A hernia is an opening in the abdominal wall, which may contain soft tissue, fatty tissue or parts of the internal organs. Treatment is essential, although hernias rarely result in serious consequences.
What characterizes a hernia?
A hernia, also called a soft tissue hernia or abdominal wall hernia, are openings in the abdominal wall. Through these, tissues or organs from inside the body can bulge outward, which can lead, for example, to so-called jams. There are different types of hernias. For example, inguinal hernias, which occur above the groin, umbilical hernias, which occur directly behind the belly button, and simple incisional hernias. There are also thigh hernias and epigastric hernias in the area around the navel. Despite the name, such fractures are not the same as fractures. Rather, they are openings that often develop over years or as a result of serious diseases. Triggers include colon cancer, chronic cough or constipation. In most cases, the hernia is repaired by surgery, although diagnosis of the triggers is also an important part of therapy.
Causes
Hernias can have a wide variety of causes. They often develop after lifting trauma, that is, an injury as a result of excessive stress. Chronic coughing as well as constipation or colon cancer can also cause soft tissue hernias. So can sudden weight gain, pregnancy or various liver diseases. Above all, diseases that are accompanied by abdominal fluid formation favor the development of a hernia. The same applies to connective tissue weaknesses. In general, hernias occur more frequently with increasing age. The exact causes are often uncertain, which makes targeted treatment difficult. In addition, most hernias are congenital. Already during the embryonic period the gaps in the abdominal wall develop and enlarge in the course of life. This form of hernia mainly affects men.
Symptoms, complaints and signs
The symptoms of a hernia are clear. Thus, there is a bulge in the area of the abdominal wall, which is accompanied by burning pain. Especially during the development of the hernia, affected people suffer from severe discomfort. However, there are also exceptions. If the developing hernia is particularly large, pain may be completely absent. Only when a so-called incarceration, i.e. the pinching of tissue, occurs, does severe pain occur. If the intestine is trapped by one or more hernias, the stool cannot escape and causes severe pain as well as vomiting. Since the blood supply is also interrupted, the pinched areas cannot be supplied with nutrients and oxygen and, in the worst case, die. If this happens, immediate action must be taken to avoid late effects. Clear signs of a hernia are also the bulges that appear in the abdominal and groin area. These can usually be felt or even seen. If they are touched, the discomfort intensifies.
Diagnosis and course
Hernias can be clearly diagnosed by physical examination. This involves a close examination of the patient and palpation of the abdomen in particular. In addition, suspicious body regions are listened to with a stethoscope. Ultrasound examination provides a close look at soft tissue hernias, while strong light sources facilitate illumination of the affected region. Mentioned examinations are used to determine how large the hernia is, where the hernial canal is located, if and what tissue is coming out of the hernia, and what measures can be taken. The physician decides whether “repositionability” is possible, that is, whether the hernia can be closed again without surgery. In addition to the physical examination, the physician takes a medical history with the patient. Within this, he or she determines how long the complaints have existed, what the patient’s living conditions are like, and whether there are any illnesses, such as a chronic cough. After this, the diagnosis can be made. The course of a hernia is generally considered to be positive. Surgery is possible at any age and almost always crowned with success. A plastic reinforcement, which is placed in the affected area during the operation, prevents a hernia from recurring. Only in the case of non-treatment and the resulting jamming can serious health problems arise.In the worst case, intestinal infarction and subsequent death occur.
Complications
Due to the hernia, the patient suffers from extremely severe pain. This pain usually manifests as burning and mainly affects the abdominal wall. Due to the persistent pain, it is not uncommon for depression and other psychological upsets to occur. Furthermore, the pain can also occur at night, leading to sleep disturbances that extremely reduce the patient’s quality of life. Should the bowel become trapped, vomiting may occur, accompanied by extreme pain. Likewise, there may be an undersupply of oxygen to the affected areas, causing damage or complete death of the affected organs. In this case, transplantation is usually necessary for the patient to continue to survive. In most cases, the hernia is diagnosed relatively quickly and clearly, so that early treatment is possible. In this case, the treatment is carried out by means of a surgical procedure, and there are no particular complications or discomforts. Life expectancy is also not reduced if treatment is initiated early. If internal organs have already been damaged by the discomfort of the hernia, transplantation may be necessary.
When should you see a doctor?
