Hernias occur due to defects in the muscular wall of fascia that holds the internal organs in place. In certain situations, the internal structures exert pressure on the muscles or fascia. When this pressure increases, the defects in the musculature gives way and a hernia occurs. There are several factors that increases the pressure on the musculature. In cases of abdominal hernia, the main risk factors are:
• Lifting of heavy objects without proper abdominal support
• Repeated bending or kneeling
• Constant coughing or sneezing
• Constipation and associated straining by passing stools
• Enlargement of prostate
• Repeated dialysis
• Diseases like cystic fibrosis
• Pregnancy and childbirth
Types of hernia
Hernias are usually classified according to their site of occurrence. The most common types of hernias are: Inguinal hernia- Almost eighty percent of all hernias are inguinal hernias. They occur when the intestine protrudes through a defect in the inguinal canal region or the abdomen. They are more commonly found in men.
Hiatal hernia- This occurs when a part of the stomach protrudes into the chest cavity. This type of hernia is commonly found in those aged above fifty. The most common cause of this is a defect in the diaphragm which is a wall that separates the chest cavity from the abdominal cavity. A major complication of a hiatal hernia is GERD (Gastroesophageal reflex disease). In this condition, the stomach contents are pushed back into the oesophagus leading to acid reflex.
Umbilical hernia- This type of hernia is usually found in children under 6 months of age. The intestines of the child bulge through an opening in the abdominal wall below the belly button. Umbilical hernias are usually self-corrective. As the abdominal muscles grow stronger, the herniating organs get pushed back into their respective places. In rare cases, the hernia may persist, requiring surgical treatment.
Incisional hernia- This type of hernia usually occurs after a major abdominal surgery. The sutured area or scar tissue will become a weak spot soon after surgery. If proper post-surgical precautions are not taken while lifting weights etc., the internal organs may push out through the scar area.
Spigelian hernia- A very rare type of hernia that occurs in the centre of the abdominal cavity.
Obturator hernia- Another rare type of hernia commonly found in females where the hernia protrudes into the pelvic cavity.
Epigastric hernia- This is a rare type of hernia found in children. Hernias are also classified as direct or indirect. Direct hernias occur due to congenital defects in the muscular walls. Indirect hernias are usually acquired and occur due to a combination of factors. Pressure effects on the abdomen and a weak spot in the abdomen can create an acquired hernia.
A strangulated hernia occurs when the muscles surrounding the herniated portion starts exerting extreme pressure on it. A loss of blood supply might occur leading to destruction of the herniated tissue mass. This condition is a medical emergency and requires immediate surgical correction.
Symptoms and signs of hernia
The common signs and symptoms of an abdominal hernia are pain and swelling in the affected area.
➢ Pain in the abdomen
➢ Fullness in the abdomen
➢ Episodes of nausea and vomiting
➢ Discomfort in the abdomen while bending and coughing