Inguinal Hernia

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A Hernia is a weakness or tear in the abdominal muscle wall, which holds the inner lining of the abdomen and internal organs in place. The weakness or tear results in the inner lining forming a pouch; the bulge a patient may see is normally a loop of intestine protruding through the tear in the muscle and into that pouch. Most hernias occur in the abdominal area, in between your chest and hip bones. Hernias that can be pushed back into place are called ‘reducible hernias’. Those that cannot be popped back into position are termed ‘irreducible or incarcerated’. 

An inguinal hernia happens when part of the intestine or fatty tissue pokes through a weakened area of the abdominal wall to either side of the inguinal canal. The inguinal canal is a passage that occurs on each side of the lower abdomen and connects to the genitals. There are overall two common types of inguinal hernia, which are:

  • Indirect inguinal hernia – An indirect hernia follows the pathway that the testicles made during fetal development, descending from the abdomen into the scrotum. This pathway usually closes before birth, although may remain a possible site for a hernia in later life. Sometimes the hernia sac may protrude into the scrotum. An indirect inguinal hernia may occur at any age.
  • Direct inguinal hernia – The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum and can cause pain that is difficult to distinguish from testicle pain. Unlike the indirect hernia, which can occur at any age, the direct hernia tends to occur in the middle-aged and elderly because their abdominal walls weaken as they age.

Generally, an inguinal hernia is typically not dangerous. However, it can be very painful, especially when you attempt to lift, bend, or cough. Therefore, treatment is essential.

Causes & Symptoms of an Inguinal Hernia

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Inguinal hernias occur as a result of a defect in the inguinal canal, which is a tubular passage that runs through the lower abdominal muscles in the groin, close to where the abdomen and the thigh groin.

The defect allows abdominal tissue (normally a short length of the intestine) to push out. Symptoms of an inguinal hernia may vary from person to person. The most common sign of an inguinal hernia is a bulge or lump in the groin. Men may also have a lump, and oftentimes swelling in the scrotum.

The bulge or lump may be painful and the pain can worsen when coughing, sneezing, lifting, or standing for a long period of time. The lump may become bigger when coughing, bending, or straining. The lump may also become smaller with less pain when lying down. Also, the skin over the hernia may become swollen and red. When the hernia restricts blood flow to the area the skin may appear to look grey or blue.

Who gets an Inguinal Hernia?

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An inguinal hernia can occur because of an inguinal canal defect that is present at birth and / or because of increased pressure within the abdomen. Therefore, the following risk factors that increase pressure within the abdomen include:

  • Gender – Adult males over age 40 are much more likely to develop direct inguinal hernias than females.
  • Family history – If any of your relatives have developed a hernia in the past, you may be at risk of developing the condition as well.
  • Abdominal surgery – Patients who have had previous abdominal surgery are at greater risk for developing an inguinal hernia.

There are other types of hernias that will affect the same way an inguinal hernia may affect you, such as:

 

Umbilical hernia

Umbilical hernias most commonly occur in infants but may also develop in adults. They are characterized by bulging around the belly button and may be more pronounced when the infant cries or coughs. In infants, umbilical hernias are usually painless, but they may cause discomfort in adults.

Epigastric hernia

Epigastric hernias appear in a line between the base of the breastbone and the belly button where fatty tissue is pushed through the hernia. Epigastric hernias are often small with few if any symptoms but may gradually grow larger and become painful.

Femoral hernia

A femoral hernia occurs when abdominal tissue is forced out of the abdomen through the femoral canal, forming a bulge that is the size of a grape. Femoral hernias tend to occur in older people. They are also more common in women, thought to be related to the weakening of the abdominal tissues during pregnancies. The triggers of femoral hernias are similar to those of inguinal hernias (heavy lifting, straining, and coughing). All femoral hernias require surgical treatment because they have a high risk of becoming strangulated.

How Does an Inguinal Hernia Affect You? How Serious is it?

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In severe cases, when abdominal tissue protruding through the hernia cannot be gently pushed back in, the hernia may be incarcerated or irreducible. This can lead to the blood supply to the intestinal tissue being cut off.

When this occurs, the hernia is said to be Strangulation can cause the tissue to die and cause severe pain at the site of the hernia. This may be accompanied by nausea and vomiting due to obstruction of the intestines. This situation is considered to be a surgical procedure known as a hernia repair.

Recommended Treatment & Rehabilitation for an Inguinal Hernia

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In order to diagnose an inguinal hernia, a thorough medical history and physical examination will likely be performed. Since inguinal hernias aren’t visible externally, they may require imaging studies for the hernia to be visualized.

