So, you noticed a lump near your belly button when you coughed last night – it’s strange, because now you’re lying down and the lump seems to have vanished! You may possibly have a hernia … but what is a hernia, exactly?
What is a hernia?
The word ‘hernia’ is a general term used to describe a bulge or protrusion of an organ through the muscle that usually contains it. A hernia happens when either fatty tissue or an organ (such as the intestine) pushes through an area of weakness in your surrounding connective tissue or muscle. This is why you see it when standing up, but not when lying down
- it often causes a bulge or swelling, which becomes more apparent on straining, standing, coughing or sneezing
- some hernias flatten out when you lie down or push on them gently
What causes a hernia?
Most hernias occur due to a combination of two things: muscle/connective tissue weakness and increased pressure on the abdominal wall. Some hernia facts:
- a hernia can be present at birth, or develop during one’s life
- the likelihood of developing a Hernia increases with age
- hernias are more common in men than women
- certain activities and conditions put you at higher risk, such as lifting heavy objects, a persistent cough or chronic constipation, to name a few.
Not all hernias are the same – here are the different types:
Inguinal hernia – this happens when fatty tissue or part of the intestine protrudes through to the inguinal canal in the groin. It’s the most common type of hernia, especially in childhood and in men.
Femoral hernia – this occurs when fatty tissue or part of the intestine protrudes through to the canal that contains your femoral artery. Femoral hernias are much less common, and are mostly found in women, especially during pregnancy.
Incisional hernia – this happens when part of the intestine protrudes through the abdominal wall where abdominal surgery was previously performed. This is more common in the elderly, as well as people who are overweight and who were inactive following their abdominal surgery.
Umbilical hernia – this happens when fatty tissue or part of the small intestine protrudes through the abdominal wall near the belly button/navel.
Umbilical hernias usually occur in new-born babies, obese women and women who have had many pregnancies (due to repeated strain on the abdominal wall)
Hiatus hernia – hiatus hernias occur when the top part of the stomach protrudes through the hiatus of the diaphragm, into the chest cavity (the diaphragm is the layer of muscle separating the chest cavity from the abdominal cavity). This type of hernia may not show any symptoms, such as heartburn, coughing or chest pain. There are other types, such as Epigastric and Spigelian hernias.
Treating a hernia
In many cases, no treatment is needed. If the hernia is not causing symptoms, is a painless swelling and is easily reducible (it can be pushed back) “watchful waiting” may be advised by your doctor. But if your have the following symptoms, your doctor may choose to treat the hernia with surgery:
- Increasing pain or discomfort
- Increased swelling
- Increased symptoms on standing, straining or lifting
When is it a medical emergency?
A hernia needs urgent medical attention from a doctor if you have the following symptoms:
- sudden, severe increasing pain
- nausea and vomiting
- inability to pass wind/flatulence
- a fever
- a swelling/hernia that has become firm and tender
- a swelling/hernia that cannot be pushed back
If you doctor does send you for corrective surgery, it may be open surgery or keyhole (laparoscopic) surgery.