How to Spot a Hernia

Finding out you have a hernia can be a strange experience. There first thing you might notice is a bulge in your abdomen, navel, groin or upper thigh. The bulge can often occur at the spot of a previous surgery. It could be uncomfortable or it may not hurt at all. The lump disappears and reappears depending on what you are doing, like standing or lying down. It may also get larger over time.

Here is what happened: a hole or defect has occurred in the muscle or connective tissue of the abdominal wall, resulting in an internal part of the body, like fatty tissue or a portion of the bowel, pushed through the opening. Hernias can be caused by natural weakness in the abdominal wall or by previous surgeries. They can be worsened by straining to lift something heavy, weight gain, persistent coughing or sneezing, or constipation. You are at higher risk if you have had an injury or abdominal surgery in the past. Hernias can happen to anyone at any age. Hernias can occur in other parts of the body, but abdominal hernias are the most common.

When to seek help

If you notice a lump that has changed or is getting painful, make an appointment with your doctor to be evaluated. Doctors can typically diagnose hernias through a physical exam, occasionally medical imaging may be needed (CT scanning or rarely ultrasound). Go to the emergency department if you experience any of the following symptoms:

• Sudden, severe pain
• Nausea and vomiting
• Constipation or gas
• Bloody stool
• The lump becomes firm or tender, or cannot be pushed back in

What to expect in treating a hernia

In non-urgent cases, doctors may recommend monitoring the hernia. However, hernias generally do not get better without surgery. Dr. Bret Cardwell of General Surgery at Cleveland Clinic Abu Dhabi, explains that there are two types of surgery: open surgery and laparoscopic surgery. “Laparoscopic surgery is a less invasive procedure,” he said, “and causes minimal scarring”. Several small incisions are made instead of a larger one, and the doctor uses an instrument called an endoscope to visualize and repair the hernia. Only a good evaluation and discussion with your surgeon can determine if you would benefit from surgery, and which surgery is best for you. During the surgery the tissue is pulled back into proper position and a mesh patch is placed in the weak area to reinforce it. “The good news is that the repair can typically be done quickly – most patients go home a few hours after surgery,” said Dr. Cardwell. Generally, patients experience some minor pain and are able to return to their normal routine within a few days. Full routine recovery can take 4-6 weeks.