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Last Updated: Oct 23, 2019
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Hernia - Know When You Need The Surgical Treatment

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Dr. B N ShuklaBariatrician • 15 Years Exp.Fellowship In Minimal Access Surgery, Fellowship In Bariatric Surgery, M.S
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A hernia occurs when an organ or fatty tissue pushes through a weak opening in the muscle that holds it in place. Hernias are common in the abdomen, but can also develop in the upper thigh, belly button and the genitals. The common types of hernia are the ones that occur in the groin viz (inguinal, femoral, obturator) around the belly button (umbilical), incisional (after a previous surgery) and hiatal (causes acid reflux) and are caused by muscle weakness. This weakness or increase in pressure in the abdomen can be triggered by lifting heavy objects without stabilizing abdominal muscles, diarrhea or constipation and chronic coughing (smokers and asthmatics) or straining to pass urine.

How can you treat hernia?

As hernia is a mechanical defect in the abdominal wall, the only definitive treatment is surgical repair of the defect. The type of surgery required depends on the size of the hernia and the severity of its symptoms. The defect may be repaired with stitches but the best option with least recurrence is to use  a mesh. The Hernias that are small and don't cause discomfort can be observed and managed conservatively with regular follow up with the surgeon. All hernias have the risk of intestines getting trapped and strangulation.

Lifestyle changes

Avoiding heavy meals, not bending over immediately after a meal and managing your body weight can reduce  the incidence of hernias. Also, you should avoid foods causing heartburn and quit smoking. If these dietary changes do not relieve your discomfort, you may need surgery to treat hernia.
 
Medication

Prescription medication given by your doctor that reduces stomach acid can relieve your soreness and improve the symptoms.

So when do you need surgery?

If your hernia is gradually growing in size, looks unsightly and is causing pain,  you should seek help and the doctor may advice you to effectively treat it through surgery. But with a hernia, there is always a risk of bowel obstruction and strangulation which may need an emergency operation.

A hernia can be repaired using two different surgical methods - open surgery or laparoscopic surgery.

In case of an open surgery, an incision is made in the skin near the bulging area. It requires a longer recovery process.
Laparoscopic surgery uses a camera and miniaturized surgical equipment to repair the hernia by making two to four small incisions in the abdomen. This method is less damaging to the surrounding tissue and has a much shorter recovery time.

Almost all of the hernias can be treated Laparoscopically, but as many surgeons are not well trained in Lapsroscopic hernia repair they do not recommend the procedure. So it's imperative you seek out a good minimally invasive surgical specialist.

Is there an alternative to surgery?

There is no other treatment apart from surgery for a hernia (imagine you have a hole in a cloth, the only way to repair it is with a thread (darning) or a patch).

Exercising regularly, losing weight or taking medications will not eliminate a hernia. Some patients feel that wearing a hernia belt will help ease the discomfort, but it will not help your hernia go away. It will only provide temporary relief. Only surgery provides a permanent and effective solution. If you wish to discuss about any specific problem, you can consult a Bariatrician.

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