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Hernia: a common problem, a simple solution

A friend of mine was recently diagnosed with a hernia and may need surgery. What is a hernia and how do I know if I have one?

Each year nearly half a million Americans seek treatment for hernias. Hernias occur when an internal part of the body (usually some part of the intestine) bulges out through the abdominal wall. Most hernias develop where the muscle has a natural tendency to be weak, and common sites of hernia include the lower abdomen, groin, or near the navel. Hernias may also occur at the site of an old surgical scar or incision. They frequently become noticeable when lifting heavy objects, exercising, coughing, or straining during a bowel movement. If left untreated, they will eventually worsen, and in some cases, can even become life-threatening.

Anyone can develop a hernia, according to Timothy Babineau, M.D., chief of the Section of Gastrointestinal Surgery at Boston Medical Center and an associate professor of surgery at Boston University School of Medicine. "Although adult men are historically more prone to them, women and children are also at risk," he says. "They may be present from birth or develop over a period of time. Unfortunately, there is nothing that can be done to prevent hernias from occurring."

Babineau says that certain lifestyle and body types tend to be more closely associated with the occurrence of hernias. People who are overweight, smoke, have a chronic cough, use steroids, or have an occupation that involves heavy lifting are more likely to suffer a hernia.
The most common symptoms of hernia include:

• A visible bulge or vague discomfort in the groin area or abdomen
• A bloated feeling, nausea, vomiting, and constipation associated with a bulge.

"Testing for hernia involves a very simple five-minute physical exam," says Babineau. "It is a painless test, completed without the need for blood work, X rays, or needles, and should be part of an annual physical exam."
Surgery is the only way to permanently repair a hernia. Wearing a brace, or truss, may alleviate symptoms temporarily, but it will not treat or repair the problem.

"Hernias will not go away over time; in fact they tend to get larger," says Babineau. "The increase in size of an untreated hernia may make eventual repair more difficult. Although hernia repairs are done primarily for relief of pain symptoms, if left untreated even painless hernias can lead to more serious complications, such as strangulation." A strangulated hernia occurs when the blood supply to the herniated intestine is restricted, which could lead to a life-threatening situation.

Babineau says physicians have made tremendous strides in the treatment of hernias, and recovery times are significantly shorter than those of 10 years ago.

Most hernias are repaired via a "tension-free" technique, where a piece of synthetic mesh is placed over the hernia defect and sutured into place. The surgery can be performed using a traditional open technique using local anesthesia, or a laparoscopic technique using general anesthesia.

Both laproscopic and open surgery have advantages and disadvantages, and if you require hernia surgery, you should discuss each option with your surgeon. Both are performed as day-surgery procedures, and take approximately 30 minutes. In most cases, patients resume normal activities within three to five days following the procedure.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on alternative medicine or other health matters, call 617-638-6767.

19 October 2001
Boston University
Office of University Relations