Hernias: Causes and Treatment Options
by Rick Alan
What Is a Hernia?
A hernia is the protrusion of an internal body part through a muscle or surrounding tissue. This can happen through a rupture, tear, or weakness in the structure.
What Causes a Hernia to Develop?
We tend to think of hernias as being the result of lifting heavy objects. In fact, they can have any number of causes, such as a natural weakness in the abdominal wall or inguinal or femoral canal, overexertion, coughing, surgery, or trauma .
Who Is Most Susceptible?
Hernias can occur in both men and women of all ages, as well as in children. However, hernias tend to be much more common in men, occurring most often in the groin area where the abdominal folds meet the thighs. These are known as inguinal hernias. This is due in part by the normal descent of the testicles into the scrotum. This creates an area in the groin where abdominal tissue can protrude if it does not close properly.
Women may be more prone to develop hernias at the top of the thigh (the femoral area), often resulting from the strain of pregnancy and childbirth.
Inguinal hernia are more likely to be found in children, with the large majority of these occurring in boys. Umbilical hernias are most commonly seen in infants. These generally appear as a protrusion in the naval area. Umbilical hernias in infants are less troublesome than other types of hernias, since they tend to close without any treatment by the time the child is 3-4 years old.
How Do I Know I Have One?
Generally, you will notice a small lump somewhere in the groin or abdominal area. Many hernias are reducible; that is, the tissue can be pushed gently back into its normal place. If you notice a bulge that does not resolve or you develop pain at the site, you should seek medical treatment.
Are They Dangerous?
If left unattended, the protrusion through the hole or gap can cause increasing amounts of pain, as more of the abdominal tissue pushes through the gap. As long as the hernia is reducible, it is not considered dangerous, but it can still put pressure on the surrounding tissue. A non-reducible hernia can become life-threatening if a part of the bulging tissue becomes trapped and circulation is cut off to the tissue.
Will It Heal by Itself?
Unfortunately, no. With the exception of umbilical hernias in infants, hernias will not go away on their own. It can take months or even years to worsen. If you suspect that you or your child has a hernia, it should be checked by a doctor because of the possible danger of strangulation.
In the short term, reducing strenuous physical activity, losing weight, and/or wearing a truss can lessen the discomfort caused by a hernia. Ultimately, the only way to fix a hernia is with surgery.
What Are the Various Surgical Options?
Open Hernia Surgery
Open hernia surgery is performed by making an incision over the site of the hernia. The part of the intestine or other tissue bulging through is then placed back into the abdominal cavity. Finally, the abdominal wall is repaired by stitching the surrounding muscle together.
Open Mesh Surgery
This hernia surgery uses a mesh plug. Here, a small incision is made at the hernia site. The bulging tissue is then returned to the abdominal cavity. The repair of this area is completed by using sterile mesh material to strengthen and repair the weak area.
During laparoscopic surgery, a surgeon inserts small instruments, including a tiny video camera, through small holes made in the abdominal wall. The doctor performs the surgery while viewing the hernia on a TV monitor.
Hernias can be successfully treated. If you notice an bulge in your skin, make an appointment with your doctor for an exam.
American College of Surgeons
Family Doctor—American Academy of Family Physicians
Canadian Association of General Surgeons
Groin hernia in adults and adolescents. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 11, 2016. Accessed March 3, 2017.
Groin hernia in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated July 23, 2015. Accessed March 3, 2017.
LeBlanc KE, LeBlanc LL, LeBlanc KA. Inguinal hernias: diagnosis and management. Am Fam Physician. 2013;87(12):844-848.
Umbilical hernia in infants and children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated November 11, 2016. Accessed March 3, 2017.
Last reviewed March 2017 by Michael Woods, MD, FAAP
Last Updated: 3/3/2017
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