Hernia: Symptoms, Causes, Treatment and Cost

When an internal organ or tissue pushes through a weak spot in the surrounding muscle or connective tissue, it is known as a Hernia. It may cause discomfort or pain, as well as a noticeable lump or bulge under the skin.

Hernias can appear anywhere on the body, including the diaphragm, groyne, upper thigh, and abdomen. While some hernias may not result in any noticeable symptoms, others may create serious issues and necessitate surgical repair.

Basically, there are many types of hernias, each a little different from the other. Below, we will be discussing in detail about some of them. Have a look:

There are several types of hernias, which occur when an organ or tissue protrudes through an opening in the muscle or tissue that holds it in place. Some common types of hernias include:

1. Inguinal hernia: This type of hernia occurs in the groin area and is the most common type of hernia. It occurs when part of the intestine protrudes through a weak spot in the abdominal wall.
2. Umbilical hernia: This type of hernia occurs around the belly button and is more common in babies and young children. It occurs when part of the intestine protrudes through the abdominal wall near the belly button.
3. Hiatal hernia: This type of hernia occurs in the upper part of the stomach, where it protrudes through an opening in the diaphragm (the muscle that separates the chest from the abdomen).
4. Incisional hernia: This type of hernia occurs at the site of a previous surgical incision. It occurs when part of the intestine protrudes through the scar tissue at the site of the incision.
5. Femoral hernia: This type of hernia occurs in the groin area and is more common in women. It occurs when part of the intestine protrudes through the abdominal wall near the femoral artery.
6. Ventral hernia: This type of hernia occurs anywhere along the midline of the abdominal wall. It occurs when part of the intestine protrudes through a weak spot in the abdominal wall.
7. Epigastric hernia: This type of hernia occurs in the upper part of the abdomen, between the rib cage and the belly button. It occurs when part of the intestine protrudes through a weak spot in the abdominal wall.
8. Spigelian hernia: This type of hernia occurs along the border of the rectus abdominis muscle, which runs down the middle of the abdomen. It occurs when part of the intestine protrudes through a weak spot in the abdominal wall.

The symptoms of a hernia may vary depending on the type and location of the hernia. Some common symptoms of a hernia include:

1. A bulge or protrusion in the affected area: This is often the most noticeable symptom of a hernia. The bulge may be more noticeable when standing or coughing and may disappear when lying down.
2. Pain or discomfort: A hernia may cause pain or discomfort in the affected area, especially when standing or coughing.
3. A heavy or dragging sensation: Some people with a hernia may feel a heavy or dragging sensation in the affected area.
4. A feeling of weakness or fatigue: A hernia may cause a feeling of weakness or fatigue, especially if it is large or if the intestine is stuck in the hernia.
5. Difficulty swallowing: A hiatal hernia may cause difficulty swallowing, as the protrusion of the stomach into the chest may interfere with the movement of food through the esophagus.
6. Heartburn or acid reflux: A hiatal hernia may cause heartburn or acid reflux, as the protrusion of the stomach into the chest may allow stomach acid to flow back into the esophagus.

There are several factors that can increase the risk of developing a hernia, including:

1. Age: As we age, our muscles and tissues naturally weaken and become more prone to hernias.
2. Obesity: Being overweight or obese can put extra strain on the muscles and tissues of the abdomen, increasing the risk of developing a hernia.
3. Pregnancy: Pregnancy can cause the muscles and tissues of the abdomen to stretch and weaken, increasing the risk of developing a hernia.
4. Heavy lifting: Repeatedly lifting heavy objects can put a strain on the muscles and tissues of the abdomen, increasing the risk of developing a hernia.
5. Chronic cough or constipation: Chronic coughing or constipation can put a strain on the muscles and tissues of the abdomen, increasing the risk of developing a hernia.
6. Previous surgery: Having surgery in the abdomen can weaken the muscles and tissues, increasing the risk of developing a hernia at the site of the incision.
7. Genetic factors: Some people may be born with weakened muscles or tissues in the abdomen, increasing their risk of developing a hernia.

It's important to note that not all hernias are preventable. However, maintaining a healthy weight, avoiding heavy lifting, and managing chronic conditions such as constipation or a chronic cough may help reduce the risk of developing a hernia.

