Hernia: types and treatment

A hernia is a protrusion of a viscus (an organ) beyond its normal confines and occurs in either the groin or the abdomen. This protrusion produces a swelling; if it clears on lying down, it is known as a reducible hernia, or if it fails to clear an irreducible hernia. Hernias can be painless, cause slight discomfort or be painful. They tend to get larger with time and can make it difficult to undertake normal activities.

Although hernias in adults can arise for a number of reasons some common examples are:

• persistent heavy coughing,
• injury or surgery,
• lifting, carrying or pushing heavy loads
• straining to produce a bowel movements
• straining to urinate e.g. men who have an enlarged prostate.
• Being overweight or pregnant

Those over 50 have a higher risk of hernia, possibly due to the muscles in the stomach wall becoming weaker with age.

The most common types of hernia requiring surgery are:

Groin

Inguinal Hernia

This is the most common type of hernia and is found in the groin. It is caused by a loop of bowel pushing through a weakness in the inguinal canal. The inguinal canal is a triangle-shaped opening between layers of abdominal muscle near the groin.

They are most common in men (98%) and occur when a loop of bowel slides down the narrow canal down towards the scrotum. The hernia usually appears as a swelling in the groin or enlargement of the scrotum, which may or may not be painful and often disappears when lying down.

Femoral Hernia

This type of hernia occurs most commonly in over- weight women and occurs when part of the intestine passes down the natural canal through which the large blood vessels for the leg pass and make a swelling on the upper and inner part of the thigh.

Abdominal

Umbilical

An umbilical hernia occurs when part of the intestine protrudes through a weakness in the abdominal wall, creating a soft swelling near the navel. They can cause abdominal pain.

Epigastric

This type of hernia is caused by a weakness in the upper abdomen, the intestine bulges between the breastbone and the navel and is most common in men.

Incisional

An incisional hernia is the result of weakness following a surgical wound or scar in the wall of the abdomen.

The aim of our hernia repair is to have;

• Minimal:
  - Incision
  - Discomfort
  - Loss of Leisure
  - Shave
  - Incapacity
  - Loss of Work
  - Hospital Stay
  - Immobilisation
  - Recurrence
•  Maximum strength

Admission

Patients are admitted on the day of operation and return home after physiotherapy, usually within 24 hours. The standard rehabilitation programme, shown below, is then followed.

Hernia Rehabilitation Programme

The hospital physiotherapist will show you how to follow this programme and the practice nurses are available for advice if you have any concerns