The hernia treatment a patient receives depends upon the type and severity of the hernia.
The hernia treatment a patient receives depends upon the type and severity of the hernia. The most common type of hernia is an inguinal hernia, which occurs when part of the intestine or a piece of fat protrudes through the abdominal wall into the groin. More prevalent in men, this type of hernia may appear in the scrotum.
A femoral hernia occurs in a similar manner, except that it appears at the upper thigh near the groin and is more common in women. Hiatal hernias occur when part of the stomach moves up through the opening of the diaphragm into the chest. Umbilical hernias are often seen in infants, with the intestines or fat protruding through the abdominal wall below the navel.
In most cases of inguinal and femoral hernias, surgery is required to repair the hernia and prevent complications. However, hiatal and umbilical hernias normally do not require surgical treatment.
A doctor may recommend keeping an eye on a small inguinal or femoral hernia rather than performing surgery right away. However, since most hernias grow larger over time, surgery will usually be necessary at some point. In addition, emergency surgery may be required if complications occur. Life-threatening complications include incarceration and strangulation of the hernia.
An incarcerated hernia causes the bowel to become obstructed. This can cause nausea, vomiting and the inability to eliminate the bowel. Strangulation occurs when blood flow to the trapped intestine is cut off, leading to the death of the intestinal tissue. Patients should seek immediate medical treatment if they experience severe pain or they experience nausea and vomiting associated with the hernia. In men, an inguinal hernia that extends into the scrotum can cause pain and swelling in the area.
The Society of Laparoendoscopic Surgeons says surgery is the only effective option for treating the hernia. While a truss, or hernia belt, can be used to keep the hernia from bulging, it is not a long-term treatment. In fact, a truss may even cause scar tissue that makes surgical repair more difficult.
Inguinal and femoral hernias are usually treated with one of two surgical methods. In the first, herniorrhaphy, the surgeon makes an incision above the hernia, pushes the protruding intestine back into the abdomen and then stitches the hernia opening closed. The second surgical technique, hernioplasty, uses a synthetic mesh patch to repair the hernia opening. The patch is secured with staples, sutures or clips. Hernioplasty can be performed either through open surgery or laparoscopically.
During laparoscopic surgery, several small incisions are made, through which the surgeon inserts miniature surgical tools and a fiber-optic tube with a miniature video camera. The surgeon uses the camera to see the surgery site and to guide the surgical tools. Most hernia repairs are performed on an outpatient basis, and patients are encouraged to begin walking as soon as possible after the surgery. However, patients should avoid heavy lifting or any activity that causes straining for six to eight weeks after surgery.
Most hiatal hernias do not cause any symptoms and, consequently, do not require treatment. However, pressure from the hernia can cause stomach acid to reflux up into the esophagus, causing a burning sensation, or heartburn. If the patient experiences heartburn as a result of a hiatal hernia, treatment normally involves simply controlling the acid reflux. To lessen symptoms, doctors may recommend patients take an antacid (such as Tums or Mylanta), H-2 blocker (such as Pepcid, Zantac or Tagamet) or proton pump inhibitor (such as Prevacid, Prilosec or Nexium). .
In addition to medications, the Mayo Clinic outlines some lifestyle changes that may help reduce heartburn caused by a hiatal hernia. Patients should:
In rare cases, hiatal hernias may require surgical repair. Surgery is normally only considered if medication and lifestyle changes are ineffective. Surgery may also be necessary if the hernia obstructs the esophagus, makes breathing or swallowing difficult or causes chest pain. To correct the hernia, a surgeon may move the stomach back into position and make the opening in the diaphragm smaller so the stomach cannot slip back through. Alternatively, a weakened esophageal sphincter may be reconstructed. The hernia may be repaired through an incision in the chest or abdomen or via a laparoscopic procedure.
Most small umbilical hernias present at birth go away by a childs first birthday. However, if a large hernia persists past the age of three or four, surgery may be required to repair it. In addition, as with other hernias, strangulation can occur. MedlinePlus indicates that parents should seek immediate medical attention if the childs hernia becomes painful, swollen or discolored. Taping over the hernia or belly button will not prevent or correct an umbilical hernia.