What is an Inguinal Hernia?
An inguinal hernia is a protrusion that occurs in the abdomen close to your groin region. They occur when fatty or intestinal tissues push out of a fragile point in the abdominal wall close to the right or the left inguinal canal, which are situated at the base of the abdomen.
The protruding can cause pain, especially during some activities such as coughing or bending down. Although they are not necessarily dangerous, if left untreated they can lead to severe complications, in which case your doctor may recommend an inguinal hernia surgery. Since inguinal hernias don’t improve on their own, it’s necessary to get an early diagnosis and treatment.
Types of Inguinal Hernia:
There can be two types of inguinal hernias:
- Indirect Inguinal Hernia – This is one of the most common types of inguinal hernia. It’s mostly found in premature births since that’s when the inguinal canal is still open. However, it can also manifest itself at any point of time in your life. It mostly occurs in men.
- Direct Inguinal Hernia – This type occurs at a more adult age, mostly in the case of men. It’s mostly caused by weakening abdominal muscles due to age.
Symptoms to Look Out for:
Some of the inguinal hernia symptoms include:
- A bulge on either side of your groin which becomes prominent when you’re standing or coughing
- A burning feeling or pain in the bulge
- Pain or discomfort while bending or coughing
- A heavy sensation at the bulge area
- Weakness or pressure in the groin area
Some of the symptoms of inguinal hernia in newborn and children are:
- Crying or coughing, or straining during bowel movements
- Loss of appetite
- Standing for a long time, in case of an older child
If it’s not possible to push the inguinal hernia in, then parts of the hernia get trapped in the abdominal canal (incarcerated hernia). When it turns into a strangulated hernia, the blood gets cut off. The signs and symptoms of a strangulated hernia are:
- Nausea and/or vomiting
- Sudden pain
- A red, purple, and dark bulge
- Inability to pass bowels and gas
Are you at risk of Inguinal Hernia?
There can be several causes for inguinal hernias. A weak abdominal canal and extra pressure on the body are considered to be the major contributors.
Some of the risk factors that can increase the chances of hernia are:
- Genetic factors
- Prior history of inguinal hernia
- Premature birth
- Cystic fibrosis
- Chronic coughing
- Chronic constipation
Some of the complications that can arise out of an inguinal hernia are:
- Pressure – Most hernias, if left untreated, become enlarged and cause pain, swelling, and pressure.
- Incarcerated Hernia – When parts of the hernia get trapped in the abdominal wall, it can impede the passage of bowel movement, causing nausea and vomiting.
- Strangulated Hernia – When the trapped hernia restricts blood flow to the small intestine, it can become a strangulated intestine, which can be life-threatening and may require urgent surgery.
- Incarcerated Inguinal Hernia – This type occurs when the tissue gets attached to the groin and can’t be pushed back to its original place.
- Strangulated Inguinal Hernia – This is a serious and life-threatening type where tissue or a part of the small intestine pushes through the abdominal muscle and the surrounding muscles clamp down on it, thereby cutting off the blood supply to the small intestine.
Usually, a physical exam is enough to diagnose an inguinal hernia. Your doctor may ask you to stand up or cough since that’s when the hernia is most prominent. If it’s reducible, your doctor will be able to push the hernia back into your abdomen. If it can’t be pushed back in, it may require an inguinal hernia surgery.
Surgery is the most common form of treatment for surgical hernias. However, it’s required only for those hernias which can’t be pushed into the abdomen. In some rare cases, people can wear a truss, padded support, that helps keep the hernia in place.
Inguinal hernia surgery is performed, with the help of general anaesthesia. The surgery is carried out by a general surgeon or Laparoscopic Surgeon.
After the anaesthesia is administered, an incision is made on both sides of the hernia. One is for inserting the laparoscope and the other is for the surgical instruments. The surgeon then separates the hernia sac, the tissue forming part of the abdominal canal, moves it to its place, and repairs the muscle defect.
For repairing small muscle defects, sutures are made which help to hold the hernia in place permanently. However, sutures are not enough for large muscle defects. In these cases, a prosthetic mesh may be required. This is a permanent method to prevent the hernia from coming out again. The mesh may not be a good idea for people who have a history of rejecting surgical implants or a condition that can be aggravated by the use of mesh. Once the mesh is put and the muscle has been sewn, the laparoscope and surgical instruments are removed. The incisions can be closed with sutures, a special glue to hold it together, or small sticky bandages called steri-strips.
It’s possible for most people to return to their daily activities within two to four weeks. During the first week, the area may be soft and you should try to avoid putting any extra pressure on the area. Some of the activities you should avoid are:
- Lifting heavy objects