In early 2018, Karen A. DiBernardo White noticed a growth about the size of a golf ball that was just below her belly button, on her left side. Within months, the protrusion grew to the size of an orange, and then about the circumference of a grapefruit.
“It was causing discomfort at first, then it got more painful as time went on,” says White, who lives in Midland, Michigan. The growth reminded White of the classic 1979 horror movie “Alien,” in which monsters grow inside victims and pop out of their skin. “I was expecting it to come out and say hello,” she says. “It was really strange. You could see it jutting out from my clothing. I was lopsided.”
Five years earlier, White had had a hysterectomy, treatment for early-stage uterine cancer, so she worried the growth was cancerous. A gynecological oncologist ordered a CAT scan, which revealed the protrusion wasn’t cancer — it was a hernia. Scarring from her hysterectomy had apparently led to an opening in the wall of her stomach, which allowed an organ to protrude. “I was so relieved,” White says. “I think I cried, I laughed. It’s only a hernia. I was happy.” White says she will eventually have laparoscopic hernia repair surgery. Untreated, her hernia could lead to a bowel obstruction, her physicians told her.
White’s bulge is a common hernia symptom, says Dr. Abtin H. Khosravi, a general surgeon and hernia specialist at St. Joseph Hospital in Orange, California. “The most common sign of a hernia is a painless bulge,” Khosravi says. “They can develop over time or present more acutely after a heavy lifting. As they grow, patients will often complain of discomfort or awareness of it with certain activities, including standing for prolonged periods of time or sitting for prolonged periods.” Some patients may report feeling intermittent pain after eating a heavy meal, which may indicate that the tissue that’s in the hernia has been pinched off, Khosravi says.
See: [On a Scale From 1 to 10: Most Painful Medical Conditions.]
Types of Hernias
At any given time, about 5 million people in the U.S. have an abdominal hernia, says Dr. Michael Rosen, a general surgeon at the Cleveland Clinic. A hernia occurs when an internal organ or other body part protrudes through the wall of muscle or tissue that typically contains it.
There are more than a half-dozen specific types of hernias, including:
— Inguinal hernia, which occurs when tissue, like from an intestine, protrudes through a weak spot in the abdominal muscles.
— Incisional hernia, in which an organ or tissue juts through a scar or incision from a previous abdominal surgery, like an appendectomy.
— Umbilical hernia, which occurs when part of the intestine or abdominal tissue peeks out through or near the navel, creating a bulge.
— Hiatal hernia, which happens when the upper part of your stomach bulges through the large muscle separating your abdomen and chest.
Treatment for Hernias
Not all hernias necessarily require treatment, says Dr. E. Alexandra Zubowicz, an advanced minimally invasive surgeon at MedStar Washington Hospital Center in the District of Columbia. She specializes in general and bariatric surgery. “If a hernia is extremely small and the patient is not having any symptoms, it’s OK to hold off on repairing it,” Zubowicz says. “However, over time, some hernias will likely get bigger and need to be repaired. Sometimes intestines can get stuck in the hernia leading to bowel obstruction or damage to the intestine, requiring emergency surgery. This is the primary reason why once a hernia becomes a certain size, a physician will recommend getting the hernia repaired.”
Treatment approaches depend on the type and severity of the hernia. For example, most hiatal hernias don’t cause symptoms and won’t require treatment. However, if you have a hiatal hernia that’s causing heartburn or GERD (gastroesophageal reflux disease), your physician may recommend over-the-counter antacids that neutralize stomach acid, OTC medication to reduce acid production and either over-the-counter or prescription drugs to block acid production and heal the esophagus, according to the Mayo Clinic.
For more serious problems, the Mayo Clinic says there are three types of surgery:
— Open surgery, which involves a cut made into the body at the location of the hernia. In this procedure, the protruding tissue is set back in place and the weakened muscle wall is stitched back together.
— Laparoscopic surgery, which is similar to open surgery. However, instead of a cut outside the groin or abdomen, tiny incisions are made. These smaller incisions allow the surgeon to insert surgical tools to complete the repair.
— Robotic hernia repair, which is also performed with small incisions. With this type of procedure, the surgeon handles surgical instruments from a console in the operating room. Robotic surgery can be used for some smaller hernias or weak areas, and can also be performed to reconstruct the abdominal wall.
What Causes Hernias?
A variety of factors can lead to hernias, says Dr. Niket Sonpal, a gastroenterologist and adjunct assistant professor of medicine at the Touro College of Osteopathic Medicine in New York City.
Factors that can cause hernias include:
— Stress
— A weak abdominal wall
— Difficulty urinating or making bowel movements
— Strenuous activity
— Pregnancy
— Chronic sneezing or coughing
Medical professionals can diagnose hernias with a physical exam, says Dr. Flavio Malcher, director of the abdominal wall program in the surgery department at the Montefiore Health System in New York City. “If (a patient) believes he or she has a hernia, the best option is to be examined by a general surgeon or his or her primary care physician,” Malcher says.
See: [7 Ways Pain Is Sometimes Misdiagnosed.]
Hernia Symptoms
Here are some potential symptoms of a hernia:
— A lump or a bulge in the groin or around the belly button
— Pain in the affected region
— Reflux, or GERD
— Bloating and constipation
1. A lump or a bulge in the groin or around the belly button.
The most common sign of a hernia is a painless bulge in the groin or near the bully button, Khosravi says. These bulges often develop incrementally over time. “As they grow, patients will often complain of discomfort or awareness of (the bulge) with certain activities, including standing for prolonged periods of time or sitting after a heavy meal,” he says.
2. Pain in the affected region.
Pain and discomfort in the area around the lump, whether it’s in the groin or belly region, can be a sign of a hernia, Khosravi says. Some people may report feeling intermittent pain after consuming a heavy meal, which can mean that the tissue in the hernia has been pinched off. “Usually this will go away if the patient pushes the hernia back in,” Khosravi says. A hard bulge with severe pain and overlying skin redness could be a sign of an emergency that requires surgery.
[What Not to Say to People With Chronic Pain.]
3. Reflux, or GERD.
Hernias that develop through defects in the diaphragm typically don’t cause an abdomen bulge, says Dr. Abraham Krikhely, assistant professor of surgery, minimally invasive and robotic, bariatric and general surgery at Columbia University Irving Medical Center in New York City. A hiatal hernia is a common type of hernia through the diaphragm associated with the upward displacement of the junction between the esophagus and stomach and possibly other abdominal organs in the chest, he says. This can lead to reflux, or GERD, which occurs when your stomach contents come back into your esophagus. Shortness of breath, difficulty with passage of food after swallowing and obstruction of the stomach can also occur with larger hiatal hernias.
4. Bloating and constipation.
Hernias can sometimes lead to obstruction of the intestines that can result in symptoms related to blockage, like bloating, abdominal cramps and constipation, Krikhely says. In some cases, hernias can create intestinal blockages that keep food or liquids from either your small intestine or your large intestine, or colon, according to the Mayo Clinic. Without treatment, the blocked parts of the intestine can die, which could create serious problems, like an infection that creates a surgical emergency, Krikhely says.
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What Are Hernia Symptoms? originally appeared on usnews.com
