Following are the common questions about Hernia:
- What is a hernia?
- What are the causes of hernia?
- What are the warning signs of hernias?
- What are the different types of hernias?
- Can hernia be cured permanently?
- What can happen if a hernia is left untreated?
- Can a hernia cause death?
- How is a hernia diagnosed?
- How can you prevent a hernia from getting worse?
- Can a pregnant woman undergo hernia surgery?
- How is a hernia treated?
- What is the best technique to treat hernias?
- Can a hernia recur after surgical treatment?
- How much does hernia repair surgery cost?
- Is hernia mesh used in all types of hernia repair surgery?
- Who is more at risk of developing a hernia?
Q. What is a hernia?
A. A hernia is a protrusion of fatty tissues or an organ through the abdominal wall due to weakness. This leads to immense pain and other problems as well. Most of the hernias occur within the abdominal cavity, usually around the groin region or between the chest and hips.
Normally, it is the abdominal muscle tissues that keep the organs in their place. When the tissues lose their strength, the pressure inside the abdomen may create a hole or protrusion in the muscles and the organ will get displaced. Over time, the hole in the muscle wall will grow and the condition will become severe until it becomes an emergency.
Q. What are the causes of hernia?
A. The primary cause of hernias is weakness and strain on the muscles. The reason that can affect the integrity of the muscles can be any of the following:
- A congenital condition that occurs when the fetus is growing inside the womb
- Aging effect
- Damage to the muscles from an injury or surgery
- Strenuous exercise
- Lifting heavyweights
- Chronic cough
- Chronic obstructive pulmonary disorder (COPD)
- Pregnancy, especially multiple pregnancies
- Constipation, which causes strain and pressure in the lower abdomen
- Being overweight or obesity
- Ascites or liver-function issues
If any one of these aforementioned conditions is present in a person, he/she is more likely to develop a hernia.
Q. What are the warning signs of hernias?
A. The warning signs of hernia include the following-
- A lump or bulge in the abdominal region that doesn't go away when you lie down.
- Swelling or bulge in the groin or scrotum region.
- Pain that keeps on increasing.
- Extreme pain when you try to lift objects.
- A bulge whose size increases day by day.
- A sense of fullness even after bowel movements.
These are the symptoms that the hernia is getting severe gradually and you should get it treated promptly.
Q. What are the different types of hernias?
A. The different types of hernia that can occur in the body include-
- Inguinal- Occurs in the groin region
- Femoral- Occurs in the groin region but a little bit downward, closer to thighs
- Incisional- Occurs near the site of previous surgery
- Umbilical- Occurs around the navel
- Hiatal- Occurs near the diaphragm where the esophagus and stomach connects
Out of these types of hernias, inguinal hernias are most common and occur in men more than women. Other types are less common but have a similar potential to cause complications.
Q. Can hernia be cured permanently?
A. There is no permanent cure for a hernia. There are only treatment methods available that can address the ongoing problem and provide relief from the symptoms. The most effective treatment for a hernia is surgical repair. Other than that, you can try preventative measures to reduce the chances of hernia occurrence.
Q. What can happen if a hernia is left untreated?
A. If left untreated for a long time, hernias can cause the following problems-
- Obstruction- The organ or fatty tissue may stuck in the abdominal wall and obstruct bowel movements. It will cause unbearable pain, nausea, vomiting, and other symptoms.
- Incarceration- It means that the organ is permanently stuck outside the abdominal wall and cannot be pushed back to its original position.
- Strangulation- If the blood supply to the incarcerated hernia is cut off, the tissues will start to die. This is called strangulation and as it leads to sepsis, it can be life-threatening.
- Pressure on the surrounding tissues- This complication usually arises in men who have large hernias. If the herniated organ pushes into the scrotum, it can cause serious pain and swell in the region.
All these complications can be complex to treat. That's why it is often recommended to get timely treatment for hernias.
Q. Can a hernia cause death?
A. In severe cases, a hernia can cause complications that can be life-threatening. These complications include obstruction, incarceration, and strangulation. These three complications are related to each other and cause permanent organ damage if not treated on time. Once the organ starts to die, it will be difficult to save the patient's life.
Q. How is a hernia diagnosed?
A. To diagnose a hernia, the doctor will first perform a physical examination.
The doctor will ask you to stand and cough/strain to make the hernia clearly visible.
If you are a man, the doctor will check the area around the testicles and groin to find the bulging hernia.
If the physical examination is not conclusive, the doctor will suggest imaging tests, including CT scan, MRI scan, and ultrasound to identify the type of hernia and to narrow down the treatment option as well.
