By Dr Ananya Mandal, MD
A hernia is the protrusion of an organ through the wall of the cavity that usually contains it. In the majority of cases, hernias form in the abdomen, when a weakness in the abdominal wall eventually forms a hole, through which adipose tissue or organs protrude. A hiatus hernia, for example, pokes through into the chest cavity via a hole in the diaphragm.
Hernias may or may not present with pain or a palpable lump at the affected site. Some vague symptoms may also manifest if an organ become pressured or stuck. Fatty tissue usually enters a hernia first, along with or followed by the organ. In some cases, symptoms such as severe pain, tenderness in the abdomen, vomiting, wind and difficulty passing stools may develop. This can mean that the blood supply to an organ or a piece of tissue trapped by the hernia is being restricted. This is referred to as strangulation. A piece of herniated bowel may also be causing an obstruction and preventing the bowel contents form moving through it as they usually would.
Who is affected?
Some of the factors that may lead to hernia are described below:
- Mechanical causes such as not lifting heavy weights correctly, hard coughing, incorrect posture or blows to the abdomen.
- Conditions that increase pressure in the abdominal cavity such as obesity, constipation, chronic lung disease and fluid build-up in the abdomen (ascites).
- Muscle weakness due to overexertion, poor nutrition or smoking, for example.
A diagnosis of hernia is based on clinical assessment of symptoms and an ultrasound scan. Occasionally, doctors may use other imaging techniques such as computed tomography or magnetic resonance imaging.
Although hernia that are left untreated do not usually resolve on their own, they do not necessarily worsen either and sometimes the benefits of surgery do not necessarily outweigh the risks. However, some forms of hernia are more dangerous than others and are at risk of becoming strangulated or causing bowel obstruction, for example. Depending on how serious the symptoms are and the patient’s general health status, a doctor may decide that surgery is the most appropriate treatment approach.
Reviewed by Sally Robertson, BSc
Last Updated: Aug 19, 2014