Men or women can develop hernias. When they do, an organ or tissue can squeeze through a weak spot in a muscle wall. When surgery is called for, several options are available.
A hernia is a weak spot, defect, or hole in the muscle layers of the abdomen, through which a part of an organ or piece of fatty tissue can poke. Hernias most often occur in the groin or at the umbilicus (belly button). But they can also occur elsewhere, such as the sites of previous surgical incisions.
What Causes Hernias?
The belly button, for instance, is where our umbilical cord attached us to our mother when we were in her womb. After birth and the cord’s cutting, the hole usually will close itself. But some people have a persistent opening that eventually can enlarge to become a hernia.
People sometimes develop an “inguinal hernia” in the groin. This can happen with strenuous activity, or sometimes after birth, a baby’s inguinal canal does not close behind them, leaving a weak spot, which eventually can become a hernia.
Other hernias can occur at weak spots like old incisions, from strenuous activities or incomplete healing.
Dr. Ivanesa Pardo discusses hernias further on the Medical Intel podcast.
What about Activities such as Lifting Heavy Items?
Physical activity, especially strenuous and high-intensity exercise, can exacerbate or even cause a hernia. There are definitely some stories about people who exercise a lot and do a lot of heavy lifting, and they suddenly feel a “pop” and have a hernia. Those are acute cases; however, there is no need to put strict limits on how much someone should exercise, rather to be smart about it. When lifting heavy things or exercising, everyone should know -- and observe -- their limits. Anyone with signs of a hernia should be careful when straining or lifting, because the hernia can become “symptomatic,” which means it requires medical attention.
An “incarceration” occurs when something – such as a piece of intestine or fatty tissue – gets stuck in an opening (hernia) and can’t be pushed back in. A more serious situation is “strangulation.” That’s when the stuck piece of tissue or organ is losing its blood supply and starting to die. That requires emergency surgery.
When Should I Seek Medical Help?
Pay attention if you feel a lump that gets larger, or more tender, when you sneeze, cough or strain. If this occurs, see your primary care physician, or a specialist, for a diagnosis.
I recommend elective surgery when the defect (hernia) is large enough that, even if it’s reducible, a segment of intestine could get stuck, which could lead to incarceration or strangulation. We can repair hernias in several ways. There’s the old-fashioned “open repair” approach, which involves a larger incision. Then, there are more modern “minimally invasive” repairs. They can be laparoscopic or robotic. Their appropriateness will depend on the particular patient, the availability of the medical facility in question, and the skills of the surgeon.
Most hernia repairs today involve implanting a mesh. This is a screen that is made of synthetic material that reinforces the muscle layers where the defect, or hernia, is. The advent of the mesh has reduced the chances of a hernia coming back after it’s been repaired.
You should talk with your surgeon about whether you need a repair, and whether mesh is appropriate.