What is Hernia?

A hernia is an opening in the abdominal wall that can contain soft tissue, fatty tissue or parts of the internal organs. Treatment is essential, although hernias rarely result in serious consequences.

What characterizes a hernia?

A hernia, also known as a soft tissue hernia or abdominal hernia, is an opening in the abdominal wall. These can cause tissue or organs inside the body to turn outwards, which can lead to so-called jamming, for example.

There are different types of hernias. For example, hernias that occur above the groin, umbilical hernias that occur directly behind the navel and simple incisional hernias. There are also thigh fractures and epigastric fractures in the area around the navel. Despite the name, such breaks are not to be equated with fractures. Rather, it is openings that often develop over years or as a result of serious illnesses.

Triggers are, for example, colon cancer, chronic cough or constipation. In most cases, the hernia is repaired by surgery, with diagnosis of the trigger also being an important part of therapy.

Causes

Hernias can have a variety of causes. They often occur after a lifting trauma, i.e. an injury as a result of excessive stress. Chronic coughing, constipation or colon cancer can also cause soft tissue hernias. Likewise, sudden weight gain, pregnancy or various liver diseases. Diseases that are associated with abdominal fluid formation in particular favor the development of a hernia. The same applies to connective tissue weaknesses.

In general, hernias are more common with age. The exact causes are often uncertain, which makes targeted treatment difficult. In addition, most hernias are congenital. The gaps in the abdominal wall already develop during the embryonic period and enlarge over the course of life. This type of hernia mainly affects men.

Symptoms, Ailments & Signs

The symptoms of a hernia are clear. This leads to a bulge in the abdominal wall, which is accompanied by burning pain. Especially during the development of the hernia, those affected suffer from severe symptoms. However, there are also exceptions. If the resulting hernia is particularly large, there may be no pain at all.

Only when there is a so-called incarceration, i.e. the pinching of tissue, does severe pain occur. If the intestine is pinched by one or more hernias, stool cannot escape and causes severe pain and vomiting. Since the blood supply is also interrupted, the pinched areas cannot be supplied with nutrients and oxygen and, in the worst case, die. If this happens, immediate action must be taken to avoid long-term consequences.

Clear signs of a hernia are also the bulges that occur in the abdomen and groin area. These can usually be felt or even seen. If they are touched, the symptoms intensify.

Diagnosis & History

Hernias can be positively diagnosed through a physical exam. The patient is examined closely and the abdomen in particular is palpated. In addition, suspicious body regions are listened to with a stethoscope. An ultrasound scan gives a close look at the soft tissue hernias, while strong light sources make it easier to illuminate the affected region.

The examinations mentioned serve to determine the size of the hernia, where the hernia canal is, whether and which tissue is protruding from the hernia and what measures can be taken. The doctor decides whether it can be “repositioned”, i.e. whether the gap can be closed again without an operation.

In addition to the physical examination, the doctor takes the patient’s medical history. Within this he determines how long the complaints have existed, what the living conditions are like and whether diseases such as chronic cough exist. Then the diagnosis can be made. The course of a hernia can generally be assessed as positive. Surgery is possible at any age and is almost always successful.

A plastic reinforcement, which is placed on the affected area during the operation, prevents another hernia from occurring. Serious health problems can only arise in the event of non-treatment and the resulting blockage. In the worst case, it can lead to an intestinal infarction and death as a result.

Complications

The patient suffers from extremely severe pain due to the hernia. This pain usually manifests itself as a burning sensation and mainly affects the abdominal wall. The constant pain often leads to depression and other psychological upsets. Furthermore, the pain can also occur at night and lead to sleep problems, which extremely reduce the patient’s quality of life.

Should the bowel become trapped, vomiting may occur, which is accompanied by extreme pain. There can also be an insufficient supply of oxygen to the affected areas, so that the affected organs are damaged or die off completely. A transplant is usually necessary for the patient to survive. In most cases, the hernia is diagnosed relatively quickly and clearly, so that early treatment is possible.

The treatment is carried out by an operative intervention, whereby there are no special complications or complaints. Life expectancy is also not reduced if treatment is started early. If internal organs have already been damaged by the symptoms of the hernia, a transplant may be necessary.

When should you go to the doctor?

If a bulge in the abdominal wall is suddenly noticed, possibly associated with severe pain and an increasing feeling of illness, a hernia is suspected. A doctor should be consulted if the symptoms are particularly intense and do not go away on their own within a day or two. If symptoms such as vomiting or fever appear, an immediate clarification is necessary. If the bulge does not cause any pain, a doctor must be consulted after a week at the latest.

Those affected should also pay attention to unusual symptoms and seek medical advice immediately in the event of acute cramps, sweating or severe discomfort. Individuals suffering from a chronic cough, constipation, connective tissue weakness or colon cancer are particularly susceptible to soft tissue hernias.

