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Types of Hernias ‚ Symptoms ‚ Causes ‚ Treatment &gall bladder surgery

Inguinal Hernias

Inguinal hernias are the most common type of hernia. They represent approximately two thirds of adult hernias and are much more common in men than in women. They occur in a part of the abdominal wall known as the inguinal canal, where a man's testicles must descend before birth. This leaves a natural defect called the internal inguinal ring that can develop into a hernia if it doesn't seal properly. As a result, the contents of the abdomen, such as intestine, may protrude through the opening, creating pain and/or a bulge.

Inguinal hernias are located in the lower abdomen just above the leg crease, near or adjacent to the pubic area. They can sometimes occur on both sides of the pubic area, and if they do, they are called bilateral inguinal hernias. Inguinal hernias, along with femoral hernias make up the 2 types of groin hernias and can produce pain that extends into the upper thigh or scrotum.

Inguinal hernias can be classified as "direct" or "indirect".

  • An indirect inguinal hernia occurs through the natural weakness in the internal inguinal ring.
  • A direct inguinal hernia is a result of weakness in the floor of the inguinal canal and is more likely to develop in older men over the age of 40. The floor of the inguinal canal is located just below the internal inguinal ring.
  • Ventral Hernias

    A hernia that appears in the abdomen at the site of a previous surgery is known as a ventral or incisional hernia. These hernias can appear weeks, months, or even years after surgery and can vary in size from small to very large and complex. If you think you have a ventral hernia, it's important to see your doctor because it may widen and become extremely difficult to repair. When repaired with a technique called tension repair, ventral hernias have a 50% recurrence rate. 2 Other hernia repair techniques, such as tension-free and laparoscopic tension-free, have much lower recurrence rates.

    Femoral Hernias

    Femoral hernias, along with inguinal hernias are groin hernias. They are much more common in women but can occur in men. These hernias appear just below the groin crease and are usually the result of pregnancy and childbirth. A weakness in the lower groin allows an intestinal sac to drop into the femoral canal, a space near the femoral vein that carries blood from the leg. These hernias are more prone than inguinal hernias to develop incarceration or strangulation as an early complication. Therefore, once these hernias are diagnosed, early repair is very strongly advised before such complications occur.

    Umbilical Hernias

    Umbilical hernias occur near the bellybutton or navel, which has a natural weakness from the blood vessels of the umbilical cord. These hernias may occur in infants at or just after birth and may resolve by three or four years of age. However, the area of weakness can persist throughout life and can occur in men, women, and children at any time. In adults, umbilical hernias will not resolve and may progressively worsen over time. They are sometimes caused by abdominal pressure due to being overweight, excessive coughing, or pregnancy. When repaired with a technique called tension repair, umbilical hernias have an 11% recurrence rate.3 Other hernia repair techniques, such as tension-free and laparoscopic tension-free, have much lower recurrence rates.

    Epigastric Hernias

    Epigastric hernias are more common in men than in women. They occur due to a weakness, gap, or opening in the muscles or tendons of the upper abdominal wall, on a line between the breast bone and the navel or umbilicus.

    Hiatal Hernias

    Hiatal hernias are slightly different from other types of hernias because they are a weakness or opening in the diaphragm, which is the muscle that separates the chest cavity from the abdominal cavity. These hernias cause reflux of acid from the stomach into the esophagus, which can lead to heartburn, pain, and erosion of the esophagus. Surgery to repair this type of hernia is usually more complicated and may require a longer hospital stay.

    Acquired vs Congenital Hernias

    Hernias can also be classified by when they occur. A person may be born with a hernia, or a hernia may be acquired from daily activity.

    • Acquired hernias are caused by the wear and tear of living, such as childbirth, weight gain, and other muscle strain.
    • Congenital hernias are present from birth and happen at points of weakness in the abdominal wall. Children's hernias are almost always congenital.
    Reducible vs Nonreducible Hernias

    A hernia with a bulge can be classified based on whether or not the bulge can be flattened.

