Hernia: Types, symptoms, diagnosis and treatment
There are several different types of hernia:
- Inguinal hernia is the most common. This occurs when part of your bowel squeezes through your lower abdomen into the groin.
- Hiatus herniais when part of your stomach pushes up into the chest through an opening in the diaphragm.
- Femoral hernia happens when fatty tissue or a part of the bowel pushes through into the groin at the top of the inner thigh.
- Incisional hernia is when tissue pushes through a surgical wound in the abdomen that has not completely healed.
- Umbilical hernia is when fatty tissue or a part of the bowel pushes through the abdomen close to your belly button (navel).
- Epigastric hernia is when fatty tissue pushes through your abdomen, between the belly button and breastbone (sternum).
- Spigelian hernia is when part of your bowel pushes through your abdomen by the stomach muscle below the belly button.
- Muscle hernia is when part of your muscle pushes through the abdomen sometimes after a sports injury.
What are the symptoms of a hernia?
For inguinal, femoral, umbilical, and incisional hernias, symptoms could include:
- An obvious swelling beneath the skin of the abdomen or the groin - it may disappear when you lie down, and may be tender
- A heavy feeling in the abdomen that is sometimes accompanied by constipation or blood in the stool (poo)
- Discomfort in the abdomen or groin when lifting or bending over
Symptoms of a hiatus hernia may include:
- Although heartburn is more likely in those with a hiatus hernia, some have no symptoms at all. Upper abdominal pain may occur.
Seek medical advice about a hernia if:
- You suspect that you have a hernia. Sometimes hernias require urgent medical care - an accurate diagnosis is important.
- If you can't get the hernia to go back in. This is called an incarcerated hernia and can lead to strangulation. Seek medical care immediately.
- You know you have a hernia, and you are nauseous and vomiting or are unable to have a bowel movement or pass wind. You may have a strangulated hernia or an obstruction, which are emergencies. Seek medical care immediately.
How is a hernia diagnosed?
A doctor's physical examination is often enough to diagnose a hernia. Sometimes hernia swelling is visible when you stand upright. Usually, the hernia can be felt if you place your hand directly over it and put pressure on it. Ultrasound may be used to see a femoral hernia, and abdominal X-rays may be performed to identify a bowel obstruction.
What are the treatments for a hernia?
In babies, umbilical hernias may heal themselves within four years, making surgery unnecessary. For all other hernias, the standard treatment is conventional hernia-repair surgery, called herniorrhaphy. It is possible to simply live with a hernia and monitor it. The main risk of this approach is that the protruding organ may become strangulated (have its blood supply cut off), and infection and tissue death may occur as a result. A strangulated intestinal hernia may result in intestinal obstruction, causing the abdomen to swell. The strangulation can also lead to infection, gangrene, intestinal perforation, shock, or even death.