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Hernias occur when a part of the body’s tissues or a portion of an organ starts to protrude out of the membrane lining or muscle which confines it. While hernias are most commonly associated with the abdominal wall, they also appear elsewhere in the body.


A person’s abdomen is a wall of sturdy muscle and tendon. It encompasses the ribcage and runs all the way down to the groin. It is responsible for containing all the organs that reside within the abdominal cavity, particularly the intestines. When an area of the abdominal wall becomes weak, it may cause the contents of the abdomen to push away from inside. This results in a bulge in the weak portion of the wall, known as a hernia.

There are three parts to a hernia: the cavity or orifice through which the piece of tissue or organ slips through (herniation), the hernial sac, a thin membrane that encloses the cavity, and the contents of this hernial sac, which may comprise of abdominal fat or pieces of intestine.


Hernias can affect people of all ages and genders. In fact, about 5 million people in the U.S. suffer from hernias, but less than 2% submit themselves to a surgical procedure to repair this ailment. This is true despite the discomfort caused by a hernia, which may grow larger, and more dangerous if complicated by “strangulation”, a term used to describe a piece of intestine becoming trapped within the hernia, thus cutting off the blood supply to the trapped tissue. This form of hernia is dangerous and will require immediate medical intervention and surgery.

Every motion made by the afflicted person adds pressure on the protruding tissue, causing it to bulge out even more. This also acts to widen the opening of the orifice or cavity, so much so that eventually, a huge portion of the protruding organ, such as the intestines, may dangle suspended through the hernial sac.

Apart from the abdomen, hernias may develop in other parts of the body, including the inguinal and femoral canals which contain blood vessels that run down to the scrotal area and lower extremities, the umbilical region (navel), the intervertebral disc, the intracranial regions (brain hernias), and if a person has had previous surgery which may result in tissue vulnerability at the incision site (incisional hernia).


There are different classifications of hernias. These include congenital hernias that occur while the fetus is in utero, such as congenital diaphragmatic hernias, and acquired hernias which develop in later in life. Hernias may either be complete or partially herniated, they may be fully visible on the outside (external hernias), or internal. Intraparietal hernias do not completely bulge out and are less liable to be detected during medical examination, bilateral hernias (Cooper’s hernia) may need prosthetic reinforcements to treat, and irreducible hernias, whose tissue contents cannot be maneuvered back to its proper location.
Image: Hernia

Of the number of hernias in existence, Inguinal hernias are the most prevalent, taking up 70% of all hernia cases. The inguinal canal is a natural opening through the front of the abdominal wall leading to the reproductive organs. When a weakness develops at its entrance or at its back wall, hernias may develop there. Femoral hernias develop when contents of the abdomen protrude into weak areas at the back of the femoral canal. Umbilical hernias are common among infants, particularly of African descent, and are characterized by herniations due to weakness along the passageway of the umbilical cord. Diaphragmatic hernias are hernias pushing their way into the chest cavity through a weak diaphragm.

There are other innumerable kinds of hernias, and many of them develop in regions of the body characterized by weakness of the muscles or other tissue pitted against pressure from a neighboring portion of tissue, fat, muscle or body organ.

Hernias present themselves either through a conspicuous lump, or discomfort and pressure at the affected site. People with hernias will also experience a dull aching feeling, a sensation of fullness, and pain while lifting heavy objects. Other symptoms include bowel obstruction, as well as nausea and vomiting, as with the case of large irreducible hernias and strangulated hernias. Conversely, there are also some hernias which remain asymptomatic.

There are certain types of congenital abdominal hernias that exist at birth, while other kinds of hernias may be caused by factors like obesity, lifting heavy objects on a regular basis, coughing or sneezing, excessive straining during defecation or urination, the presence of fluid in the abdominal cavity, chronic lung disease, and even a genetic predisposition to inherit the disorder.

If left untreated, hernias may result in complications like strangulation, which is characterized by excessive pressure on the hernial contents, causing blood supply to these body portions to be cut off; obstruction of the forward motion of bowel contents, particularly in bowel-related hernias, and dysfunctioning of the surrounding systems, such as heartburn caused by hernias located in the abdominal area, or sciatic nerve pain caused by intervertebral disc hernias. Other complications include inflammation and an accumulation of fluid within the hernial sac (Hydrocele).


An increased risk for acquiring hernias can be brought about by weak or previously injured muscles, a history of surgery, pregnancy, a family or personal history of hernias, chronic cough or constipation, advanced age, prematurely born infants, occupations that require standing for long periods of time, excessive lifting or straining, and obesity. Males have 10 times more chances of developing hernias compared to females, even infants who are born with congenital hernias or children who are diagnosed with inguinal hernias are male.


In the normal course of diagnosis, detecting hernias may not need a battery of tests. Hernia protrusions may usually be felt during a physical examination. Other types of hernias that are more difficult to spot, like the hiatal hernia, may be determined by the symptoms of a patient, such as heartburn or chest pains. A diagnostic test known as a barium swallow will involve the patient swallowing a substance laced with barium which will show up in an x-ray of the digestive system, allowing the hiatal protrusion to stand out. An endoscopy may also be used to detect hernias via a small camera at the tip of a thin tube inserted into the mouth and down the stomach.


As soon as a hernia makes its appearance, the patient must immediately seek treatment, particularly if the hernia causes pain or aches, discomfort, pressure, and is tender to the touch. Not all hernias require surgery, but they may eventually make a turn for the worse if not corrected.

Surgery to repair strangulated hernias, as well as employing a laparoscopic procedure to correct the herniated protrusion has been proven effective.

Very little can be done to prevent the occurrence of hernias. Proper posture when lifting heavy objects, keeping a healthy weight, and taking occasional sitting breaks from prolonged standing can reduce the risks of developing this disorder.

Seven percent of patients who have undergone surgery to repair hernias will have complications. These complications, such as hernia recurrence, nerve irritation, and build-up of fluid in the scrotum last only for a short period of time and are usually treatable.

The Baylor College of Medicine is currently conducting a study to search for options to improve the quality of life of primary and recurrent incisional hernia sufferers, particularly those who cannot undergo surgery due to poor health. The results of this study will be compared to that of patients who have opted to undergo surgery to repair their hernias.
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