GETTING A HANDLE ON HERNIA
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Hernia is an age-old condition that can afflict anyone at any time. Read on for answers to some of the most frequently asked questions about it.

What is hernia?

Hernia is a condition in which a portion of the intestine breeches and juts out from its containing muscle wall, forming a visible lump under the skin. Because the hernia site is usually located where this abdominal wall is weak or torn, it was called a "rupture" in the past.

When hernia first occurs, you may experience a little pain and feel that something has given way. The pain soon wears off and a lump, which can get bigger when you cough, appears. Hernia is mostly a cause of discomfort and a bit of a nuisance, although that can change if the protrusion gets stuck and blood supply cut off. Called a strangulated hernia, this is very painful and is potentially fatal, as blood poisoning can occur when dead intestinal tissue turns septic. An emergency operation is thus needed to clear the blockage, repair the tear and prevent further complications.

What causes hernia?

Hernia is caused by a sudden rise in pressure within the abdomen, which is why it is often associated with vigorous exercise. But other activities can also force the intestine through the abdominal wall, such as heavy lifting, intense coughing or even straining on the toilet.

What are the different types of hernia?

Anyone has the potential to experience hernia - men, women, children or the elderly; and there are multiple ways hernia can occur - generally grouped into:

  • Inguinal hernias - lower abdomen and pubic area; more common in men
  • Femoral hernias - lower groin or at the crease of the groin; more common in women
  • Incisional hernias -located at the site of a previous surgery on the abdomen
  • Umbilical hernias - muscle weakness present at birth, at or around the belly button or navel; more common in infants and young children

Hernia can also occur on the upper stomach through a weakness or tear in the diaphragm. Called hiatus hernia, it has symptoms similar to heartburn, including heart palpitations and "balling" of food.

How is hernia treated?

Because hernia is a physical condition, it cannot be cured by medication or go away if left alone. A doctor has to confirm the diagnosis and an operation is needed to repair the site, although hernia operations are very advanced, with minimal invasiveness and fast recovery.

In particular, laparoscopic (keyhole) surgery only needs a small incision to help the surgeon see and repair the hernia. A specialised hernia mesh is then used to patch the wall defect - keeping the tear closed and supporting the muscle throughout healing.

If keyhole surgery is not possible, open surgery is required, and an incision is made to reach the protrusion and coax it back in place.

The hernia defect is then repaired and a mesh is fixed to reinforce the repair. Recovery is usually slightly longer and during this recovery period for both techniques of surgery the patient should not over-exert or do anything to destroy the repair.

Can hernia recur?

Yes, it can, at the original hernia site as well as at any other abdominal areas where the muscle wall is weak. Hernia surgical mesh implants, however, greatly reduce the chances of recurrence, as modern materials have very few side effects and can be safely used to strengthen the area permanently.
DR. TAY KHOON HEAN
Hepatobiliary Surgeon

MBBS, FRCS (Glasg), FRCS (Edin), FICS, FAMS

Tay Khoon Hean Surgery
6 Napier Road #08-02 Gleneagles Medical Centre.

Tel: 6471 1221

Website: www.tkhsurgery.com