Hernias are among the most common medical conditions in India. About 10 out of 100 people in the adult population suffer from the condition at some point. India has a high prevalence of hernias as a result of congenital muscular weakness and age-related deficiencies. Upon reading this page, you will be able to have a clear understanding of all things related to hernia.

What is a Hernia?

Hernias are caused by weakening of the muscles near an organ, which results in the intestine or other tissues protruding through the weak spots. In most cases, a hernia occurs in the abdomen between the chest and hips, but it can also occur in the upper thigh and groin. Hernias are caused by several factors. There are several factors contributing to the condition, including smoking, poor nutrition, chronic constipation, and consuming tobacco.

Even though most hernias don’t cause immediate complications, certain cases might require surgery to prevent life-threatening complications because hernias don’t heal on their own. People of all ages are susceptible to hernias. Hernias are caused by weak or ruptured muscle tissues, causing internal organs such as the intestine to protrude. There are two types of hernias, acquired and congenital. Hernias can be inborn, or acquired through obesity, weightlifting, and coughing or sneezing persistently.

Types of Hernia

There are several types of hernia that you can experience, including inguinal, hiatal, umbilical, ventral, femoral, etc. A few types of hernia are explained below in detail:

Inguinal Hernia: Inguinal hernias, also known as groin hernias, are hernias that develop due to an abnormal weakness in the inguinal canal. It can be extremely uncomfortable and interfere with everyday living. Hernias in the inguinal canal happen when abdominal tissue or organs push through a weak spot. In males, this type of hernia usually occurs when the opening between the testicles and abdomen isn’t properly closed. The opening usually closes shortly after birth. However, when the opening is partially open, the integrity of the muscle wall gets compromised thus leading to the creation of a weak spot. Typically, a bulge forms when the tissues press against the weak spot. It may or may not cause any symptoms for a while. Once the bulge persists in pushing the muscle wall and creating a hole in the wall, symptoms will appear leading to severe pain and discomfort.

Inguinal hernia is of two types, including direct inguinal hernia and indirect inguinal hernia. A direct inguinal hernia is typically caused due to weak muscles in the inguinal canal and age-related stress. When foetal growth delays resulting in a persistent opening in the inguinal canal, it leads to indirect inguinal hernias. The only cure to inguinal hernia is surgery as they do not resolve on their own.

Hiatal Hernia: An hiatal hernia is caused by a bulge in the upper part of your stomach that stretches the large muscle between your abdomen and the chest. The food tube (oesophagus) passes through a small opening in the diaphragm (hiatus) before connecting to the stomach. A hiatal hernia, thus occurs when the stomach pushes up through the hiatal opening and into the chest.

In most cases, a small hiatal hernia is not problematic. It would be difficult for you to know you have one until your doctor discovers it while checking for another condition. Large hiatal hernias, however, can cause food to back up into the oesophagus, causing heartburn. Medication or self-care can usually treat this problem. If it is very large, surgery may be necessary.

Umbilical Hernia: Hernias arising in the inner lining of the belly, near the belly button, are known as umbilical hernias. The early stages of this condition are often painless. However, they do not go away on their own. Therefore, umbilical hernias must be repaired surgically. A navel hernia occurs when the muscle wall supporting the internal organs is destroyed, causing the navel to be damaged. As a result, the belly button bulges and can be pushed down. Bulges, however, tend to grow gradually and may become more noticeable when pressure inside the abdomen increases.

These hernias are most common in children and women. Typically, children develop this hernia after their umbilical cord is recently cut and their muscles are more prone to weakness. Thus, when children cough or strain too much, the organ eventually pushes through the belly button and causes an umbilical hernia. As well, pregnancies, especially multiple pregnancies, are more likely to result in umbilical hernias in women.

Ventral Hernia: In a ventral hernia, the abdominal wall is weakened along the vertical center. A person suffering from this condition may experience abdominal pain, especially when lifting or straining. In most cases, a ventral hernia is treated with surgery, including open, laparoscopic, and robotic procedures. A ventral hernia can be of three types, including epigastric hernia, umbilical hernia and incisional hernia.

Epigastric (stomach area) hernias occur between the breastbone and the navel (belly button). Both men and women can develop this type of hernia. Umbilical (belly button) hernia causes a bulge inside the belly button leading to pain and discomfort. Incisional hernia often develops after previous surgery at the treated site. Nearly one third of patients who have undergone abdominal surgery usually develop an incisional hernia. Hernias of this type can occur anywhere between months and years following abdominal surgery.

Causes of Hernia

The two causes of hernias are weakness in muscles and straining. A hernia may develop rapidly or slowly, depending on the reason behind it. There are several causes of weak muscles or strains that can lead to hernias, including:

  • 1. Birth defect, resulting from development during pregnancy
  • 2. Ageing or being older
  • 3. Trauma, injury or surgical procedures
  • 4. Heavy lifting or strenuous exercise increases abdominal pressure
  • 5. Excessive coughing or Chronic Obstructive Pulmonary Disease (COPD)
  • 6. Multiple pregnancies
  • 7. Straining during bowel movements due to constipation
  • 8. Obesity or excessive weight gain
  • 9. Ascites

Another risk factor for developing a hernia is certain medical conditions. These include:

  • 1. Premature birth or low birth weight
  • 2. Cystic Fibrosis
  • 3. Diabetes
  • 4. Smoking weakens connective tissue
  • 5. Hereditary or family history

