Hernia

Hernia
A hernia is an opening or weakness in the muscular structure of the wall of the abdomen. This defect causes a bulging of the abdominal wall. This bulging is usually more noticeable when the abdominal muscles are tightened, thereby increasing the pressure in the abdomen. Any activities that increase intra-abdominal pressure can worsen a hernia; examples of such activities are lifting, coughing, or even straining to have a bowel movement. Imagine a barrel with a hole in its side and a balloon that is blown up inside the barrel. Part of the inflated balloon would bulge out through the hole. The balloon going through the hole is like the tissues of the abdomen bulging through a hernia.
Serious complications from a hernia can result from the trapping of tissues in the hernia -- a process called incarceration. Trapped or incarcerated tissues may have their blood supply cut off, leading to damage or death of the tissue. The treatment of an incarceration usually involves surgery.
Where are hernias located?
The most common location for hernias is the groin (or inguinal) area. There are several reasons for this tendency. First, there is a natural anatomical weakness in the groin region which results from incomplete muscle coverage. Second, the upright position of human posture results in a greater force pushing toward the bottom of the abdomen, thereby increasing the stress on these weaker tissues. The combination of these factors over time breaks down the support tissues, enlarging any preexisting hole, or leads to a tear, resulting in a new hole.
Several different types of hernia may occur, and frequently coexist, in the groin area. These include indirect, direct, and femoral hernias, which are defined by the location of the opening of the hernia from the abdomen to the groin. Another type of hernia, called a ventral hernia, occurs in the midline of the abdomen, usually above the navel (umbilicus). This type of hernia is usually painless. Hernias can also occur within the navel (umbilical hernia).

Symptoms and signs
Symptoms of a hernia include pain or discomfort and a localized swelling somewhere on the surface of the abdomen or in the groin area.


 Anesthesia is used for hernia surgery
Most hernia repairs can be done with a variety of anesthetic methods. With modern general anesthetic techniques and monitoring, general anesthesia can be very safe. However the surgery can also be performed under local anesthesia or regional anesthetics, often using sedation medications at the same time to help relax the patient. The specific type of anesthetic for an individual patient is selected after careful evaluation of the patient's general health and individual concerns.


What can be done to prevent a hernia?
Most of the factors that lead to the development of hernias are beyond the control of the individual. Some of those factors are inherited and develop as the individual grows. The arrangement of the local tissues and their thickness and strength may greatly affect the relative risk of developing a hernia over a lifetime. However, that risk can be increased by failure to use good body mechanics when lifting, poor abdominal support posture, and weight-control problems.


Are hernias inherited?
Since genetics dictate inherited features and structure, there is a significant risk of inheriting the anatomical features that may predispose to a hernia. There may also be inherited factors that result in tissue weakness, which ultimately allows the deterioration of the supporting structures and leads to the formation of a hernia. However, this does not necessarily imply that the offspring of an individual with a hernia will ultimately develop the problem.


Do hernias usually develop on both sides of the body?
Groin hernias are somewhat more likely to develop on both sides. This is probably because the structural elements develop symmetrically, and the stresses on the body that occur over time are similar on both sides. When a patient becomes aware of a groin swelling on one side, examination by a doctor will often identify a small hernia on the opposite side.