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All you need to know about hernias

16 March 2018

What is a hernia?

A hernia is a hole in the abdominal muscle, allowing the lining of the abdominal cavity, together with another structure such as a loop of bowel, to pop out and produce a lump. They most commonly occur in the groin, when they are usually called inguinal hernias, but they can occur at other places, such as the middle of the abdomen, particularly around the umbilicus (tummy button).

Who gets a hernia?

A hernia can occur at any age, and can even be found in newborn babies. They are more common in male patients, and around a quarter of men develop a groin hernia at some point in their lifetime1. A family history, as well as certain conditions that raise the pressure within the abdomen such as constipation or a persistent cough, can increase the chance of developing a hernia2,3.

What are the symptoms of a hernia?

A hernia may not produce any symptoms at all, and is often found when a doctor examines a patient for other reasons. Symptoms include a swelling that typically occurs after physical activity, and pain, which again is often worse after physical exertion. The swelling may be worse at the end of the day, and usually disappears on lying flat. Interestingly, pain is typically more severe in small hernias, because a small hole in the abdominal muscle gets stretched more as the abdominal contents pop out.

How are they diagnosed?

The diagnosis of a hernia is usually easily made on examination of the lump by a doctor; either a GP or a surgeon. Sometimes the diagnosis is more difficult, particularly if the swelling is not obvious on examination, and it is occasionally necessary to perform a scan, such as an ultrasound or MRI, to detect the hernia.

How are they treated?

Most hernias require an operation to fix them. If the hernia is not causing any pain, surgery is still discussed as over time the hernia can increase in size and typically starts to cause pain later on.  Most operations are performed under general anaesthesia with the patient asleep, but if they have other medical problems that makes a general anaesthetic risky, it may be possible to repair the hernia under local anaesthetic with the patient awake.

Most hernias are fixed by placing a small sheet of mesh over the hole in the abdominal muscle.  For a range of hernia types, there is usually the option of a laparoscopic (key-hole) repair. The advantage of this is that there is often less pain and a quicker return to normal activities4.  

How long will it take to recover after surgery?

It depends on the type of surgery, but many operations are performed as a day case. A patient will need to rest for a few days following surgery, but typically for an inguinal hernia repair a patient can usually resume normal activities within the first week. It is best to avoid heavy lifting, however, for two or three weeks, and driving should be avoided until the pain subsides enough to allow an emergency stop manoeuvre.

Mr Gary Atkin, Consultant General Surgeon here at Spire Harpenden Hospital performs surgical treatment for hernias, bowel cancer, gallstones and much more. He states: “I endeavour to take a compassionate and personal approach, ensuring patients feel comfortable and fully understand the treatment options available to them.”

  

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