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In the past, we've explored hernias common to children and given parents a better understanding of signs and symptoms, as well as traditional treatments. But what about adults? Are hernias in adults similar to those seen in children? We asked Francisco Reyes, MD, PPG — General Surgery, to share more on the topic.
What is a hernia?
A hernia is defined as a protrusion of an organ through an opening in the wall of the cavity in which it is contained. Basically, it’s a hole in the abdominal wall muscle that allows organs to go through.
Are there different kinds of hernias that are common in adults?
There are many different types of hernias, with abdominal wall hernias being the most common. Abdominal wall hernias include umbilical hernias, inguinal (groin) hernias and incisional hernias (from previous surgeries).
What causes hernias?
There are many risk factors that can contribute to having a hernia. Ultimately, increased pressure in the abdominal cavity from things like heavy lifting, chronic coughing or sneezing, or chronic constipation can cause hernias. Previous abdominal surgery or previous hernia repairs can increase your risk, as can risk factors such as older age, being male, smoking, and a family history of hernias.
What are the signs and symptoms of a hernia?
Signs and symptoms vary depending on location. Small hernias can be asymptomatic, or they can present as pain or discomfort. Most often, patients will complain of a bulge in the abdominal wall (for example, the belly button, groin, or previous abdominal wall scar). Coughing, heavy lifting, or straining can aggravate a hernia and increase any pain or discomfort.
When do hernias need to be repaired and why?
In general, all hernias should be repaired. Hernias will never go away on their own, they’ll only increase in size.
How are hernias repaired?
There are many different types of surgeries to fix different types of hernias. The goal is to ultimately close the defect and reinforce the closure with mesh if needed. This can be done in an “open” fashion where you make an incision over the hernia and fix it through that incision, or it can be done laparoscopically (making small incisions and putting a camera in the abdomen and fixing them from the inside of the abdomen). It can also be done laparoscopically with the assistance of the da Vinci robotic Surgical System.
Parkview Health system has invested in this advanced robotic surgical system at several of its locations, including most recently at Parkview Whitley Hospital. The robot gives surgeons a wider visual field during the surgery while allowing them to make much smaller incisions. All this helps promote less discomfort for the patient as well as potentially shorter healing time after surgery.
What are the complications if you don’t have a hernia repaired?
There are many possible complications. We primarily worry about “strangulation”. This is when a segment of the bowel (intestine) gets stuck in the hernia and causes the bowel to swell, potentially cutting off the blood supply. This would require emergency surgery and potential resection of the segment of bowel involved. Other complications include an increase in pain, being unable to push the hernia back in, bowel obstructions and constipation.
Not all hernia repairs are an emergency. Many patients have had their hernias for years and it either didn’t bother them or they didn’t know they had one. If the pain from a hernia is getting worse or occurring more frequently, then it should be repaired sooner rather than later. If you’re unable to push the hernia back in, you begin feeling nauseous, or you begin vomiting, that’s a sign of strangulation, and you should seek medical attention as soon as possible.
If you are concerned that you may have a hernia, speak with your primary care physician and they can refer you to a surgeon to be assessed.