An increase in body weight, various liver diseases, pregnancy and old age are also possible triggers of a hernia. If the symptoms and complaints mentioned occur in combination with one of these points, a doctor’s visit is indicated. In addition to the family doctor, a gastroenterologist or a specialist in internal medicine can be consulted. In the event of acute symptoms, it is best to go directly to the nearest hospital.

Treatment & Therapy

A hernia does not necessarily have to be treated. Small soft tissue hernias can be observed as they often persist for many years without growing any further. Larger openings are closed surgically. If this does not happen, the aforementioned incarceration may occur, which can have serious consequences for the patient.

In addition to the actual treatment, the therapy also focuses on the diagnosis of the trigger. If the hernia is not congenital, it is necessary to determine which diseases or lifestyle habits led to it and how these can be corrected. This is a long-standing process that goes along with preventing further hernias.

Outlook & Forecast

The prognosis for surgical interventions for hernias is usually good, with timely diagnosis and prompt surgery. It largely depends on the type and size of the hernia, as well as the ability to reduce the risk factors associated with developing hernias.

Older age, longer, larger hernias, and longer duration of irreducibility are risk factors for acute complications, such as strangulation and intestinal obstruction. Approximately 5% of primary inguinal hernia surgeries are performed in the emergency room.

Abdominal hernias do not usually occur in children. However, they recur in about 10 percent of adults. An operation is seen as the only chance of recovery. Subsequent surgical intervention for hernia recurrence is less successful than the initial surgery.

If diagnosed early in childhood, the prognosis for children who have had a surgically treated inguinal hernia is very good. There are only occasional complications associated with inguinal hernias that can lead to death. However, these are rare. This is most common in children whose hernias are diagnosed too late or whose hernias have been strangulated, ultimately leading to organ failure.

Prevention

Hernias are difficult to prevent because they often develop without a specific trigger or are even congenital. However, a healthy lifestyle with sufficient exercise, a balanced diet and little stress can reduce the risk of occurrence many times over. Avoiding alcohol and nicotine also has a fundamentally positive effect.

Otherwise, existing illnesses such as a chronic cough or constipation should be treated early so that the pressure on the abdominal cavity does not persist for too long. From an advanced age, regular check-ups are a good way of preventing hernias and other diseases that are not noticeable from the outside.

Aftercare

An unoperated hernia must be checked at regular intervals. If the symptoms worsen or the hernia enlarges, an operation is necessary in many cases. Follow-up care of surgically treated hernias is also necessary. In principle, the patient can walk slowly and climb stairs directly after the operation.

However, a grace period of two weeks must be observed postoperatively. Heavy physical exertion should be avoided. Under no circumstances should the patient lift or carry heavy loads after a hernia operation. If the operation could not be performed minimally invasively, the grace period is extended to a period of six to twelve weeks.

In order to promote optimal wound healing, patients should refrain from swimming and going to the sauna for fourteen days after the operation. In open procedures, a longer waiver is often necessary. The exact period should be clarified in consultation with the doctor treating you. In addition, it is recommended to refrain from consuming tobacco after the operation, since smoking can disrupt and delay the process of wound healing.

Light painkillers can be taken to treat pain, especially in the first three days after the operation. Cooling the affected areas can also have a pain-relieving effect. In addition, an operated hernia must be checked after two weeks via ultrasound. At this point, if necessary, the sutures are removed. Rehabilitation measures and/or physiotherapy units are usually not necessary for hernias.

You can do that yourself

A soft tissue fracture does not necessarily have to be operated on. However, if the symptoms are severe and the hernia is very large, so that there is a risk of life-threatening complications, an operation should be carried out promptly. If you have a known hernia, it is advisable to carefully monitor physical changes and take part in regular check-ups.

If the hernia is not congenital, another disease is the cause. This should be determined by a specialist. A visit to an internist or a gastroenterologist is recommended for this.

To prevent aggravation or recurrence of hernias, heavy objects should not be lifted. A healthy lifestyle also has a preventive effect and supports healing. This includes a balanced diet rich in vital substances , regular exercise in the fresh air and avoiding alcohol and nicotine.

All measures that serve to reduce stress also have a fundamentally positive effect: Yoga and Chi Gong or autogenic training. They strengthen the immune system and reduce the risk of additional stress on the organism. If it is caused by a chronic cough, it should be treated urgently.

In addition to classic antibiotic therapy, natural remedies such as grapefruit seed extract or tea and lozenges made from cistus are also recommended. These have a germicidal effect and thus act like a natural antibiotic. The supportive treatment of the intestines with probiotics also helps with respiratory diseases by supporting the work of the immune system.

Hernia