What causes hernias?

Posted on 15 November 2013

A hernia is not a life-threatening condition, but if left untreated, it may strangulate, cause a bowel obstruction or turn septic. In this case emergency surgery may be the only thing that will save your life says Dr Sergei Dartchiev, general surgeon at Mediclinic Sandton.

What is a hernia?
A hernia is a weakness in the abdominal wall that you can be born with, or a tear to the same tissue that happens with strain – like coughing, sneezing, lifting something too heavy, or straining during constipation or pregnancy – through which internal organs protrude. It may present with a lump that causes a dull pain, but the lump can be pushed back into your body when laying down, only to pop out again when the pressure in your abdomen changes. Anyone can get a hernia, from newborns to the elderly, and it’s also not a condition you can take precautions to guard against.

Once a hernia’s been diagnosed, what treatment can I expect?
Patients go to their GP complaining of pain or an uncomfortable lump in their abdomen. If the GP suspects a hernia, you’ll be referred to a general surgeon for confirmation and surgical repair. The surgeon will do a physical exam, as well as an ultrasound and/or X-ray which will determine if it’s a straightforward case that’s viable for repair. But if you’re in huge amounts of pain, vomiting and have a fever, get to the emergency centre straight away.

Hospitalisation for keyhole surgery is for the day or overnight, depending on your case and/or physical condition. The surgeon makes three 1cm to 1,5cm cuts; one in the belly button and one to the left and right of the abdomen. Surgical mesh is then inserted on the inside of the tear via the laparoscope – not over it like a plaster – large enough to cover both sides, and stitched into place either side with dissolvable sutures. If there are no massive complications, surgery will take under two hours and you’ll probably go home that day.

If I leave my hernia untreated, what can happen?
It could lead to bowel-strangulation, septicemia, obstruction and death. Some hernias can be left alone if the patient isn’t fit for surgery and there are no obstructions. In those cases, the surgeon will recommend wearing supportive clothing/underwear to keep the hernia from popping out and causing pain.

Will a repaired hernia continue to affect my life post-surgery?
The doctor will advise you to take it easy for six weeks, but you can return to routine after five days, avoiding rigorous exercise, heavy lifting and watching for infection or fever, but it should not recur in the same spot.

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Published in Gastroenterology

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