Q. How can you prevent a hernia from getting worse?
A. There is no guaranteed way to prevent hernia development, especially if it is caused due to inherited weakness in the abdominal wall. However, you can avoid certain risk factors to prevent the condition. The prevention tips include-
- Maintain a healthy weight through diet and exercise.
- Eat foods that are rich in fiber to make sure that bowel movements are smooth and strain-free.
- Avoid lifting heavy weights or lifting them using proper techniques. Generally, it is suggested that a person should lift heavy weights by bending the knees instead of the back.
- Quit smoking as soon as possible. Smoking can weaken the muscles over time and also increase the chances of chronic cough.
- See a doctor if you have a persistent cough.
Q. Can a pregnant woman undergo hernia surgery?
A. Generally, it is not recommended for a pregnant woman to undergo hernia surgery. The doctor will most likely ask the woman to take precautions and wait for the treatment until after she had given birth. However, in some cases, a hernia may cause complications and emergency treatment may be needed.
As a result, the doctor may perform surgical repair during the second trimester. A mesh is also placed for support as the risk of the hernia coming back during pregnancy is high. But the mesh can also limit the abdominal muscles' flexibility and cause pain. Therefore, the surgeon needs to consider all possible scenarios before performing hernia repair surgery.
In other cases, the doctor may suggest hernia repair during a C-section birth.
Q. How is a hernia treated?
A. The basic principle behind hernia treatment is to close the hole or opening in the abdominal muscles safely and prevent the organ from protruding from the muscle tissues.
To do this, open, laparoscopic, or robotic techniques may be used. Furthermore, if required, the surgeon may also place a hernia mesh around the muscle opening to prevent the organ from displacement. The best method for hernia treatment is determined by the surgeon after proper diagnosis.
Q. What is the best technique to treat hernias?
A. There are three different techniques available for hernia treatment- open surgery, laparoscopic surgery, and robotic surgery. Out of these three techniques, robotic surgery is comparatively new due to which many people don't prefer this technique.
Between open and laparoscopic hernia repair, the best technique is decided after accurately diagnosing the patient. If the patient has an inguinal hernia, the surgeon may recommend open surgery rather than laparoscopic because it has higher intraoperative complications than open repair. In other cases, the surgeon may prefer the laparoscopic technique as it is minimally invasive, causes less pain, and allow the patient to recover quickly.
Therefore, it can be said that there is no best technique for hernia repair. However, there will be a more suitable technique to treat hernia that will be determined by the hernia specialist.
Q. Can a hernia recur after surgical treatment?
A. The majority of hernia surgeries are successful and don't result in hernia recurrence. However, there are always chances that a hernia may return months or years after the surgery. In various cases, the patient develops an incisional hernia which occurs due to surgical treatment. To make sure this doesn't happen, the doctor provides a detailed guide to the patient that ensures they stay in good shape and reduce the chances of developing a hernia.
Q. How much does hernia repair surgery cost?
A. The cost of hernia surgery varies from patient to patient.
- The minimum price is around Rs. 55,000.
- The average cost of the procedure is around Rs. 65,000.
- The maximum expense of the entire treatment can be up to Rs. 2,60,000.
The doctor will give you an estimate of the overall treatment after a thorough diagnosis. There are also several factors due to the which the final cost may vary for each patient-
- The severity of the condition
- The type of hernia you have
- Risks and complications associated with the procedure
- Method of surgery (open or laparoscopic)
- Cost of hernia mesh (if used)
- Choice of hospital
- Surgeon's fee
- Diagnostic tests before and after surgery
- Hospital admission, stay and discharge fee
- Post-surgery support and follow-ups
Q. Is hernia mesh used in all types of hernia repair surgery?
A. No. Hernia mesh is not required for all hernia repairs. In many cases, the patient decides to undergo hernia surgery when the damage to the abdominal muscles is very minimal, the surgeon decides to stitch the tissues normally without placing a mesh for support. However, if the condition is advanced and the damage to the muscle tissues is severe, the surgeon will use a suitable mesh to support the weak muscle tissues and act as reinforcement by keeping the organ in place. Whether a hernia mesh will be used or not depends on the severity of the condition. The doctor will make a decision accordingly.
Note: Hernia repair surgery that is performed without using mesh, is called herniorrhaphy. And if a mesh is used for the repair, the procedure is called hernioplasty.
Q. Who is more at risk of developing a hernia?
A. There are certain factors that increase the risk of developing a hernia in a person. If you have any of the following, you need to watch out for the symptoms and seek treatment on time.
- Old age
- Premature birth or having a low birth weight
- Chronic or repetitive cough
- Cystic fibrosis
- Chronic constipation
- Family history of hernias