    • A reducible hernia is a hernia with a bulge that flattens out when you lie down or push against it gently. This type of hernia is not an immediate danger to a person�s health, although it may be painful and worsen over time if left untreated.
    • A nonreducible hernia occurs when the loop of the intestine becomes trapped and a person loses the ability to make the bulge flatten out. Nonreducible hernias are often very painful and require prompt medical attention.
    Potentially Life-Threatening Hernias

    Hernias can also be classified based on their status and severity. An incarcerated hernia or obstructed hernia is one in which the tissues have become trapped. This is also called a nonreducible hernia and is very serious because it may lead to intestine or tissue strangulation. A strangulated hernia happens when part of your intestine or other tissue becomes tightly trapped and the blood supply is cut off. Strangulated hernias can result in gangrene. This condition is considered a medical emergency and requires immediate surgery to undo the blockage and repair the hernia.

    What Are Symptoms of Hernias

    ach hernia is different, and the symptoms of a hernia can appear gradually or suddenly. Different people feel varying degrees of pain. Some people even feel that something has ruptured or given way. Other symptoms may include:

    • Feelings of weakness, pressure, burning, or pain in the abdomen, groin, or scrotum
    • A bulge or lump in the abdomen, groin, or scrotum that is easier to see when you cough and disappears when you lie down
    • Pain when straining, lifting, or coughing

    can i prevent hernias

    There really is no guaranteed way to prevent getting a hernia or to prevent recurrence of a hernia. Some hernias are due to a congenital condition. The best thing you can do is stay healthy by eating right, maintaining a healthy weight, and exercising regularly. For more information, read Prevention.

    what causes hernias?

    Many hernias begin as a congenital defect, a weakness in the abdominal wall that a person is born with. If you have a weak point in a muscle wall, pressure from extra body weight, coughing, heavy lifting, or from straining during bowel movements can force the muscle apart, allowing part of an internal organ (or some other part of the body) to push its way through. Once that happens, the defect (hernia) will continue to enlarge until it is repaired.

    Are hernias hereditary?

    Hernias aren't really hereditary. You may inherit a tendency to have weak abdominal muscles from one of your parents, but hernias themselves are either acquired or congenital. Acquired hernias are caused by the wear and tear of living, such as childbirth, weight gain, and other muscle strain. Congenital hernias happen when you're born with points of weakness in the abdominal wall. Children's hernias are almost always congenital. Many adult hernias are also congenital but may have been too small to detect at an earlier age.

    can heavy lifting cause a hernia?

    You may have heard that hernias are caused by heavy lifting, but that is a myth. While heavy lifting and other strenuous activities can aggravate a hernia, they don't actually cause them. Most hernias are the result of a weakness in a muscle that exists long before a hernia even appears. Many hernias are present at birth. Other factors, including advancing age, injury, and surgical incisions can help weaken muscles too.

    how does smoking affect a hernia?

    Chronic coughing from the lung irritation caused by smoking can put you at increased risk for a hernia. It can also cause a hernia to recur. Heavy smokers also tend to develop abdominal hernias at a higher rate than non-smokers. That's because exposure to nicotine can help weaken the abdominal wall.

    why are men more prone to inguinal hernias than women?

    Men are more prone to inguinal hernias than women because of basic differences in anatomy. The area where hernias occur most often has a very different function in men than in women. The internal inguinal ring, through which a man's testicles descend before birth can be a natural weak spot of the anatomy that is at risk. The peritoneum, a sac which envelopes the abdominal cavity, is another possible weak spot.

    is medical treatment necessary for a hernia?

    It is necessary and important to have a hernia repaired through surgery. If a hernia is left untreated, it may increase in size and become more painful. Most importantly, any hernia can lead to more serious, even life-threatening complications. If you think you have a hernia, see your doctor. Your doctor can confirm the diagnosis and discuss your treatment options.

    do hernias always require surgery?