Asymptomatic hernia is not a dangerous condition, but a symptomatic hernia can cause life-threatening conditions. Such issues include necrotizing enterocolitis (severe inflammation of intestines) and sepsis.

Generally, hernia patients have a bulge under the skin of the abdomen or the groin, which may be tender and disappear when they lay down.

Hernia patients always feel full in the abdomen and often suffer from constipation or experience blood in the stool. Here are some other things that hernia patients feel:

• Discomfort in the abdominal area or groin while lifting weight or bending over
• Burning or itching at or around the bulge
• Sense of weakness or pressure in the groin region
• Heartburn
• Difficulty in swallowing
• Intense pain
• Vomiting
• Regular constipation
• Constant pain and swelling around the testicals
• Upper abdominal pain

Different hernia types pose different risk factors for the patients. Have a look:

• Inguinal hernia: Risk factors for inguinal hernias include age, obesity, heavy lifting, and previous abdominal surgery. Men are more likely to develop this type of hernia.
• Umbilical hernia: Risk factors for umbilical hernias include premature birth, obesity, and multiple pregnancies.
• Hiatal hernia: Risk factors for hiatal hernias include obesity, smoking, heavy lifting, and repeated episodes of vomiting.
• Incisional hernia: Risk factors for incisional hernias include obesity, previous abdominal surgery, and infection at the site of the surgical incision.
• Femoral hernia: Risk factors for femoral hernias include obesity, previous abdominal surgery, and pregnancy. Women are more likely to develop this type of hernia.
• Ventral hernia: Risk factors for ventral hernias include obesity, previous abdominal surgery, and infection at the site of the surgical incision.
• Epigastric hernia: Risk factors for epigastric hernias include obesity, heavy lifting, and previous abdominal surgery.
• Spigelian hernia: Risk factors for spigelian hernias include obesity, heavy lifting, and previous abdominal surgery.

It's important to note that these are just some of the risk factors for each type of hernia, and not all people with these risk factors will necessarily develop a hernia.

Here are some ways you can help prevent a hernia:

• Smokers should Quit smoking immediately: Smoking can increase the risk of developing a hiatal hernia. Quitting smoking can help reduce this risk. They can also consult their doctor to prepare a smokers cessation plan for themselves.
• Maintain a healthy weight: Being overweight or obese puts extra strain on the muscles and tissues of the abdomen, increasing the risk of developing a hernia. Maintaining a healthy weight can help reduce this risk.
• Avoid heavy lifting: Lifting heavy objects can put strain on the muscles and tissues of the abdomen, increasing the risk of developing a hernia. When lifting heavy objects, use proper lifting techniques, such as bending your knees and keeping the object close to your body.
• Manage chronic conditions: Chronic conditions such as constipation and a chronic cough can put strain on the muscles and tissues of the abdomen, increasing the risk of developing a hernia. Managing these conditions through lifestyle changes and medical treatment can help reduce the risk of developing a hernia.
• Avoid straining during bowel movements: Straining during bowel movements can put extra pressure on the muscles and tissues of the abdomen, increasing the risk of developing a hernia. To avoid straining, make sure you are getting enough fiber in your diet and drink plenty of fluids.
• Take care of your incision after surgery: If you have had surgery in the abdomen, make sure you follow your doctor's instructions for caring for the incision. This can help prevent the development of an incisional hernia.

There are several tests that can be used to diagnose a hernia:

• Physical examination: A physical examination is often the first step in diagnosing a hernia. During the examination, the doctor will look for signs of a hernia, such as a bulge or protrusion in the affected area. The doctor may also ask the patient to perform certain movements, such as coughing or standing, to see if the hernia becomes more noticeable.
• Imaging tests: Imaging tests such as an X-ray, CT scan, or MRI can be used to get a clearer picture of the hernia and help confirm the diagnosis.
• Ultrasound: An ultrasound can be used to visualize the hernia and assess its size and location. This method uses high-frequency sound waves to prepare an image of the organs and their positioning inside the body.
• Herniography: This test involves injecting a contrast dye into the area around the hernia and then taking X-rays to visualize the hernia and assess its size and location.
• Endoscopy: This test involves inserting a thin, flexible tube with a camera on the end through the mouth and into the stomach. This can be used to visualize a hiatal hernia and assess its size and location.

