Hernia repair

A hernia occurs when an internal organ protrudes through a gap or opening in the wall around it. The two most common types of hernias are hiatal hernia and inguinal or groin hernia.

A hiatal hernia forms when the top part of the stomach protrudes through the opening in the diaphragm where the esophagus or food pipe joins the stomach. The diaphragm is the large muscle that divides the abdomen from the chest. Most of the time the hernia is small and there are no symptoms. If the hernia is larger, it may allow food or acid to back up into the esophagus. This may cause heartburn, belching, or chest pain.

Most cases of hiatal hernia can be treated without surgery. A change in eating habits, losing weight, using antacids, and the elevation of the head of the bed will help. Occasionally severe cases require surgery to push the portion of the stomach back into the abdominal cavity into its proper position. Then the opening in the diaphragm is made smaller.

An inguinal hernia is in the groin. The groin is the area where the lower abdomen meets the thigh. A part of intestine bulges through a weak area in the muscles of the abdomen. The intestine bulges through this weak area in the muscle for many reasons. Aging, heavy lifting, chronic illness, physical activity, pregnancy, large weight gain, smoking, or straining during bowel movements or urination are all causes. An inguinal hernia often shows as a lump when the person stands or strains. The lump, or bulge, may go away when the person lies down. There may be pain or discomfort in the groin when coughing or lifting. Occasionally in men, the intestine may enter the scrotum. This can cause pain and swelling in the scrotum.

Usually the bulge can be pushed back into place. When the bulge cannot be pushed back inside the abdomen, it may be trapped or incarcerated. An incarcerated hernia may cause more and constant discomfort. A healthcare provider should be consulted. If the blood supply to the tissue is pinched or cut off, it may swell. The tissue can die. It is very painful, and may cause nausea and vomiting. This is a strangulated hernia, which is an emergency needing immediate medical attention. Surgery is almost always needed.

Hernias do not go away by themselves. They do not improve with time. The only treatment of a hernia is surgery to repair it. Surgery can repair most inguinal hernias in a short and simple operation. The surgeon makes a small cut over the hernia. The intestine is pushed back to its normal position. Then the weak area is sewn together. In a newer operation, a mesh patch is secured over the weak area. Sometimes a special instrument called a laparoscope is used. Several very small cuts are made. The laparoscope, a long thin-lighted tube is put in the cuts, and the repair of the hernia is made this way.

Occasionally, a man may wear a truss (which is a belt that places pressure against the hernia). It may give a sense of support. This is not a long-term solution for a hernia.

Following a hernia repair, stress should not be put on the abdominal muscles. Lifting heavy objects or straining with a bowel movement should be avoided. These measures may prevent the hernia from coming back.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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