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Written By
Dr. Swati Mishra
BDS
Reviewed By
Dr. Rajeev Sharma
MBA, MBBS
Last updated on:
07 Dec 2022 | 03:43 PM (IST)

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Hernia

Hernia

Also known as Breach, Fissure, Fracture, Schism, Burst, Cleavage, Cleft, and Crack

Overview

A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that normally contains it. Most hernias occur within the cavity in the stomach, between the chest and the hips. 


Hernias can be caused due to weakness or strain on the muscles or a combination of both. Generally, hernias can be felt or seen as bulges and don't cause many symptoms. But, any physical activity that causes strain, can lead to pain, burning, a feeling of pressure, or a pulling sensation. The prevalence of hernias is generally based on the type which is based on the location.

The major risk factors for a hernia include physical strain, weight lifting, obesity, and pregnancy. While, it may not be a life-threatening disorder but hernia can cause severe complications if taken lightly

While surgery is the only option to treat hernias, the symptoms can be managed or prevented by not straining yourself along with certain lifestyle modifications like making sure you are not constipated, taking care of your injuries, and not lifting heavy weights.

Key Facts

Usually seen in
  • Adults above the age of 60 years.
Gender affected
  • Both men and women, but more common in men.
Body part(s) involved
  • Stomach
  • Groin
  • Belly button
  • Diaphragm
  • Leg
Prevalence
  • India: About 25 out of 100 men and 2 out of 100 women (2016)
Mimicking Conditions
  • Lymphadenopathy,
  • Lymphoma
  • Metastatic neoplasm,
  • Hydrocele
  • Epididymitis
  • Testicular torsion
  • Abscess, hematoma
  • Femoral artery aneurysm
  • Undescended testicle
Necessary health tests/imaging
Treatment
  • Surgery: Laparoscopic surgery, Open procedures, and Reconstructive surgery.
Specialists to consult
  • General physician
  • Urologist
  • Gastroenterologist
  • General surgeon

Types of Hernia


Hernia is the bulging of internal organs and based on the location it can be of different types. Some of the most common types include:

Inguinal hernia

This type of hernia is seen when fatty tissue or a part of your bowel pokes through the top part of your inner thigh (groin). It is most commonly seen in older men and can occur due to strain on the stomach.

Hiatus hernia

This occurs when part of the stomach pushes up into your chest through an opening in the thin sheet of muscle that separates the chest from the stomach (diaphragm). It usually just presents as heartburn or acidity and can occur as a result of the diaphragm becoming weak with age or pressure.

Femoral hernia

These are not very common and occur due to the same reason as inguinal hernia or protrusion of fat tissue into the groin. These are more commonly seen in women as a result of pressure on the stomach.

Umbilical hernia

This is seen near the belly button when the fat tissue pokes through it. It is commonly seen in babies if the opening in the stomach from where the umbilical cord passes through does not seal properly after birth.

Other types 

These may include the following:

  1. Incisional hernia: This is a very common complication of surgeries where tissue pokes
    through a surgical wound in the stomach that has not fully healed.

  1. Diaphragmatic hernia: It is a type of hiatus hernia where organs from the stomach
    move into the chest through an opening in the diaphragm. This can also affect babies if
    their diaphragm does not develop properly in the womb.

  1. Epigastric hernia: This is seen as a lump in the midline between your belly button and breastbone which can cause pain.

  1. Muscle hernia: This type of hernia occurs as a result of a sports injury where part of a
    muscle pokes through the stomach or leg.

  1. Spigelian hernia: It occurs when part of your bowel pokes the stomach at the side,
    below your belly button.

Listen to our expert to learn more about hernia.


Symptoms Of Hernia

A hernia in the stomach or groin can produce a noticeable lump or bulge that can be pushed back in and laughing, crying, coughing, straining during a bowel movement, or physical activity may make the lump reappear. 

Hernia, in most cases, is felt or seen as bulges and do not cause symptoms. However, it can lead to pain, burning, a feeling of pressure, or a pulling sensation, especially during physical strain. 


