A hernia means that some of the abdominal contents are trying to push their way through a weak spot in the abdominal wall. If they succeed, a lump may suddenly appear in the groin – the most common spot.

Do hernias go away?

A lump in the groin often signifies a hernia. It’s a common condition, easily remedied by proper treatment, but so many people ignore it, hoping it will simply disappear. It won’t go away.

How do you detect a hernia?

These lumps can reach an enormous size and be extremely disfiguring, but because the affected part is usually not visible, many people will continue to nurse their hernias, not bothering to seek treatment until something goes wrong.

Often, these same people will fret about a minor facial blemish or some other practically invisible disfigurement, and expect instant attention from the doctor, underlining our belief that people are often far more preoccupied with outward appearances than basic health matters.

In the groin or inguinal region, there are beneath the skin various normal apertures (or rings) through which certain structures pass. Although these are firmly closed, they do represent weak spots. Sometimes when children are born these rings fail to close.

A sudden strain may exert extra force on the rings. This may be in the form of incessant harsh coughing or heavy lifting, especially if the sudden release of a heavy load causes the abdominal wall to take the brunt of the force.

The force is exerted downwards and outwards, and within a second it is possible for the weakness to be discovered. It is further weakened and a protrusion may rapidly occur.

It’s a bit like the inner tube of a bicycle wheel trying to force its way out when a weak spot is developing in the overlying tire.

These are called congenital hernias and they are much more likely to occur when children have rings that have not closed up. In fact, some doctors believe that many hernias occur in this manner. They may not become apparent for some years until an abnormal strain makes their presence obvious.

How do you know if you have a hernia or not?

All sorts of names are given to hernias depending on their location and their anatomy, but basically they are represented by a swelling in the groin.

The swelling is usually small and soft to begin with. When the patient is lying down, it tends to disappear, as the contents fall back into the abdominal cavity.

Left untreated, and especially if the patient’s job entails a lot of heavy straining, the hernia inevitably increases in size.

As long as it keeps sliding in and out of the sac, little trouble occurs. But there is a big danger that one day the contents of the hernia (or hernial sac as it is more correctly called) will suddenly become jammed. If the contents happen to be a segment of the bowel – and this is usually the case – then trouble suddenly looms.

How serious is a hernia?

The hernia becomes incarcerated and gives rise to a frightening situation. The bowel is suddenly obstructed and food is no longer able to pass along it normally.

Often, within hours, this can develop into an acute surgical emergency. Pain, nausea, vomiting and reduced bowel actions are the most probable symptoms, but these may vary. Unless the patient is given immediate surgical treatment to relieve the obstruction, his life may be in danger.

Can a hernia heal on its own?

So, as you can see, the treatment of a hernia is very important. Ignoring a hernia, hoping it will simply disappear and that no harm will happen, is living in a fool’s paradise, burying the head in the sand. The day of reckoning may come, and there is no way of telling if and when.

The idea of wearing trusses and binders and belts belongs to a bygone era. These devices were usually unhygienic, cumbersome, and non-curative, and are not worth considering.

Can hernias be treated without surgery?

Surgery is the best treatment for a hernia, and even people of advanced years can usually cope with the operation. It entails little risk and the success rate is generally high.

Recurrences are possible, of course, but they are usually caused by the patient not following the doctor’s instructions for the post-operative care of his wound. It is essential to avoid strains for many weeks, even months, afterward if the operation is to be a success.

Besides groin hernias, other sorts may occur.

Incisional hernias

These may follow an abdominal operation, if the scar of the operation, which is usually weak for some time after surgery, breaks down. Pressure from within gradually causes the scar to bulge. If this is marked, another operation may be necessary to repair the wound.

Umbilical hernias

These usually occur only in infants and children. The hole behind the navel through which blood vessels pass before birth may fail to close, and a bulge may appear. Most heal of their own accord and surgery is rarely required.

Sometimes, umbilical hernias occur in adults, especially overweight women. The bowel may become involved and surgical repair may become necessary.

Epigastric hernias

These are tiny bulges in the midline between the navel and the lower margin of the breastbone. They occur in approximately three percent of the population. They are often unnoticed by the patient and are discovered by the doctor when he is checking for something else.

Hiatus hernia

This occurs when part of the bowel bulges through the diaphragm into the cavity that contains the lungs.

A burning, gnawing, acid sensation is usually present in the epigastric region – that is, the area immediately below the breastbone.

Hiatus hernia is very common and probably accounts for a large number of patients with stomach upsets and dyspepsia. Antacids give the best and quickest relief. Surgery is rarely needed for hiatus hernia.

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