If a bulge is suddenly noticed in the abdominal wall area, possibly associated with severe pain and an increasing feeling of illness, a hernia is suspected. A physician should be consulted if the symptoms are particularly intense and do not resolve on their own within one to two days. If symptoms such as vomiting or fever are added, immediate clarification is necessary. If the bulge does not cause pain, a doctor must be consulted after one week at the latest. Affected persons should also watch out for unusual symptoms and seek specialist advice immediately in the event of acute cramps, sweating or a severe feeling of malaise. Individuals suffering from chronic cough, constipation, connective tissue weakness or colon cancer are particularly susceptible to soft tissue fractures. An increase in body weight, various liver diseases, pregnancy and old age are also possible triggers of a hernia. If the above symptoms and complaints occur in combination with any of these, a visit to the doctor is indicated. In addition to the family doctor, a gastroenterologist or a specialist in internal medicine may be consulted. In the case of acute symptoms, it is best to go directly to the nearest hospital.
Treatment and therapy
A hernia does not necessarily need to be treated. Small soft tissue hernias can be observed, as they often persist for many years without growing further. Larger openings are closed surgically. If this is not done, the aforementioned incarceration may occur, which can have serious consequences for the patient. In addition to the actual treatment, the therapy also focuses on the diagnosis of the triggers. If the hernia is not congenital, it is necessary to determine which diseases or lifestyle habits have led to its development and how these can be remedied. This is a long-term process that involves the prevention of further hernias.
Outlook and prognosis
The prognosis for surgical intervention for hernias is usually good, with timely diagnosis and prompt surgery. It depends predominantly on the type and size of the hernia and the ability to reduce risk factors associated with hernia development. Older age, longer, larger hernias, and longer duration of irreducibility are risk factors for acute complications, such as strangulation and bowel obstruction. Approximately 5% of primary inguinal hernia surgeries are performed in the emergency department. Abdominal hernias do not usually occur in children. However, they recur in about 10% of adults. In this case, surgery is considered the only chance for recovery. Further surgical intervention for recurrence of the hernia is less successful than the initial surgery. If diagnosed early in childhood, the prognosis for children who have had an inguinal hernia treated surgically is very good. There are only occasional complications associated with inguinal hernias, which may result in death. However, these are rare.This is most common in children whose hernias were diagnosed too late or whose hernias were strangulated, ultimately leading to organ failure.
Prevention
Hernias are difficult to prevent because they often develop without a specific trigger or are even congenital. However, a healthy lifestyle with sufficient exercise, a balanced diet little stress can reduce the risk of development many times over. Abstaining from alcohol and nicotine also has a generally positive effect. Otherwise, existing illnesses such as chronic cough or constipation should be treated at an early stage so that the pressure on the abdominal cavity does not persist for too long. From an advanced age, regular check-ups are a good prevention against hernias and other diseases that are not externally noticeable.
Follow-up care
An unoperated hernia must be checked at regular intervals. If the symptoms worsen or the hernia enlarges, surgery is necessary in many cases. Aftercare of surgically treated hernias is also necessary. In principle, the patient can walk slowly and also climb stairs directly after the operation. However, a grace period of two weeks must be observed postoperatively. In addition, heavy physical exertion should be avoided. Under no circumstances should the patient lift or carry heavy loads after a hernia operation. If the operation could not be performed minimally invasively, the grace period is extended to a period of six to twelve weeks. To promote optimal wound healing, patients should refrain from swimming and sauna sessions for fourteen days after the operation. In the case of open procedures, a longer period of abstinence is often necessary. The exact period should be clarified in consultation with the attending physician. In addition, it is advisable to refrain from tobacco consumption after the operation, as smoking can disturb and delay the process of wound healing. Light painkillers can be taken to treat pain, especially during the first three days after surgery. Cooling the affected area can also relieve pain. In addition, an operated hernia must be checked via ultrasound after two weeks. At this time, if necessary, the stitches will be removed. Rehabilitation and/or physical therapy sessions are not usually necessary for hernias.
Here’s what you can do yourself
A soft tissue hernia does not necessarily require surgery. However, if the symptoms are severe and the hernia is very large, posing a risk of life-threatening complications, surgery should be performed promptly. If the hernia is known, it is advisable to carefully monitor physical changes and regularly attend preventive examinations. If the hernia is not congenital, it is due to another disease. This should be determined by a specialist. A visit to an internist or gastroenterologist is recommended for this purpose. To prevent aggravation or the recurrence of hernias, heavy objects should not be lifted. A healthy lifestyle also has a preventive effect and supports healing. This includes a balanced diet rich in vital substances, regular exercise in fresh air, and abstaining from alcohol and nicotine. All measures that serve to reduce stress also have a fundamentally positive effect: Yoga and Chi Gong or autogenic training. They strengthen the immune system and reduce the risk of additional strain on the organism. If a chronic cough is the cause, it should be treated urgently. In addition to classic antibiotic therapy, natural remedies such as grapefruit seed extract or tea and lozenges made from cistus are also recommended. These have a germicidal effect and thus act like an antibiotic from nature. Supportive treatment of the intestines with probiotics also helps with respiratory diseases by supporting the work of the immune system.