Some other hernia symptoms include:

  • Swelling or bulge in the groin or the scrotum

  • Pain at the site of the bulge that increases while lifting

  • Dull aching pain around the bulge

  • Increase in the bulge size over time

  • Bloating

  • Bowel obstruction

In case of hiatus hernia, there may not be bulges on the outside of the body, instead, the symptoms may include:

  • Chest pain

  • Indigestion

  • Difficulty in swallowing

  • Frequent ringing food back up in the mouth

  • Heartburn

Suffering from heartburn?

Understand what medications to take to tackle this problem.

Causes Of Hernia

Hernia can develop quickly or over a period of time by a combination of muscle weakness and strain.

Research shows that there are numerous risk factors that can cause a hernia.

Risk Factors For Hernia


There are a lot of risk factors that can increase your chances of developing a hernia. They include:

Congenital conditions

Birth defects in which there is a hole in the diaphragm can increase the risk of the peaking of the bowel, stomach, or even the liver can move into the chest cavity. This gap can form in the womb during the development of the fetus. 

Family history of hernias

Studies suggests that patients with a family history have their primary hernias as well as their recurrence at a younger age than patients without a family history.

Age

Inguinal hernia is more frequent in individuals of older age than young adults because of loss of strength of the stomach wall and conditions which increase the pressure on the stomach.

Sex

Men are much more likely to get inguinal hernias than women, because of the location of the inguinal canal. Abdominal wall and umbilical hernias are also more common in pregnant women.

Pregnancy

The intra-abdominal pressure is usually high in pregnancy, increasing the chances of herniation or its recurrence. The incidence of umbilical hernia among pregnancies accounts for 0.08%.

Know the top 5 tips that every pregnant woman should be aware of.


Injury or surgery

Incisional hernias happen when the surgical cut in the stomach wall doesn't close properly after surgery. 

Lifting weights

Strenuous sports and physical activity, particularly weight-lifting, can lead to an inguinal hernia due to excessive strain on the muscles.


Note: Strenuous sports can also cause a condition known as sports hernia, which has similar symptoms but is not actually a hernia.

Premature birth or a low birth weight

Infants who are born prematurely are at an increased risk of having an inguinal hernia. Also, those with very low birth weight have a 3 times greater risk of requiring an emergency procedure than heavier infants. 

Chronic cough 

Repetitive cough over a long period of time increases the pressure and strain on the stomach walls leading to a hernia.

Constipation

 It can increase straining during bowel movements leading to the emergence of abdominal hernia.

Learn the reason behind constipation and how to manage it.

Ascites 

This is a condition in which there is fluid buildup in the stomach. Studies show that ascites can be a major etiologic factor as umbilical hernias occur almost exclusively in patients with persistent ascites who undergo surgery for liver cirrhosis.

Obesity

It adds to the risk of developing recurrent hernias as being obese or overweight increases the strain and pressure on the muscles of the stomach and makes them weaker and more prone to developing hernias.

Read more about 5 common causes of obesity that you should know.



Lung diseases

The risk factor for hernias also includes chronic lung infections, collagen disorders, and cystic fibrosis. For a diaphragmatic hernia, weakness of the diaphragmatic muscles can be the cause. 

Smoking

Smoking weakens the connective tissue. Studies have shown that smoking is a known risk factor for the development of a hernia and it can also increase the risk of recurrence.


Want to quit smoking?

Try our extensive range of smoking cessation products that can help you get rid of this deadly habit.

 

Diagnosis Of Hernia

Diagnosing hernia can be easy and mainly consists of a physical examination in which your doctor will first take a look while you are standing, by asking you to tense your stomach muscles and cough. Then you may be asked to lie down and the doctor will feel how big the hernia sac is and see whether it can be pushed back into the abdomen. A stethoscope can aid to assess bowel sounds in the hernia sac. Other to diagnose a hernia may include:

Imaging techniques

A more definitive diagnosis of a hidden hernia requires imaging as part of the workup to confirm the clinical suspicion and this may include: 

Book your tests now.