    Surgery is the only way to cure a hernia. A hernia will not go away on its own. The good news is that today, many types of surgical hernia repairs are available. However, your surgeon may not always recommend it, depending on your medical history.

    how do surgeons repair hernias?

    Surgeons use several hernia repair techniques today that fall into three basic categories: tension repair , tension-free repair , and laparoscopic tension-free repair . Your doctor may suggest one or several techniques as options for treating your hernia. Understanding all of your options will help you to decide which surgical method is best for you.

    what are the risks of hernia surgery?

    A rectocoele repair procedure involves restoring the supportive tissue between the vagina and rectum to treat a prolapse of the rectum through the vaginal wall. In some cases, the surgery may be performed laparoscopically, involving minimally invasive surgery and micro-video cameras.

    Anal sphincter repair

    As with any surgery, infection and/or bleeding are possible. The risk of complications increases if the patient smokes, does drugs, is a heavy drinker, is very young or very old, or has other medical conditions. In addition, there is a slight chance that the intestines, bladder, blood vessels, or nerves may be injured during the procedure, or that extended scarring may occur.

    what type of anesthesia will be used during surgery?

    The type of anesthesia you receive depends on your general health, the type of hernia repair being done, and the facility where you have surgery. Most laparoscopic tension-free repairs require general anesthesia. Tension and tension-free repairs can be done with general, local, spinal, or other types of anesthesia

    how long is the recovery period?

    The recovery period depends on what type of hernia you have, the procedure used by your surgeon, and your normal level of activity. Under many circumstances, you will have your surgery on an outpatient basis and be back at home the same day. You may feel discomfort walking, especially up and down stairs, for the first few days. You also may not be able to drive or do anything strenuous for the first week. Some patients experience minimal pain or discomfort and are back to normal in just a few days. Other patients may take longer to fully recover, especially if their normal routine involves strenuous activity. This topic is best discussed with your surgeon.

    when can i return to work?

    How soon you can return to work depends on the kind of work you do. Full recovery from hernia surgery may take anywhere from one to six weeks. If you have a very strenuous job or one that requires heavy lifting, it may be several weeks before you can get back to work. On the other hand, if you have a desk job, you may be back to work in as little as three days. Ask your doctor for advice on when to return to work and resume your normal daily activities.

    when can i drive again?

    Driving is generally not recommended for at least 48 hours following surgery because the effects of anesthesia are still present in the body. Driving also puts a strain on the incision site, so your doctor may ask that you wait a while to drive. In addition, if you are taking pain medication, you may not be able to drive or operate machinery. Ask your doctor when it is safe for you to resume driving.

    when can i play sports again?

    Depending on the type of sport you play, you may be able to return to low-impact, noncontact sports in just a few days. It may take one to two weeks to return to sports that require greater exertion. You may be able to resume competitive and contact sports as early as two weeks after surgery. It is important to ask your doctor when you should return to sports.

    I have been diagnosed as gall bladder stones. Do I require surgery?

    Diagnosis of gall bladder stones is by ulatrasound scan of the abdomen which is usally performed for some abdominal discomfort. There is no medical treatment for gall stones. A majority of gall bladder stones will require surgery.

    I had abdominal pain just one day. After that I have no problems at all. Do I still need surgery?

    It is always better to get an operation done when there is no pain.It is easy for the patient as well as the surgeon.

    Do you just remove the stones or the whole gall bladder itself?

    The entire gall bladder needs to be removed as it is diseased and forming stones. Removal of stones alone will not be enough.

    Which method is preferable. Open or laparoscopic surgery?

    Now-a-days open surgery is rarely done. Laparoscopic surgery is the preferred method of treatment. In some rare instances the treatng doctor may prefer open surgery if the patient has some severe respiratory or cardiac disease.?

    How long should i stay in the hospital after surgery?

    Usually less than 6 hours after surgery. This is due to good anaesthesia, pain medication and a standard surgical technique.

    Do I need to avoid any foods after removal of the gall bladder?

    There is absolutely no need to avoid any food items after removal of gall bladder..