernias.
2. Gender: Males are highly susceptible towards developing inguinal hernias as compared to women. It is because men have a natural weakness in the abdominal wall. This causes the testicles to descend during foetal development.
3. Increased Abdominal Pressure: Due to regular and vigorous heavy lifting, straining, and exercising.
4. Previous Operation: Surgical incisions can weaken the muscular structures, subsequently causing hernia.
5. Obesity: Extra body weight puts more pressure on the abdominal wall. The extra strain on the muscles and tissues can weaken them.
6. Chronic Cough: Persistent coughing, often due to smoking or other respiratory conditions, can strain the abdominal muscles.

While not all hernias can be prevented, certain measures can reduce the risk. These include:

1. Maintain a Healthy Weight: Reduces the strain on the abdominal wall.
2. Strengthen Core Muscles: Regular exercises to support the strength of the abdomen region.
3. Quit Smoking: Reduces chronic coughing and improves overall health.
4. Eat a High-Fibre Diet: Prevents constipation and straining during bowel movements.

Read in Detail: Best Ways to Prevent Hernia Problems

A hernia is typically diagnosed through physical examination and imaging tests. Here are the steps involved:

Physical Examination

A gastroenterologist will evaluate and search for signs of a hernia. This may involve:

• Feeling the abdomen or groyne area for any bulges or lumps
• Asking the patient to cough or bear down to make the hernia more prominent
• Checking for tenderness or pain in the affected area

Imaging Tests

Depending on the type of hernia suspected, additional scans may be ordered to confirm the diagnosis:

• Ultrasound: Sound waves generate images of hernias in the pelvic area and abdomen. It is beneficial for diagnosing inguinal or scrotal hernias in men and for ruling out other causes of pain in women.
• CT Scan (Computer Tomography): Uses X-rays to create detailed images of the abdominal area and organs.
• MRI (Magnetic Resonance Imaging): Involves radio waves and a magnetic field to generate detailed imaging of the abdominal organs and muscles. It may be used to detect tears in the abdominal muscles.

Medical History

The healthcare provider will assess the detailed medical records to understand a few factors. These include symptoms, previous surgeries, and underlying medical conditions that may be contributing to the hernia.

How to prepare for a gastroenterologist consultation?

It is important to prepare beforehand for a consultation with a healthcare provider. Here are the steps that should not be missed:

• Gather all important medical records and test results to bring to your appointment.
• Make a list of all current medications, including dosages and frequency.
• Document the symptoms in detail, including the onset, frequency, and impact on daily life.

Questions to Ask the Gastroenterologist

Before a clinic or hospital visit, patients must keep their questions ready. Here are the essential doubts that must be cleared with the gastroenterologists:

1. What type of hernia do I have?
2. What are the treatment options and recommended course of action?
3. What are the potential risks of the treatment?
4. How will this condition affect my day-to-day life?
5. Are there any lifestyle changes I should make?
6. What is the prognosis for my condition?
7. How often will I need follow-up appointments?

The treatment choice is typically based on the type, size, and severity of the hernia. Surgical repair is the definitive solution for hernias, whereas non-surgical options can provide temporary relief and symptom management. Here are the available options:

Hernia Treatment in Ayurveda

• Snehana (Oleation Therapy): Warm essential oils like sesame oil or ghee are massaged into the body, helping to dislodge and remove toxins from the body's channels.
• Virechana (Purgation Therapy): This procedure involves using herbal laxatives to clear the digestive system and remove excess pitta (heat) from the body.
• Niruha Basti (Medicated Enema): Medicated enemas are used to cleanse the colon and support the digestive system.

Hernia Treatment in Homeopathy

• Nux Vomica: Used for various types of hernia, especially when associated with chronic constipation or diarrhoea.
• Calcarea Carbonica: Effective for obese patients with weak abdominal muscles. It is also used to treat umbilical hernia in babies and children.
• Rhus Toxicodendron: Beneficial for hernias caused by physical strain or injury. It helps in reducing pain and inflammation.
• Bryonia: Typically required for hernias associated with chronic constipation and abdominal discomfort. It helps in relieving symptoms and improving bowel movements.

