What Is an Abdominal Hernia?

In general, a hernia refers to the protrusion of an organ through a weak area in the muscles or tissue that surround and contain it. Most commonly, the word hernia is used to refer to an abdominal hernia. This type of hernia occurs when an organ or fatty tissue pushes the inner lining of the abdominal wall (the outer layer of muscle, fat and tissue that extends from the bottom of the ribs to the top of the thighs) through a weak area in the abdominal muscles, causing an outpouching of the abdominal wall. This area may have been weak at birth, or it may have been weakened by age, injury or a previous surgical incision. The outpouching, which turns into a noticeable bulge, can contain fat, intestine or other tissue.

The bulge can be either reducible, meaning that the fat or tissue can be pushed back into the abdominal cavity and the hernia will flatten and disappear, or nonreducible, which means the fat or tissue cannot be pushed back into the abdomen and the hernia will not flatten.

Whether a hernia is reducible depends on how far it protrudes through the abdominal wall and how tightly it is held by the abdominal muscles. If the hernia is nonreducible, it must be repaired surgically, because the outpouching can contain intestine, which can lose its blood supply and die if it becomes tightly trapped (called strangulation). Strangulation of an intestine causes extreme pain, can block digestion and may even cause gangrene in that area of intestine. In this case, emergency surgical repair is required.

A hernia can literally develop in anyone, from a newborn baby to a senior citizen. The following factors can increase an individual’s risk for developing a hernia by straining or increasing pressure on the abdominal wall:

  • A chronic cough, such as smoker’s cough Obesity
  • Straining during bowel movements or while urinating
  • Pregnancy
  • Straining to lift heavy objects
  • Persistent sneezing, such as that caused by allergies

The following are common few of abdominal hernia:

Inguinal  Hernia: The inguinal hernia is the most common type of hernia. When a male’s testicles descend into the scrotum, this causes a naturally weakened area in the wall of the abdomen, called the internal ring. This weakened area makes men more susceptible to a hernia at this location. An indirect inguinal hernia is the most common type of inguinal hernia. It occurs at the internal ring in the groin area. The intestine drops down into the internal ring and can extend down into the scrotum in men or to the outer folds of the vagina in women. An indirect inguinal hernia can be the result of an inherited weakness at the internal ring or one that occurs later in life. The latter is known as an acquired hernia.

Less common than an indirect inguinal hernia, a direct inguinal hernia occurs near the internal ring instead of within it. They are acquired hernias that usually occur after age 40 as a result of aging or injury.

Umblical Hernia : Seen at the umbilicus.      

Incisional Hernia :From a previous surgical scar.

Noticeable bulge somewhere in the abdomen or groin area or in the scrotum for men.

If the bulge is reducible, it may enlarge when the person is standing and become smaller when he or she lies down.

A hernia may cause sharp or dull pain that worsens when having a bowel movement, during urination, or while lifting a heavy object. The pain might worsen as the day progresses, especially with long periods of standing

In the case of a strangulated hernia that contains intestine, the herniated section of intestine might become blocked. This blockage may cause blood in the stool, constipation, fever, severe pain, vomiting and even shock. If these symptoms are experienced, emergency medical attention is needed.

Treatment options for a hernia include the following:

  • Hernia repair surgery: Hernia repair surgery is an effective treatment for hernias. As with almost any surgery, there are some risks involved with a hernia repair operation. These risks, along with the risks of not having surgery, should be discussed with a doctor before a treatment decision is made. Remember that successful surgery will end discomfort, repair the hernia, and stop the hernia from progressing.
  • Conventional hernia repair surgery : Traditional hernia repair surgery involves making an incision in the abdominal wall around the hernia, moving the hernia back into the abdomen, and then closing and reinforcing the abdominal wall. This type of hernia repair often does not require an overnight hospital stay.

  • Laparoscopy : Laparoscopy is a surgical procedure for hernia treatment in which a fiber optic viewing tube and special instruments are used to repair the hernia without making a large incision. This procedure requires less recovery time than traditional hernia repair surgery. The possibility and effectiveness of laparoscopic repair should be discussed with a doctor.

  • NO TREATMENT : A patient always has the option of not undergoing treatment, but he or she should understand that the hernia may become worse and that there is a risk of intestinal strangulation.

In preparation for the surgery, blood tests, an electrocardiogram (ECG), and/or a chest X-ray might be ordered to evaluate the patient’s health. After a hernia repair surgery, a hospital stay will be for one day to three days, depending on size of the hernia.

The surgery is usually performed under spinal or general  anesthesia in adults and under general anesthesia in children. During repair of the hernia, the weakened tissue that contributed to the development of the hernia will be closed and strengthened with a synthetic mesh. After the surgery, the patient may receive fluids and pain-relieving medication through an intravenous (IV) tube for a few hours.

  • No weight lifting, pulling, pushing
  • No straining at stools
  • Treat cough, colds, constipation immediately

A doctor should be notified immediately if any of the following symptoms are experienced after the surgery:

  • Fever
  • Difficulty urinating
  • Excessive bleeding
  • Redness in the area of the incision
  • Excessive tenderness or swelling
  • Severe or increasing pain
  • Maintaining a healthy weight
  • Exercising to tone the muscles of the abdomen
  • Receiving medical help for chronic constipation, allergies or a chronic cough
  • Eating high-fiber foods
  • Avoiding the risk factors mentioned earlier.