What is a hernia?
A hernia is a tear in your muscle or tissue that allows part of your insides to bulge out. It can be a bulge of an internal organ or your intestines. Sometimes you can see the hernia, depending on its location and size. Certain activities can worsen the condition, like bending over or lifting heavy objects.
Hernias usually occur in your groin. Inguinal hernias are in the groin and are mostly found in men. Femoral hernias are in the upper thigh near the groin. These are much less common and are mostly found in women. The abdomen is another frequent hernia location. If hernias occur in the midline of the abdomen, they are called ventral hernias. If they occur at the site of a previous surgical scar, they are incisional hernias. Umbilical hernias occur in association with your belly button and are found more commonly in babies.
In a hiatal hernia, part of the upper stomach comes through an opening in your diaphragm, or chest wall. This hernia can cause acid to leak from your stomach into your esophagus. The esophagus is a tube that connects your throat to your stomach. Effects of hiatal hernias include heartburn, indigestion, and acid reflux.
Hernias also can be birth defects. A congenital diaphragmatic hernia occurs when your diaphragm doesn’t form right. This can create space for your stomach to move into your chest. Sometimes doctors find the defect when you’re a baby. Other times, they may not find it until later in life. In severe cases, your stomach can crowd your chest organs, like your lungs and heart. Surgery can help repair your diaphragm so that you don’t develop other problems, such as breathing difficulties.
Symptoms
You might not have symptoms, depending on the type of hernia you have. One common sign of a hernia is the visible bulge in the affected area. Other reported symptoms include pressure, a cough, heartburn, and difficulty swallowing. Severe hernia symptoms are shooting pain, vomiting, and constipation. If your hernia becomes soft or you can’t push it in, go to the emergency room. Hernias can cause your organs or tissue to become infected, blocked, or strangled.
What causes a hernia?
The various types of hernias can have different causes. In general, a hernia starts with pressure on an organ or your intestines. A hernia forms when this pressure happens in the same area as a weakened muscle or tissue. Some people are born with weak muscles or tissue that isn’t fully developed. However, most people get hernias as their bodies age and their muscles weaken.
You also can get a hernia, or worsen an existing one, from certain movements and habits. These include:
- Picking up heavy objects (especially lifting them in the wrong way and with weak muscles)
- Overusing the same muscle
- Straining during coughing, sneezing, diarrhea, or constipation
- Being overweight or having poor nutrition
- Using tobacco
Diagnosis
Your doctor usually can detect a hernia in a physical exam. They also might order tests to further assess your condition and the cause. An ultrasound test uses sound waves to scan your body. A barium X-ray takes images of your digestive area and intestines. A computed tomography (CT) scan also uses X-rays to get pictures. An endoscopy studies your esophagus and stomach using a small camera at the end of a flexible tube.
Prevention Tips
You can’t always prevent hernias. Some are caused by genetics that you can’t avoid. A congenital diaphragmatic hernia is a birth defect. You also can be born with weak muscles that make it easier to get a hernia later in life.
You can reduce your chance of getting some types of hernias by:
- Eating smaller meals
- Losing weight if you have obesity
- Avoiding or limiting alcohol and tobacco
- Avoiding or limiting certain foods (such as things that are spicy or high in fiber)
- Using proper lifting techniques to prevent strains
Treatment
Treatment options depend on the type of hernia you have and your state of health. At first, your doctor may suggest monitoring your condition for changes. This may also include making changes to your diet, activity, and habits. Medicines may help lessen hernia symptoms.
If the hernia doesn’t improve or worsens, your doctor will discuss surgery. There are two types of surgical treatment. Laparoscopic surgery is less invasive. Your doctor or a surgeon will make small cuts in the affected area to fix the hernia. Open repair surgery requires a larger cut to make the repair.
As part of surgery, your doctor might use surgical mesh. This is considered a medical device. The purpose of surgical mesh is to act as a support for your weakened muscle or tissue. Mesh products can be synthetic or made from animal tissue. Surgical mesh comes in two forms. Temporary mesh is one that your body will absorb. It works with your muscles and tissue to strengthen over time. Permanent mesh is meant to provide long-term muscle support.
Living with a hernia
Most types of hernias can be treated and corrected. However, it’s common for hernias to come back. In some cases, surgical mesh can help reduce this chance. Talk to your doctor or surgeon about the best treatment option for you and how to prevent recurring hernias.
People who have a congenital diaphragmatic hernia may have other health issues. Talk to your doctor about how to treat and manage these.
Questions for your doctor
- Are there exercises I can do to strengthen my muscles and prevent a hernia?
- What’s the chance of my hernia coming back?
- My hernia only bothers me from time to time. Do I even need to see a doctor?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