Celebs affected

Amitabh Bacchan
Megastar Amitabh Bachchan developed multiple hernia in his lower abdomen which caused him severe pain. He tweeted "So the doctors have been after me for surgery, well two actually on either side of the abdomen and I have been avoiding it because of my busy schedule. But I shall have to take care of it now."
Dwayne Johnson
Also known as “The Rock”, during the shooting of a movie he injured himself and the painful accident tore his abdomen wall, for which he had to undergo emergency hernia surgery.

Specialist To Visit


Hernias occur in different body parts, and each type requires a different specialist to diagnose and treat different types of hernias.
Some of the doctors that you can consult include:

  • General physician

  • Urologist

  • Gastroenterologist

  • General surgeon

A urologist is a doctor who specializes in the study or treatment of the function and disorders of the urinary system. A gastroenterologist is a medical practitioner qualified to diagnose and treat disorders of the stomach and intestines.

When to see a doctor?

You should see a doctor immediately if you have a hernia and you develop any of the following symptoms:

  • Sudden and severe pain

  • Difficulty pooping or farting

  • Nausea and vomiting

  • The bump turns red, purple, or darker

  • Hernia becomes firm or tender, or cannot be pushed back in.

If you notice any of these symptoms, don’t hesitate and seek advice from our trusted team of doctors. 


Prevention Of Hernia

Preventing a hernia can be tricky, here are a few things to keep in mind that can reduce the pressure on your abdomen, thus preventing your chances of landing up with a hernia:

Maintain an ideal body weight

Being overweight can put stress and pressure on your stomach with the extra fat. Shedding some extra kilos will help to greatly reduce your risk of developing a hernia.

Add fiber to your diet

Fiber-rich, low-acidic foods like apples, pears, carrots, sweet potatoes, and leafy greens are good dietary choices when you have a hernia as they help you prevent constipation, thus preventing hernia.

Read more about 5 foods that are loaded with fiber and can also help you lose weight.

Do not lift heavy objects

Be careful and use the correct form when lifting weights or heavy objects. Don’t over-exert yourself.

Take care of your wounds

Avoid any activities that put pressure on your wounds, and always use any gel to promote wound healing. Also, limit sexual activity until your wound has healed completely.

Note: Do not get pregnant within six months of any surgery as it can lead to an umbilical hernia.

Treat your cough

Heavy coughing puts stress on your stomach, which may cause a hernia. Call your doctor if your cough doesn't go away after a few weeks.

Check out our range of cold and cough products that can help you relieve the symptoms.

Say no to smoking

Smoking is a known risk factor and can also lead to persistent cough, increasing your chances of developing a hernia.

Learn about 5 ways your body reacts when you stop smoking.


Treatment Of Hernia


Hernia repairs are very common, while surgery is the only treatment that can repair hernias, watchful waiting is also an option for people who do not have complications or symptoms with their hernias. Surgical options include:

Mesh for hernia repair

Surgical mesh is a medical device that is used to provide additional support to weakened or damaged tissue. Mesh is often used to help strengthen the hernia and reduce the risk of recurrence. 

Laparoscopic surgery

Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the stomach and pelvis without having to make large incisions in the skin. This is a minimally invasive procedure that uses multiple small incisions no more than 1 centimeter in length to access the hernia. A mesh may or may not be required to do the repair

Open procedures

This is a type of surgery that uses a single incision to open the abdomen and access the hernia, after which the hernia is repaired using mesh. Open procedures are ideally suited for patients with large or multiple hernias. The open repair can be done with or without surgical mesh. 

Reconstructive surgery

Abdominal wall reconstruction repairs defects in the walls of the stomach while reducing tension and providing structural support.


Note: Your doctor may give you medications for the pain and in most cases, the pain will lessen during the first week so that drugs are no longer needed.

Read more about types of painkillers and when they should be taken.


Home care For Hernia

If you are diagnosed with a hernia, you can try these home remedies that can help you manage the symptoms:


Castor oil (Arandi ka tel): This oil helps to inhibit inflammation inside the stomach and promote proper digestion.


