Overview of Inguinal Hernia
An inguinal hernia takes place in the abdomen near the groin area when tissue, such as part of the intestine, bulges from a weak spot in the abdominal muscles. It is developed when fatty or intestinal tissues push through the abdominal wall near the right or left inguinal canal. The bulge that is caused due to inguinal hernia can be severely painful, especially when the patient coughs, bends over, or lifts a heavy object. An inguinal hernia may slide in and out of the abdominal wall. A doctor can typically move it back inside the abdominal wall with just a gentle massage.
Key signs and symptoms of an Inguinal Hernia
- A typical inguinal hernia can be detected when a patient has a bulge in the area on either side of the pubic bone, which is evident when he/she is upright, especially while coughing
- Pain in the groin, especially while bending over, coughing, or lifting
- A burning sensation at the bulge
- A heavy or dragging sensation in the patient’s groin
- Weakness or pressure in the groin
- Occasional pain and swelling around the testicles when the bulging intestine sinks into the scrotum
Inguinal Hernia is commonly seen in:
- The chance of an occurrence of inguinal hernia increases with age in adults, and inguinal hernias are most common in people between the age of 75 to 80.
- Amongst children, inguinal hernias are most common in the age group of 0 and 5 years.
- While in infants, inguinal hernias are commonly seen in premature births.
Primary causes of an inguinal hernia
Though there is not just one specific cause for the occurrence of an inguinal hernia, the weak spots within the abdominal and groin muscles are considered to be a major contributor. Too much pressure on this area of an individual’s body can result in a hernia.
Other causes include:
- A weak spot in the abdominal wall
- Straining while urinating or during bowel movements
- Vigorous activity
- Pregnancy
- Persistent coughing or sneezing
Types of Inguinal Hernia
4 Types of an inguinal hernia include indirect or direct, incarcerated, and strangulated.
Indirect inguinal hernia
Indirect inguinal hernia mostly occurs in premature births before the inguinal canal gets closed off. However, it can take place in a woman’s body at any time during her life. This condition is most common in males. It is known to be the most common type of inguinal hernia.
Direct inguinal hernia
A direct inguinal hernia is commonly seen in adults as they get older. Most researchers believe that weakening muscles during adulthood results in a direct inguinal hernia and it is much more prevalent in men.
Incarcerated inguinal hernia
An incarcerated inguinal hernia occurs in the abdomen when the tissue gets stuck in the groin and isn’t reducible. This type of hernia cannot be pushed back into place.
Strangulated inguinal hernia
Strangulated inguinal hernias take place when the intestine in an incarcerated hernia has its blood flow cut off. Strangulated hernias are a relatively serious medical condition and can be life-threatening. This type of hernia demands emergency medical care.
Diagnosis of Inguinal Hernia
Inguinal hernia can be easily diagnosed through a physical exam. A surgeon will check for a bulge in the patient’s groin area. Since standing and coughing make a hernia more evident, surgeons often ask patients to stand and cough or strain.
In case the diagnosis is vague after a physical exam, the surgeon suggests imaging tests to check for an inguinal hernia which will also be useful to check for complications.
Imaging tests for an inguinal hernia include
- Ultrasound- It utilizes sound waves to create an image of a patient’s organs
- Computed tomography (CT)- It employs a combination of x-rays and computer technology to create images
- Magnetic resonance imaging (MRI)- It takes snapshots of the patient’s body’s internal organs and soft tissues without using x-rays
Hernias are best diagnosed clinically and most often you don’t need any tests to diagnose hernias. Investigations are used only when we are in doubt about the diagnosis.
Treatment of inguinal hernias- Methods
Patients with inguinal hernias typically require surgery to repair the hernia. A surgeon can conduct inguinal hernia repair through open surgery or laparoscopic surgery. The recommended type of surgery by a surgeon depends on the size of the hernia, age of the patient, health, and medical history.
Open Inguinal hernia surgery
While conducting an open hernia surgery, a surgeon makes a cut in the patient’s groin which is typically 6 to 8cm long to clearly view and repair the hernia. Further on, the lump of fatty tissue or loop of the bowel is placed back into the patient’s abdomen. Then, to strengthen it, the surgeon places a mesh in the abdominal wall, at the weak spot where the hernia came through.
In most cases, patients are given local anesthesia and a sedative for open hernia surgery. However, seldom surgeons may give patients general anesthesia or a spinal block to numb the body from the waist down.
Laparoscopic Inguinal hernia surgery
While conducting a laparoscopic hernia surgery, three small cuts are made in the patient’s lower abdomen and a laparoscope is inserted to view and repair the hernia. It is connected with a video camera (smaller than a dime). A piece of mesh is used by the surgeon to close and strengthen the abdominal wall.
In laparoscopic hernia surgery, patients most often receive general anesthesia. A patient recovers faster after laparoscopic surgery than open hernia surgery.
Prevention Steps Against Inguinal Hernia
One cannot prevent the hereditary defect that makes him/her vulnerable to an inguinal hernia. However, one can reduce strain on the abdominal muscles and tissues by taking the following steps.
- One must maintain a healthy weight. An individual must talk to a doctor about the most suitable exercise and diet plan.
- One must consume enough high-fiber foods. Eating fruits, vegetables, and whole grains can help in preventing constipation and straining.
- One must always lift heavy objects carefully or even avoid heavy lifting to prevent the occurrence of an inguinal hernia. Also, while lifting something heavy, one must always bend from the knees, not the waist.
- One must not smoke. Apart from its role in many serious diseases, smoking often causes a chronic cough that can lead to or worsen an inguinal hernia.