Symptoms of Hernia

When a hernia occurs in the abdomen or groin, a bulge or lump may be apparent. However, this can be pushed back in when lying down or disappear when sitting up. After a lump has been pushed in, it may reappear when you laugh, cry, cough, strain during a bowel movement, or engage in physical activity. Here are some additional symptoms you might experience:

  • 1. A bulge or swelling in the groin or scrotum
  • 2. Extreme pain at the site of the bulge.
  • 3. Pain while lifting weights
  • 4. Increase in the size of the bulge overtime
  • 5. Faint sensations of aching or induced discomfort,
  • 6. Feeling of abdominal fullness
  • 7. Bowel obstructions

Hernia Risk Factors

During the surgery: An operation to repair a hernia may be complicated by a number of complications. Surgical hernia removal procedures carry the following risks, despite their rarity:

  • 1. Reaction to anaesthesia
  • 2. Wound infection
  • 3. Blood clot
  • 4. Urinary Tract Infection (UTI)

If left untreated: If left untreated, hernias can obstruct blood flow into the muscles and cause incarceration or strangulation of the tissues, which is potentially life-threatening. People experiencing inguinal obstruction might also experience nausea, constant fever, blood in stools, vomiting, stomach pain, and a painful lump in the groin. Getting medical attention for such cases is a life-threatening emergency.

Hernia Treatment

Treatment options for hernias that do not require surgery include medication and lifestyle changes. While waiting for surgery or if they are not healthy enough for surgery, wearing a corset, binder, or truss may ease the discomfort. While these solutions may work temporarily, a hernia usually does not disappear on its own without surgery.

Types of Hernia Surgery

Hernia can only be permanently repaired by undergoing a repair surgery. Unless the hernia is causing significant pain or discomfort, the doctor may recommend a watchful waiting process and continue observing the hernia until the patient is ready for surgery. Hernias are usually treated surgically to prevent potentially life-threatening complications. The top three kinds of hernia surgery are explained below:

Open Hernia Repair Surgery: This is the conventional and most commonly used technique for hernia repair. As part of an open procedure for hernia repair, the surgeon makes a cut or incision in the groin, and then identifies the hernia “sac,” which contains the bulging intestine. Afterward, the surgeon stitches the abdominal wall to close the hernia back into the abdomen. A synthetic mesh may be used if the hernia protrudes through a large opening.

Laparoscopic Hernia Repair Surgery: This is a much more advanced technique which is specially used for treating inguinal hernias. It is a minimally invasive surgery that is performed by making tiny incisions (depending upon the severity of the hernia) instead of a large opening. Through one of these micro incisions, a thin camera-fitted laparoscope is inserted and the abdomen is inflated with CO2 gas which is harmless in nature. This gas creates space for the surgeon to view the internal structures vividly. To strengthen the abdominal wall, the surgeon might use synthetic mesh. Within a month, the small abdominal incisions are barely visible after the procedure is completed. Children and pregnant women are not advised to undergo this procedure of hernia repair.

Robotic Hernia Repair Surgery: The third option is robotic hernia repair surgery, in which a robot guides the surgeon through a laparoscope to view inside the abdomen and repair the hernia. This procedure is very similar to that of laparoscopic hernia repair surgery. The only difference is that in this process the surgeon is seated at a console in the operating room and handles the surgical instruments. With the help of the robot, the surgeon is able to see the inside of the abdomen in 3D, and the artificial mesh can be used to reconstruct the abdominal wall with minimal stitches.

How to Prevent Hernia?

Here are the top seven things that can be done to prevent hernia:

  • 1. Use proper lifting techniques. Do not lift heavy weights
  • 2. Maintain a recommended healthy body weight
  • 3. Increase your core strength by exercising regularly
  • 4. Control diabetes
  • 5. Quit smoking
  • 6. Drink plenty of water
  • 7. Consume high protein diet

Frequently Asked Questions

Is hernia a serious operation?

Although hernia repair surgery is a serious operation, with an expert surgeon, it does not involve many risks and complications. With latest technological advancements, the hernia surgery these days is performed with minimal incisions, thus it is becoming risk free.

Is having hernia surgery painful?

While you might experience some pain or discomfort after the hernia surgery, you will be asleep during the procedure. Mostly all types of hernia surgeries are performed under the influence of general anaesthesia, thus the patient does not feel any pain. The pain felt by the patient post surgery is administered with the help of prescribed painkillers.

Can you walk after hernia surgery?

Mostly, there are no medical or physical restrictions on activity after hernia surgery. You can easily walk, climb stairs or have sexual intercourse after you recover from the surgical wounds. Infact, most surgeons suggest incorporating normal activities as soon as possible in order to boost the recovery time.

Does a hernia make you look fat?

Hernia generally looks like a lump or bulge beneath the skin. They do not add to the chubby look of the body but are physically visible.

Do hernias heal on their own?

No, hernias do not go away on their own. The only way to get rid of hernia is a surgical repair. If this condition is left untreated, it can cut off the blood supply to the intestine and many such other complications.

What happens if a hernia is left untreated?

If hernia is left untreated, it can lead to life threatening escalations, such as necrotizing enterocolitis (severe inflammation of intestine) and sepsis.

How can I control a hernia without surgery?

Hernia can be controlled without surgery by wearing hernia belts, holding the hernia while coughing, taking light walks, intaking a fibre-rich diet, etc.

What is a doctor who performs hernia surgery called?

A doctor who performs hernia surgery is called a laparoscopic surgeon.

How much does hernia surgery cost in India?

The minimum price for Hernia Surgery in India starts from INR Rs. 55,000 and can range up to Rs 75,000 depending upon multiple factors, including hospital charges, diagnostic tests, consultation fee, etc.

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