Aloe vera juice: Aloe vera has anti-inflammatory properties with soothing effects and consuming the juice before meals can be beneficial for easing out some of the symptoms of hernia.


Ginger (Adrak): Studies suggest that ginger can be useful in treating various gastric ailments like constipation, bloating, indigestion, nausea, and vomiting.


Black pepper (kali mirch): Black pepper is more than just an added flavor. It stimulates healing and can also suppress acid reflux which can help to cure the swollen region of a hernia.


Buttermilk (Chhachh): It is loaded with good bacteria and is considered a safe option for people with hiatal hernia as it can reduce acids in the stomach.


Want to know the amazing health benefits of buttermilk?


Turmeric (Haldi): It contains an active ingredient called curcumin and is believed to make the muscles stiffer, that may prevent the formation of hernia.

Complications Of Hernia


If the contents of the hernia get entrapped in the weak point in the stomach wall, the contents can block the bowel, leading to the following complications:

  1. Severe or sudden 

  2. Nausea, and vomiting

  3. Peritonitis (inflammation of the tissue that covers the lining of the stomach)

  4. Intestinal strangulation (if the trapped section of the intestines does not get enough blood).

Did you know?
The impact of the COVID-19 pandemic led to a marked reduction in the number of elective hernia repairs, which led to complications due to the delay in the treatment.
Did you know?

Alternative Therapies For Hernia

The only treatment for a hernia is surgery, but there are certain alternative therapies that have shown promising results to alleviate the symptoms of hernia. They include:

Yoga 

Studies show that yoga therapy with selected asanas is effective in the treatment of reversible inguinal hernias. It is important that you choose the right yoga poses to relieve the pressure on your stomach, strengthen the muscles of the stomach and close up the inguinal canal.


Know the 6 benefits of Yoga that even doctors swear by.


Acupuncture

This has been shown to be an effective treatment for several health issues, including hiatal hernia. Studies demonstrate that anesthesia through acupuncture is a feasible anesthetic option as it reduces the amount of local anesthetic required, thus decreasing the complications. It is effective in pain relief and inhibiting gastrointestinal upset leading to a rapid postoperative recovery, which is usually complication free.

Traditional Chinese medicine (TMC)

Traditional Chinese medicine is effectively treating hernia as it uses herbs that clear away heat and toxic materials, promote qi circulation to relieve pain, diminish swelling and remove stasis, and has a good curative effect.

Living With Hernia


Large, clearly visible hernias are very unpleasant and can be quite distressing, while a hernia cannot heal itself, it can almost always be treated effectively with surgery. But, the good news is that most hernias can be repaired with minimally invasive surgery which has a low complication rate and most patients are able to get back to their normal routine quickly. Certain tips to keep in mind if you have been diagnosed with a hernia:

Be active, the right way

Being physically active in certain ways has been shown to help prevent hernias, but other types of exercise can put too much pressure on your abdomen. Beneficial exercises may include:

  • Cycling: Light cycling may be considered safe for people with smaller hernias and may also strengthen your muscles.

  • Walking: Walking is one of the most beneficial and simple exercises to perform and comes with many health benefits. 

  • Swimming: Swimming can relieve a lot of pressure, strain, and pain.

Note: Any type of exercise that involves very high levels of exertion can also increase your hernia risk. Speak with your doctor and find out whether these exercises are appropriate for you.

Read about 5 amazing health benefits of swimming.

Eat fiber-rich foods and in smaller quantities

Incorporating high-fiber foods into your diet can prevent constipation and strain during bowel movements. Also, smaller meals can be effective for decreasing the symptoms associated with hernias based on the fact that the less pressure you put on your stomach internally, the easier it is for you to digest your food.
Foods that may help in this area include:

  • Fruits

  • Vegetables

  • Whole grains

  • Nuts and seeds

  • Dried beans and peas


Note: Laxatives, like mineral oil, milk of magnesia (magnesium hydroxide), or MiraLAX (polyethylene glycol) can also help with constipation.