Hernia Surgery Options

• Open Hernia Repair: In this surgery, the surgeon makes a single large incision over the hernia site. The herniated tissue is pushed back into place, and the weakened area is strengthened, often with a piece of surgical mesh.
• Laparoscopic Surgery : This minimally invasive technique involves multiple incisions. A laparoscope (a camera attached to a thin tube) and surgical instruments are inserted through these incisions. The surgeon repairs the hernia from the inside, often using mesh to support the area.
• Robotic Surgery: This approach involves using robotic arms controlled by the surgeon from a console. This technology increases surgical precision and is beneficial for complex hernia repairs.

Read Also: Precautions to Be Taken After Hernia Surgery

Hernia Treatment without Surgery

• Supportive Devices:Trusses, corsets, or hernia belts can help manage symptoms by applying gentle pressure to keep the hernia in place. Although this may not be a permanent solution, it provides temporary relief, especially for patients who are not immediate candidates for surgery.
  

Hernia Treatment Cost

The treatment cost of Hernia in India is variable based on the type of surgery. It can differ based on the hospital, the complexity of the case, and the specific treatment required.

The average cost for umbilical hernia surgery is ₹85,000, and inguinal hernia surgery is ₹90,000.

Delaying hernia treatment can lead to several significant risks and complications. These may include:

1. Incarceration: It occurs when the herniated tissue becomes trapped and cannot be pushed back into the abdominal cavity. This can lead to bowel obstruction and severe pain.
2. Strangulation: This is a severe complication where the blood supply to the strained tissue is cut off. It can result in tissue death (necrosis) and sepsis (infection).
3. Increased Surgical Complexity: Over time, scar tissue may form around the hernia, making the surgical procedure more complex.
4. Pain and Discomfort: As the hernia enlarges, physical activities like lifting and coughing can be painful.
5. Limitation of Activities: Hernias can restrict the ability to perform strenuous activities, exercise, or even daily chores.
   
   

When to call a doctor?

It is necessary to seek medical attention if the patient experiences certain indications. Here is a list:

1. Severe abdominal pain
2. Nausea and Vomiting
3. Fever
4. Signs of jaundice

Balanced and healthy meals can play an important role in managing hernia symptoms and preventing complications. Here are some dietary recommendations:

High-Fibre Foods

Help in maintaining regular bowel movements while decreasing the risk of constipation. Some examples include:

• Fruits: Apples (with skin), pears, berries, and citrus fruits like oranges and grapefruits
• Vegetables: Carrots, broccoli, spinach, Brussels sprouts, and artichokes
• Whole Grains: Whole wheat bread, oatmeal, bran flakes, and barley
• Legumes: Lentils, black beans, kidney beans, and soybeans
• Nuts and Seeds: Almonds, peanuts, pecans, flaxseeds, and chia seeds

Proteins

Necessary for muscle restoration and growth, which can help in increasing the strength of the abdominal wall. Here are some examples:

• Animal-Based: Skinless chicken breast, turkey, lean cuts of beef, tuna, shrimp
• Plant-Based: Soybeans (tofu, tempeh, edamame), lentils, beans, and quinoa.

Hernia is a common disease that can cause significant discomfort and complications if left untreated. Early detection and appropriate treatment are crucial. Understanding the symptoms, causes, and prevention strategies can help you manage this condition effectively.

At HexaHealth, we specialise in connecting patients with expert doctors for optimal care in hernia prevention and management. Our team ensures comprehensive support throughout your treatment journey, from diagnosis to recovery.

Contact us for personalised healthcare solutions.

Suggested Reads:

• Laparoscopic Hiatal Hernia Repair
• Laparoscopic Ventral Hernia Repair
• Ventral Hernia Surgery

Patient Success Story - Hernia Surgery