Overview

What is a hernia?

A hernia occurs when part of your insides bulges through an

opening or weakness in the muscle or tissue that contains it.
Most hernias involve one of your abdominal organs pushing
through one of the walls of your abdominal cavity. Hernias can
occur gradually as you get older and regular wear and tear on
your muscles begins to add up. They can also result from an
injury, surgery or birth disorder.

What are some of the different types of hernias?

 Inguinal hernia
Inguinal hernias are the most common type of hernia. They
occur when the intestines push through a weak spot or tear
in the lower abdominal wall, often in the inguinal canal.

The inguinal canal is found in your groin. In men, it’s the

area where the spermatic cord passes from the abdomen
to the scrotum. This cord attaches to the testicles. In
women, the inguinal canal contains a ligament (called the
round ligament) that helps hold the uterus in place.

Inguinal hernias are more common in men because the testicles descend through the
inguinal canal shortly after birth. The canal is supposed to close almost completely behind
them.

 Hiatal hernia
A hiatal hernia occurs when the upper part of your stomach bulges
through the large muscle separating your abdomen and chest
(diaphragm).

Your diaphragm has a small opening (hiatus) through which your

food tube (esophagus) passes before connecting to your stomach.
In a hiatal hernia, the stomach pushes up through that opening and
into your chest.

A small hiatal hernia usually doesn't cause problems. You may never know you have one
unless your doctor discovers it when checking for another condition.

But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to
heartburn.

 Femoral hernia
A femoral hernia occurs when tissue pushes through a weak spot in the muscle wall of the
groin or inner thigh. Symptoms can include a tender or painful lump, groin discomfort,
abdominal pain, and more.

 Umbilical hernia
An umbilical hernia is a bulge near the belly button, or navel. Intestines or other tissues may
bulge through an opening or a weak spot in the stomach muscles. The hernia has a sac that
may hold some intestine, fat, or fluid. Many umbilical hernias are caused by pressure near the
belly button. Pressure may come from increased weight, repeated straining, or pregnancy.
 A very small hernia may not cause problems. But your doctor may recommend repairing the
muscle. This helps you avoid the risk that the hernia might trap some of the tissues or
intestine. This could be an emergency.

 Incisional hernia
An incisional hernia is a problem that occurs when a bulge of tissue pushes through the wall
of muscle that's holding it in. It happens after surgery in the belly, in the area of the incision. It
can happen months or even years after surgery.

This type of hernia can occur in people who:

 Are very overweight.
 Are older.
 Used steroid medicines.
 Smoke.
 Had a wound infection after surgery or had more than
one surgery using the same incision.

 Epigastric hernia
An epigastric hernia is a problem that occurs when a
bulge of tissue pushes through a weak part of the belly
wall. It happens between the breastbone and the belly
button, or navel.

Epigastric hernias often have no symptoms. But they can

cause pain in the upper belly. Most of the time, these
hernias are small. You can have more than one at a
time.

Hernia causes
Hernias are caused by a combination of muscle weakness and strain. Depending on its
cause, a hernia can develop quickly or over a long period of time.

Some common causes of muscle weakness or strain that can lead to a hernia include:
 a congenital condition, which occurs during development in the womb and is present
from birth
 aging
 damage from an injury or surgery
 strenuous exercise or lifting heavy weights
 chronic coughing or chronic obstructive pulmonary disorder (COPD)
 pregnancy, especially having multiple pregnancies
 constipation, which causes you to strain when having a bowel movement
 being overweight or having obesity
 ascites

There are also certain risk factors that make you more likely to develop a hernia. They
include:
 being born prematurely or having a low birth weight
 being older
 chronic cough (likely due to the repetitive increase in abdominal pressure)
 pregnancy
 chronic constipation
 being overweight or having obesity
 smoking, which leads to the weakening of connective tissue
 a personal or family history of hernias
 Surgical Procedures
Herniorrhaphy (tissue repair)

 Herniorrhaphy is the oldest type of hernia surgery and is still being used. It involves a surgeon making a long
incision directly over the hernia then using surgical tools to open the cut enough to access it. Tissues or a
displaced organ are then returned to their original location, and the hernia sac is removed. The surgeon
stitches the sides of the muscle opening or hole through which the hernia protruded. Once the wound has
been sterilized, it is stitched shut.

Hernioplasty (mesh repair)

In hernioplasty, instead of stitching the muscle opening shut, the surgeon covers it with a flat, sterile mesh,
usually made of flexible plastics, such as polypropylene. The surgeon makes small cuts around the hole in the
shape of the mesh and then stitches the patch into the healthy, intact surrounding tissues. Damaged or weak
tissues surrounding the hernia will use the mesh, as a supportive, strengthening scaffold as they regrow.

Management:
1. Avoid any activities that can increase pressure within the abdominal cavity. This includes heavy lifting and
persistent coughing.
2. Medication:

 NSAID
 Antiemetic
 Antibiotic
 Stool softeners
 Analgesics

Reference:
Medical News Today. (2017, November 30). All you need to know about hernia repair. Medical News Today.
https://www.medicalnewstoday.com/articles/319753