Computed Tomography (CT) scans are usually used to help diagnose an inguinal hernia, however, an X-ray can also be used when a CT scan is unavailable. In some cases, laparoscopy, which is a minimally invasive surgical procedure, may be required to determine the severity of the hernia.

It is important to promptly diagnose hernias due to the increased risk of developing a small bowel obstruction, which refers to a blockage of the small intestine that can result in other complications, such as the loss of blood supply to surrounding tissues or bladder compression.

Depending on size, location, and symptoms, a physician will decide to treat the hernia surgically or monitor it for changes until intervention becomes necessary. However, it is important to note that hernias do not resolve on their own and will grow in size and complexity over time.

Your surgeon may recommend a minimally invasive, surgical repair. Recent advances like robotic surgery allow for reduced pain by combining minimal surgical access with the precision of open surgery. However, larger hernias will require more invasive surgery than newer, smaller hernias.

Types of hernia surgery include open surgery and laparoscopic surgery, as described below:

  • Open surgery – In open surgery, the surgeon cuts through the body where the hernia is located. The bulging parts are put back into place and the tear is stitched. Instead of sutures, a doctor might use a mesh panel to provide support.
  • Laparoscopic surgery – Using small incisions through which surgical tools, the organs / tissues are moved back to where they belong, and the hole is repaired. This is considered minimally invasive surgery and has a quicker recovery time than open surgery.

All surgeries require incisions. Therefore, this means there is a chance of complications, including:

  • Persistent pain – Some patients tend to continue to have persistent pain after surgery.
  • Nerve or blood vessel damage – During surgery, there is a slight chance that the nerves, veins, or tissue around the area can be damaged. Damaged nerves or blood vessels can cause numbness, pain, or lower blood flow around the area.

After surgery, a patient may experience pain around the surgical site. A surgeon will prescribe medication to help ease this discomfort while he / she recovers. Following a hernia repair, one may be unable to move around normally for several weeks. Any strenuous activities may need to be avoided.

Open surgery often requires a longer recovery process than laparoscopic surgery. Your surgeon will let you know when you can return to your normal routine. Ignoring symptoms can result in emergency surgery for obstruction or strangulation of the bowel.

Over-the-counter and prescription medications that reduce stomach acid can relieve your discomfort and improve symptoms. These include antacids and proton pump inhibitors.

Certain exercises that work to strengthen your abdominal muscles can help reduce your risk of getting an inguinal hernia. Other exercises can help you recover after hernia surgery. Here are a few exercises to help prevent and recover from a hernia:

 

Button pulls

Lie down on your back with your knees bent. Your feet should be planted on the surface, and your hands should be on your hips. Afterward, take a deep breath through your nose. As you breathe out, pull your belly button in toward your back. Hold this position for several seconds. Finally, relax and breathe normally, then repeat the procedure 2-3 times.
 

Seated bicep curls

Sit down so that your back is resting against something, and your feet are firmly placed on the ground. Then, grab two lightweight dumbbells with your palms facing forward, and let your arms hand to the side.

Lower your shoulders and push your shoulders back. Afterwards, take a deep breath. While you breathe out, bend each elbow at the same time and bring the weights toward your chest. Be sure to keep your back straight and shoulders down, and do not overextend your wrists. Lastly, inhale and gently bring the weights back down to your starting position.

 

Cycling exercise

First, lie on your back on a mat. Then, bend your knees and keep them in an elevated position. Now using both legs, start the cycling motion. Once you feel the burn in the abdomen, stop the exercise.

 

Walk for 30 minutes

Walking for about 30 minutes a day will help strengthen your lower and upper abdomen.

Alternative & Homeopathic Treatment for an Inguinal Hernia

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While home remedies won’t cure your inguinal hernia, there are some things that you can do to help with your symptoms linked to hernias, such as the following:

 

Aloe Vera

Aloe Vera has anti-inflammatory and soothing properties. It acts as a natural pain reliever when one is suffering from a hernia. For effective results, drink a glass of Aloe Vera juice. Aloe Vera is also good for treating a hernia if it is consumed between meals. The liquid of Aloe Vera can also be applied to the affected part.

 

Taking short and light meals

Changes in diet are good for getting relief from an inguinal hernia. This will not make the hernia go away, but it will reduce its severity.

 

Ice pack

In cases of a hernia there can be redness, inflammation, and pain. And ice will help reduce it. Applying an ice pack to the affected area will reduce contraction, pain, and inflammation.

 

Yoga

Yoga can always be helpful for preventing hernia but it should only be done if an individual can comfortably do the strenuous asanas otherwise a professional’s advice must be sought before trying these poses. The asanas focus on strengthening abdominal muscles, compressing the inguinal canal, and relieving abdominal pressure.

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