How hernias happen, and what to do when you get one

This article is sponsored by MedStar Washington Hospital Center

Hernias: How they occur, how they can be repaired

A hernia is a weak area or a hole in the muscle layers of the abdomen. Some hernias never cause problems and don’t require treatment.

However, when you have a hernia, the concern is something inside could poke through, either a part of one of your organs, such as an intestine or a piece of fatty tissue. If that piece gets stuck, it’s called an incarceration.

Hernias may occur along the front of your body, from your chest to abdomen to your groin. They are common in the belly button and groin. You may have a weak spot because an area didn’t completely close where your umbilical cord was attached at birth or because you have had a surgical incision.

A hernia is more serious when the incarceration becomes a strangulation. This is when the piece of tissue or organ that has pushed through and is stuck loses its blood supply and starts to die. If that is the case, emergency surgery is required.

What could happen

You can get a piece of an organ or tissue poking through because your body’s process of repairing tissue breaks down. It may be because you inadvertently put pressure on a weak area by straining when lifting something heavy or doing other intense physical activity.

Having a hernia doesn’t mean you should give up physical activity. Rather, be careful about any strain you put on your body.

“If you don’t have a hernia, I would say definitely don’t pass beyond your own limits, and every person knows for the most part what their own limits are,” says Dr. Ivanesa Pardo, a general and bariatric surgeon at Medstar Washington Hospital Center.

If something pokes through, it could be gradual, or it could be sudden, perhaps accompanied by a “pop” noise.

How to recognize a hernia

You can check for a hernia and something poking out by looking for swelling or bulges. As with many medical conditions, if you have a family history of hernias, your risk is higher.

You are also at risk if you are pregnant, are overweight or have lost a lot of weight. Additionally, the strain from constipation or a chronic cough due to, for example, smoking or lung problems from cystic fibrosis, can trigger a hernia.

If you notice anything of concern, make a doctor’s appointment to have the area examined

How to treat a hernia

A hernia doesn’t necessarily require surgery, but you’ll want to monitor it to prevent an incarceration or strangulation.

You can also make lifestyle changes to avoid your hernia progressing to the point that it needs surgery. These include reaching and maintaining a healthy weight, doing exercises that increase muscle strength around the hernia, avoiding foods that cause heartburn and acid reflux, and quitting smoking.

However, your hernia may reach a point where surgery is necessary.

“If it’s large enough where a segment of intestine could get stuck, where we talked about incarceration and strangulation, I would recommend to electively repair it before that were to happen,” Pardo says.

She pointed out that elective surgery is better than emergency surgery, which would be required if the hernia became a strangulation. Surgery will either be an open repair procedure with a large incision or a minimally invasive procedure that is laparoscopic or robotic. Either way, you likely will require a mesh implantation, which reinforces the muscle layers where the defect is and greatly reduces the chance of a hernia returning.

If you have questions or concerns about a hernia, make an appointment with your doctor. Together, you can create a plan to monitor and manage it, so you can live comfortably.

For more insights from Dr. Pardo on hernia diagnosis, treatment and repair, click here.

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