Hernia, Its Prevention and Management

When do you call it a Hernia, and who is affected?

Due to a defect in anterior abdominal wall musculature, the intestines or omental fat will protrude out from the defect, which will appear as a localised bump over the abdomen with or without associated symptoms depending on the duration of the bump. Commonly affected sites are from the umbilicus and around the umbilicus, from previous abdominal surgical sites like caesarean surgery (very common in females), open surgery for appendicitis etc., or it can arise from the inguinal region (common in men). Both males and females of all age groups can get hernia. In children, usually, it’s congenital inguinal hernia which will be present since birth.

What causes hernia?

It can be congenital or acquired due to increased intra-abdominal pressure while lifting heavy weights, straining during defecation, urination, chronic cough, smoking, previous abdominal surgeries etc.

When to approach a doctor?

When the patient notices a swelling that will be initially prominent on standing or straining and disappears at rest, it is advised to seek a surgeon’s help and get it treated. If delayed, the patient will gradually develop pain, constipation, increase in the size of the swelling which will become irreducible even on lying down where the intestines or omental fat will get obstructed or strangulated and the patient will have severe pain, abdominal distension and vomiting which is a surgical emergency.

Can Hernia be treated without surgery?

It’s a NO. We can temporarily manage the pain with medication and prevent complications by applying an abdominal binder when it’s a reducible type of hernia. But we cannot cure the condition completely without surgery.

What surgical modalities are available?

Laparoscopic surgeries like IPOM, IPOM+, TEP, TAPP etc. are the best modalities where we will enter the abdomen with three tiny cuts over the skin and pull the protruded contents back into the abdomen, closing the defect and strengthen the muscle wall by placing a mesh to prevent a recurrence. The benefits of Laparoscopic surgery being it’s a minimally invasive surgery, short hospital stays, early recovery etc. Open hernioplasty is an age-old modality, which is better indicated for complicated hernias though it needs prolonged hospital stay, long recovery time and a high rate of wound infections.

Can we prevent hernia?

Yes. Dietary, lifestyle modifications can prevent acquired hernias. Using weight lifting belts as a support while lifting weights, using abdominal binders in previously operated patients, avoiding smoking, and having a fibre-rich diet to prevent constipation, weight loss etc. will prevent one from getting hernia.

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