There are several possible complications of a hernia, including:

• Strangulation: This occurs when the hernia becomes trapped and the blood supply to the protruding tissue is cut off. This can be a life-threatening emergency and requires immediate medical attention.
• Obstruction: This occurs when the hernia blocks the intestine, causing difficulty passing stool or gas. This can lead to abdominal pain and bloating.
• Incarceration: This occurs when the hernia becomes trapped and cannot be pushed back into place. This can cause pain and may require surgery to correct.
• Chronic pain: Some people with a hernia may experience chronic pain in the affected area, even after the hernia has been repaired.
• Recurrence: A hernia that has been repaired may come back (recur) at a later time.

It's important to note that home remedies are not a substitute for medical treatment for a hernia. That being said, here are some home remedies that may help alleviate some of the symptoms of a hernia:

• Apply a cold compress: Applying a cold compress to the affected area may help reduce swelling and discomfort.
• Take over-the-counter pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may help reduce pain and inflammation.
• Eat a high-fiber diet: A high-fiber diet may help reduce constipation, which can put strain on the muscles and tissues of the abdomen and exacerbate hernia symptoms.
• Avoid Spicy Foods: Doctors suggest avoiding spicy food and tomato-based foods to prevent acid reflux. Health professionals also suggest giving up cigarettes.
• Avoid heavy lifting: Lifting heavy objects can put strain on the muscles and tissues of the abdomen and may exacerbate hernia symptoms.
• Wear a truss: A truss is a special device that can be worn to support the hernia and help prevent it from becoming trapped or strangulated.

It's important to note that these home remedies may not cure a hernia and should not be used as a substitute for medical treatment. If you have a hernia, it's important to follow your doctor's treatment plan and seek medical attention if you experience worsening symptoms or complications.

If you have a hernia, it's important to follow a healthy and balanced diet to help manage your symptoms and prevent complications. Here are some general recommendations for what to eat if you have a hernia:

• Fruits and vegetables: Aim to include a variety of colorful fruits and vegetables in your diet. These foods are rich in vitamins, minerals, and fiber, which can help support overall health and prevent constipation.
• Lean proteins: Choose lean sources of protein such as chicken, turkey, fish, and plant-based proteins like beans and tofu. These foods can help support muscle health and repair.
• Whole grains: Choose whole grains such as whole wheat, quinoa, oats, and brown rice instead of refined grains. These foods are rich in fiber and nutrients, which can help support overall health and prevent constipation.
• Stay hydrated: Drink plenty of water and other fluids to help prevent constipation and maintain good bowel function.
• Avoid heavy, greasy, or spicy foods: These types of foods can be difficult to digest and may exacerbate hernia symptoms.

If you have a hernia, it's important to follow a healthy and balanced diet to help manage your symptoms and prevent complications. Here are some general recommendations for what to avoid if you have a hernia:

• High-fat foods: Foods that are high in fat can be difficult to digest and may exacerbate hernia symptoms.
• Citrus foods: including oranges, grapes and lemons should also be avoided.
• Spicy foods: Spicy foods may irritate the digestive system and worsen hernia symptoms.
• Caffeine: Caffeine can stimulate the digestive system and may exacerbate hernia symptoms.
• Alcohol: Alcohol can irritate the digestive system and may worsen hernia symptoms.
• Carbonated beverages: Carbonated beverages can cause bloating and may exacerbate hernia symptoms.

In some cases, doctors recommend watchful waiting if the hernia is not causing any pain or discomfort to the patient. You can also wear a truss to relieve your symptoms, but it is highly recommended to check with your doctor first as it is critical that the truss fits the patient properly.

In children, the doctors try to reduce the size of the bulge by applying manual pressure to avoid a hernia operation.

Hernias that cause pain and discomfort, or are big in size require surgery to avoid serious complications. Mainly, there are three types of hernia surgeries - Open Hernia Repair, Minimally Invasive Hernia Repair and Laser Hernia Repair.

