Hernia or rupture is a swelling just under the skin, usually occurring in the lower part of the stomach or upper part of the thigh.
The swelling is caused by a bulging of a part of the bowel into, and through, an opening in the muscles which form the wall of the abdomen. An operation can affect a complete cure.
The front wall of the abdominal cavity is made up of muscle and fibers covered with skin on the outside and a thin, strong lining inside.
Sometimes the muscles don’t close up completely during growth, and a small gap is left, especially in places where there is a natural opening to allow blood vessels to pass from one part of the body to another.
When this happens, the inside lining may bulge into or through the gap, making a small “sac” or bag. This bulge may remain flat for years if the gap is small and the muscles strong and active.
But, one day, sudden exertion or unaccustomed exercise, or any action which catches the muscles by surprise, may force a bit of bowel into the bulge, causing the swelling which is known as hernia or rupture.
Not due to injury
Though there may be some pain due to the sudden stretching of the sac and the surrounding tissues, there has been no actual tearing of the muscles.
It is hardly ever true, even among older people, that hernia is due to the tearing or rupture of the muscles, or injury. The possibility of a hernia developing has usually been there from birth.
Sometimes the filling of the sac is gradual – a painless process. In a few middle-aged or elderly people, especially if they are fat or have had a wasting illness or prolonged strain, the hernia or “sac” may bulge through a fiber of the abdominal part of the muscles and wall.
Dangers of hernia
A hernia is dangerous only if one of two things happens. If a piece of bowel which finds its way into the sac becomes “kinked” its blood supply may be cut off, and the bowel may decay and die. Or the bowel may become blocked, and obstruct the rest of the bowel.
Luckily neither of these things happens often, but if it does it must be treated without delay. The pain and discomfort which go along with such complications would warn you to send for your doctor immediately; so as long as you feel well you needn’t worry.
Operation the best
A hernia can be cured by operation, and you would be wise to have this done if possible, because of those dangers already mentioned, as well as for your own comfort.
There is no reason to fear that you will be left with a weakness, or that the condition will recur after the operation. In young people, a simple operation, removal of the sac, gives a complete cure.
If you have had a large hernia for many years, or the kind of rupture due to muscle weakness, the cure is not so simple, but that is the surgeon’s concern. After an efficient operation, the cure is usually complete, provided there has been sufficient tissue with which to make the repair.
Immediately after the operation healing takes place, and during this time you must be careful. Even then, though, some muscular activity is better than none, to prevent still more weakening of the muscles.
Most surgeons nowadays will encourage you to do some exercises, increasing gently, from the first day after your operation. After seven to ten days in bed, you will find yourself gradually returning to normal for the next three weeks.
By the time the month is up you will forget that you ever had an operation, still less a rupture, and you will be able to enjoy a normal active life, without taking any special precautions, although in older people or with large hernias of long duration where the tissues are thinned out and poorly developed, some care to avoid “straining” should be taken.
You can help yourself by trusting your surgeon and following his advice as best you can. Don’t be afraid to move and exercise if he tells you to. He knows his job and has done it well. The rest is up to you.
The continued use of a truss after the operation is not necessary except in very special circumstances when your surgeon definitely advises you to wear one.
Meanwhile, if you are waiting for admission to hospital, or if for any reason an operation is inadvisable just at present, consult your doctor about what you should do to prevent things from getting worse.
If there is likely to be a long delay, he may advise you to wear a truss and will tell you where to get it made. This will prevent your hernia from getting any bigger. If no truss is worn, you must be careful to avoid violent muscular efforts and strain and to support the site of the hernia when you cough.