Thursday May 18, 2017
Feeling a bit lumpy and bumpy? Got a swelling that you can push down, only for it to pop back up? It could be a hernia! Although it's always best leave it to the professionals to diagnose - such as our GPs at at London Doctors Clinic - why not brush up on your knowledge of the topic by reading today's blog posts all about hernias!
What Is A Hernia?
A hernia occurs when an organ pushes through the wall of the place where it normally exists. For example, the bowel pushing through the wall of the abdomen. A hernia normally develops in the abdomen between the chest and hips, but can involve the groin or upper leg. There are many types of hernia, with many of them appearing as large, painless lumps.
Types of Hernia
Inguinal Hernias develop when a small piece of fatty tissue or a small piece of bowel pushes through a ring in the inguinal area (groin/upper thigh). This is the most common type of hernia and often occurs in men, especially older men or those that have put a lot of strain on their abdomen.
Femoral Hernias are similar to inguinal hernias in that they involve fatty tissue or a small piece of bowel pushing through into the upper thigh. They occur more commonly in women, but again are associated with age and repeated abdominal strain.
Umbilical Hernias occur when tissue or bowel pokes through a weakness in the abdominal wall near the belly button. They can occur in babies when the umbilical cord doesn’t seal properly after birth and are common in women who have had children, because of the abdominal weakness associated.
Hiatus hernias occur when the stomach pushes through the diaphragm near the oesophagus (food pipe), into the chest. They may cause heartburn.
Other Types of Hernia
Other types of hernia tend to be rarer but can include:
- Incisional Hernias - these occur when tissue pokes through a surgical wound if it hasn’t healed correctly.
- Epigastric hernias - like umbilical hernias, these occur between the belly button and the breastbone.
- Spigelian hernias - these are when a small amount of tissue pushes through the abdominal wall at the side of the body, below the level of the bellybutton.
Who Is At Risk of Developing a Hernia?
Risk factors for developing hernias include anything that can increase the pressure around the stomach and belly button. This includes:
- Manual labour
- Fluid in the chest or abdomen
- Hard coughing bouts
- Straining due to constipation
- Incorrect posture
The muscles in the area may be weakened by poor diet or smoking, allowing hernias to be more common in certain places.
Incorrect posture may increase the risk of developing hernias
Hernias may cause pain, especially when coughing, going to the toilet or lying down, as this increases pressure in the abdomen. You may also notice they increase in size at this time. The hernia may give a heavy or dragging sensation, particularly in men.
The bulge may come and go as the organs in the abdomen shift, but the weakness which results in the hole that the tissue can escape through will remain and so the hernia may reappear.
Your hernia may be classed under several different groups, and it may be considered reducible or non-reducible.
If it is reducible, this means the lump can be pressed back in to make the skin flat and smooth again. A non-reducible hernia is firmer and will not be compressed.
Hernias can become more complex if you develop any of the following symptoms:
- Sudden constant and severe pain
- Tenderness over the hernia
- The hernia can no longer be pushed in
This may be a sign that the part of the bowel that has pushed out of the abdomen is having it's blood supply cut off (known as strangulation). A piece of bowel may also enter the hernia and become blocked, known as obstruction - this may be associated with feeling sick, vomiting or fever.
How Your GP Will Assess A Hernia
To start with, the GP will assess the following aspects:
- Where is it?
- What type of hernia is it?
- What does your hernia contain? Just tissue, or some bowel?
- What are the associated symptoms?
- What is your general health like?
To determine what is in your hernia, an ultrasound may be performed - this is a painless test. If your hernia contains some bowel, it is a considered a higher risk for blockage or strangulation and so surgery will be recommended more quickly. If your hernia is affecting your ability to carry out daily activities or causing any pain, surgery may also be recommended.
There are two types of surgery for hernias - laparoscopic or open surgery.
Laparoscopic surgery, also known as keyhole surgery, involves making a series of small cuts in the abdomen through which a small camera and surgical tools are passed through, allowing the surgeon to push the bowel back into it’s correct place and potentially place a wire mesh to keep it there.
Laparoscopic surgery can be converted to open surgery if the hernia is particularly large or complicated; this is when the surgery is conducted through one single cut to the abdomen.
There are two types of surgery for hernias - laparoscopic and open surgery
If you've already been diagnosed with a hernia and would like some more advice, or you've noticed a new lump that you suspect might be a hernia, our private doctors at LDC are more than happy to discuss your concerns or provide the professional diagnosis you may be looking for. Simple book an appointment at one of our nine GP surgeries - we even have same day doctor appointments available! As always, if you need to find a GP, LDC is here for you.
By Katie Hodgkinson