When a defect or weakness occurs in the abdominal wall, the contents of the abdomen protrude through the defect. This is called a hernia. It affects both genders at any age but is more common in men. It can be felt under the skin as a lump. Most commonly, a hernia presents as a gradually increasing swelling which is usually painless. Often, the swelling disappears on lying down and appears or increases on standing. The swelling is usually noted in the groin as it is the most common site of a hernia. A hernia can occur in any part of the abdomen. It can also occur through the scar of previous abdominal surgery or around the umbilicus. A Reducible Hernia is usually painless and can be pushed back in but comes out on standing or coughing.
Sometimes, the swelling becomes painful when it increases in size or when it doesn’t disappear. In certain patients, this could even be the first presentation, explains Dr Erbaz Riyaz Momin, General and Laparoscopic Surgeon, Apollo Spectra Hospital Mumbai. “This presentation is worrisome and needs urgent attention and is known as an Incarcerated Hernia. In certain situations, it may get aggravated and the blood flow to the hernial contents is affected leading to a Strangulated Hernia. This is a surgical emergency and delay in seeking surgical opinions may have serious implications for the patient,” he said.
Pain in the hernia, a hernia not decreasing on lying down or severe pain with an increase in the size of hernia are some warning symptoms that the patient needs to be aware of.
Tips for patients awaiting hernia surgery
* Relax, a majority of hernia are uncomplicated.
* Do not lift heavy weights.
* Avoid constipation by including fresh fruits and vegetables in your diet and stay hydrated.
* If you have constipation or difficulty passing urine (in elderly males with the prostate problem) ask your surgeon for appropriate medications.
* If you have discomfort then lie down on your back.
* On lying down, the hernia will decrease and you should feel better.
Warning features of a hernia
* Pain or discomfort.
* Increase in hernial swelling along with pain or discomfort.
* Increase in the swelling with constipation or inability to pass flatus.