Explore our wide range of products that can help you if you have constipation.



Stay hydrated

It is important to maintain optimum hydration if you have a hiatal hernia. Drinking water outside meal times can help in diluting the digestive juices and aid in proper digestion, preventing constipation.

Avoid heavy lifting

If you have to lift a heavy object, bend down with your knees instead of your waist. Make your legs rather than your torso do most of the lifting effort. And if an object is too heavy for you to lift comfortably, know your limits and don’t do it. 

Use ice packs

An ice pack on the hernia will act as a quick inflammation reliever when your hernia is causing too much discomfort. Always cover the ice with a soft cloth and do not leave it on for long periods. 

Check if your prostate is enlarged

An enlarged prostate can increase pressure on the stomach by causing strain during urination. Most men develop an enlarged prostate as they age. Avoid straining during bowel movements or while urinating to decrease your chances of a hernia.


Enlargement of the prostate gland can be diagnosed by prostate-specific antigen. To know if you have this condition, 


Frequently Asked Questions

References

  1. Types of Hernia. Hernia. National Health Services UK. Jun 2019.External Link
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Hernias: Overview. 2016 Sep 21 [Updated 2020 Jan 30].External Link
  3. de Goede B, Verhelst J, van Kempen BJ, et al. Very low birth weight is an independent risk factor for emergency surgery in premature infants with inguinal hernia. J Am Coll Surg. 2015;220(3):347-352.External Link
  4. Jansen, P.L., Klinge, U., Jansen, M. et al. Risk factors for early recurrence after inguinal hernia repair. BMC Surg 9, 18 (2009).External Link
  5. Coelho JC, Claus CM, Campos AC, Costa MA, Blum C. Umbilical hernia in patients with liver cirrhosis: A surgical challenge. World J Gastrointest Surg. 2016 Jul 27;8(7):476-82. External Link
  6. DeLancey JO, Blay E Jr, Hewitt DB, Engelhardt K, Bilimoria KY, Holl JL, Odell DD, Yang AD, Stulberg JJ. The effect of smoking on 30-day outcomes in elective hernia repair. Am J Surg. 2018 Sep;216(3):471-474.External Link
  7. Kulacoglu, H. (2018). Umbilical Hernia Repair and Pregnancy: Before, during, after…. Frontiers in Surgery.External Link
  8. Miller J, Cho J, et al. Role of Imaging in the Diagnosis of Occult Hernias. JAMA Surg. 2014;149(10):1077-1080. External Link
  9. Bradley M, Morgan D, Pentlow B, Roe A. The groin hernia - an ultrasound diagnosis? Ann R Coll Surg Engl. 2003 May;85(3):178-80.External Link
  10. Halpenny D, Barrett R, O'Callaghan K, Eltayeb O, Torreggiani WC. The MRI findings of a de Garengeot hernia. Br J Radiol. 2012 Mar;85(1011):e59-61.External Link
  11. What is Hernia? Hernia Surgical Mesh Implants. US Food And Drug Administration. Apr 2018.External Link
  12. Hernia Treatment Options. Comprehensive Hernia Center. Hopkins Medicine.External Link
  13. Haniadka R, Saldanha E, Sunita V, Palatty PL, Fayad R, Baliga MS. A review of the gastroprotective effects of ginger (Zingiber officinale Roscoe). Food Funct. 2013;4(6):845-855.External Link
  14. Alagesan J, Venkatachalam S, Ramadass A, Mani SB. Effect of yoga therapy in reversible inguinal hernia: A quasi-experimental study. Int J Yoga. 2012;5(1):16-20.External Link
  15. Chu DW, Lee DT, Chan TT, Chow TL, Que MB, Kwok SP. Acupuncture anaesthesia in inguinal hernia repair. ANZ J Surg. 2003;73(3):125-127.External Link
  16. Hammoud M, Gerken J. Inguinal Hernia. [Updated 2022 Jun 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.External Link
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