If you think you may have a hernia, it's a good idea to see a doctor for a proper diagnosis and treatment plan. The type of doctor you should see for a hernia depends on the location and severity of the hernia. Here are some options:

• General surgeon: A general surgeon is a doctor who specialized in surgery of the abdomen and other organs. They are often the first point of contact for people with a hernia and can diagnose and treat a hernia through surgery.
• Gastroenterologist: A gastroenterologist is a doctor who specialized in the digestive system and its disorders. They may be involved in the diagnosis and treatment of hiatal hernias.
• Urologist: A urologist is a doctor who specialized in the urinary system and the male reproductive system. They may be involved in the diagnosis and treatment of inguinal hernias.
• Obstetrician/gynecologist: An obstetrician/gynecologist is a doctor who specialized in the female reproductive system and pregnancy. They may be involved in the diagnosis and treatment of femoral hernias.

It's important to see a doctor if you think you may have a hernia, as untreated hernias can lead to more serious complications. A doctor will be able to diagnose a hernia and recommend treatment options.

After open surgery, a patient may take up to four to six weeks to fully recover. Right after the surgery, the patient would only be able to perform necessary daily functions but would only be able to resume routine activities after six weeks.

On the other hand, Laparoscopic Hernia Surgery has significantly less downtime. The hospital stay is also very less and the surgery scars also heal in a very quick time.

The average cost of a hernia surgery in India is about Rs 65,000. It, however, may change depending upon the city, type of hospital, age of the patient, fees of the surgeon, etc.

There are two types of meshes used in the surgery. Non-absorbable mesh is supposed to stay in the body indefinitely, providing permanent reinforcement to the repaired hernia. On the other hand, absorbable mesh dissolves in the body over time, as it is not supposed to provide long-term reinforcement to the repair site. This type of mesh is used when the doctor believes that by the time it will dissolve, the new tissue growth would be able to provide strength to the repair.

Swelling at surgical site, and genital areas, abdominal bloating, bruising and fluid accumulation in groin region are very normal occurrences after a hernia repair surgery. Patients are advised to rotate ice packs for 15 minutes every hour for the first three days to subside the swelling. Here are other guidelines for postoperative care:

• Wound Care: You must ensure that the dressing on the surgery wounds remains dry for the first three days. After three days, you can take a shower but have to make sure that you do not keep the wet dressing on after the shower. You are also advised not to submerge your incision into a pool or lake.
• Activity: You can climb stairs and go on walks if feeling okay. You, however, should not do any strenuous activity, including lifting weights, sexual intercourse or any other type of exercise until your post-op visit. Based upon your situation, your doctor may or may not enhance the duration of these restrictions. People with complex hernia are suggested to wear binder. You can travel in a car but should not drive until you are on medications. Also ensure to take breaks and stretch your legs on a long trip within a month of the surgery.
• Pain and Discomfort: OTC medications are also recommended to manage the postoperative pain. The patient's doctor may also prescribe a strength pain medication.
• Diet: The patient should take clear liquids for the first 24 hours. Subsequently, the patient can advance the diet while avoiding everything that may cause constipation.
• Fighting Constipation: Stay on a full liquid diet for the first 24-36 hours. Speak with your doctor to prepare a medication-diet chart for your specific needs to avoid the chances of constipation.
• Consult Your Doctor: If fever is over 101 degree fahrenheit, skin is getting red, swelling is increasing, bleeding or drainage from incisions, and if you had to go to ER for a urinary catheter.

There are minimal to no side-effects of laparoscopic hernia surgery. Some of the rare side-effects of hernia mesh may include:

• Adhesion
• Bowel obstruction
• Bowel perforation
• Infection
• Rejection
• Migration
• Recurrence
• Chronic Pain

Conclusively, Hernia is only treatable with surgery and Laparoscopic Hernia Surgery is the best way to get rid of the problem without opening up your body too much. You can prevent this condition through some lifestyle and dietary changes. If your hernia is not causing any pain, doctors recommend you wait watchfully before going for surgery.

Medications are only a temporary solution that will only subside the symptoms for a time being. Hence, getting a doctor's opinion is highly recommended. In about 10 percent of adults, a hernia may recur requiring the patient to undergo another surgery.