Hernia - Signs and Repair


Q1. What is hernia?
A hernia occurs when an organ protrudes from where it normally resides through some connecting channels. These organs can be the intestines, stomach, colon or bladder. A lump may occur under the skin if any of the above organs bulges through the abdominal wall.

Q2. Are there many types of hernia? Which are the most common?
There are different types of hernia, and the three most common ones are: palpable external hernia, e.g. inguinal hernia in the groin or paraumbilical hernia near the belly button, and the internal hernia such as hiatal hernia. Internal hernia is not palpable, nor can it be seen by naked eyes.

Q3. What are the symptoms of hernia?
Symptoms vary with the location of hernia. If it occurs near the groin area or belly button, i.e. inguinal hernia, a prominent protrusion is seen when the patient stands or strains. The same bulge will become less obvious, even disappear when one lies down. Please seek medical advice if the bulge does not flatten or you feel pain near the hernia, which may suggest hernia strangulation. An internal hernia such as hiatal hernia may cause acid reflux after meals or during sleep, leading to heartburn, bloating, etc.

Q4. Who are at higher risk for hernia?
Males are more likely to have hernia, especially in the groin. Hernia is also more common in people with chronic constipation, weight problems, chronic cough or prostate hyperplasia.

Q5. How is hernia diagnosed?
Inguinal hernia, e.g. those develop in the groin or the belly button area, can be diagnosed based on medical history and clinical examination. Internal hernia such as hiatal hernia can be diagnosed with CT scan or endoscopy.

Q6. How is hernia treated? Is surgery required?
Inguinal hernias may cause strangulation of the intestines or other organs. Surgical repair is usually recommended. To reduce the chance of hernia recurrence, doctors need to identify the cause of hernia, whether it is chronic cough, benign prostate hyperplasia or obesity. For hiatal hernia, treatment depends on the presence of obvious symptoms such as acid reflux or esophagus obstruction. It needs only monitoring if the hernia is asymptomatic. Otherwise, medication or surgical intervention is required.

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