If you're a guy, you probably know the drill by now: The
doctor snaps on a latex glove and tells you to turn your head and
cough. You probably wonder, "Why do I have to do
this?"
Your doctor is checking you for a condition called a
hernia
. There are several types of hernias, and they don't just
happen to guys - everyone from your baby sister to your grandfather
can develop them. But learning to prevent hernias isn't hard to
do.
What Are Hernias?
A
hernia
(pronounced:
hur
-nee-uh) is an opening or weakness in the wall of a muscle, tissue,
or membrane that normally holds an organ in place. If the opening
or weakness is large enough, a portion of the organ may be able to
poke through the hole. Imagine an inner tube poking through a hole
in an old tire - that's what a hernia is like.
Hernias happen more frequently in certain parts of the body,
like the abdomen, groin and upper thigh area, and belly button
area. They also can happen in any place where you may have had an
incision from surgery.
How Do People Get Hernias?
It might take a long time for a hernia to develop or it might
develop suddenly. Hernias are caused by a combination of muscle
weakness and strain, although the cause of the weakness and the
type of strain may vary. Hernias are actually more common in babies
and toddlers. And most teens who are diagnosed with a hernia
actually have had a weakness of the muscles or other abdominal
tissues from birth (called a
congenital defect
). In these cases, straining your muscles doesn't cause the
hernia; it only makes the hernia more apparent (and painful!).
Here are some types of strain on the body that may induce
hernias:
- obesity or sudden weight gain
- lifting heavy objects
- diarrhea or constipation
- persistent coughing or sneezing
- pregnancy
These types of strain on their own probably won't give you a
hernia. But when they team up with a weak muscle, a hernia is more
likely to result.
Many hernias are discovered during routine physical exams. If
you're a guy, you may have had a physical exam where your
doctor gave you a
testicular exam
and checked your testicles for a hernia. By placing a finger at the
top of your scrotum and asking you to cough, the doctor can feel if
you have a hernia.
It's good for girls to know about hernias, too, because they
can affect you, especially if you've been pregnant or are
obese. A doctor can check for any possible hernias in girls by
gently pressing on the organs or looking for possible signs during
an examination.
Types of Hernias
Inguinal Hernias
Inguinal (pronounced:
in
-gwuh-nul) hernias are more likely to occur in guys than girls.
More than 70% of all hernias that occur are inguinal hernias, which
means that a part of the intestines protrudes through an opening in
the lower part of the abdomen, near the groin, called the inguinal
canal. In guys, the inguinal canal is a passageway between the
abdomen and the scrotum through which a cord called the spermatic
cord passes (the testicles hang from the spermatic cord). In girls,
the inguinal canal is the passageway for a ligament that holds the
uterus in place. Nearly all cases of inguinal hernias in teens are
due to a congenital defect of the inguinal canal. Instead of
closing tightly, the canal leaves a space for the intestines
to slide into.
If you have an inguinal hernia, you might be able to see a bulge
where your thigh and your groin meet. In guys, the protruding piece
of intestine may enter the scrotum, which can cause swelling and
pain. Other symptoms of an inguinal hernia might include pain when
you cough, lift something heavy, or bend over. These types of
hernias require surgery to repair; in fact, inguinal hernia
operations are the most common type of surgery performed on kids
and teens.
Umbilical Hernias
Umbilical hernias are common in newborns and infants younger
than 6 months. They occur when part of the intestines bulge through
the abdominal wall next to the belly button. In babies with
umbilical hernias, parents may see bulging around the belly button
area when the baby cries. Unlike other types of hernias, umbilical
hernias may heal on their own, usually by the time a baby is 1 year
old. If not, surgery can repair the hernia.
Epigastric Hernias
In an epigastric (pronounced: eh-pih-
gas
-trik) hernia, which is also called a ventral hernia, part of the
intestines protrude through the abdominal muscles located between
the belly button and the chest. It's mostly guys who have to
worry about this type of hernia - about 75% of epigastric hernias
occur in males. People with this type of hernia may notice a lump.
Surgery is a common way to fix this problem.
Incisional Hernias
If you've had surgery in your abdominal area, you might
experience this type of hernia. In incisional hernias, part of the
intestines bulge through the abdomen around a surgical incision. In
this case, surgery actually weakened the muscle tissue in the
abdomen. This type of hernia requires another surgery to repair
it.
Hiatal Hernias
This type of hernia occurs at the opening of the diaphragm where
the esophagus (the pipe that food travels down) joins the stomach.
If the muscle around the opening to the diaphragm becomes weak, the
uppermost part of a person's stomach can bulge through the
diaphragm. Hiatal (pronounced: high-
a
-tul) hernias are common, although small ones don't usually
cause any symptoms. Unlike the other types of hernia, you won't
be able to see a bulge on the outside of your body, but you might
feel heartburn, indigestion, and chest pain. Hiatal hernias can be
treated with medication and diet changes, but they do sometimes
require surgery.
What Do Doctors Do?
If you notice a bulge or swelling in your groin, abdomen,
scrotum, or thigh, you should talk to your doctor. Sometimes a
hernia may also cause sharp or dull pain and the pain may worsen
when you are standing.
With most types of hernias, including inguinal, umbilical,
epigastric, and incisional, your doctor will be able to see and
feel the bulge and diagnose you with a hernia.
Except for umbilical hernias in babies, hernias don't just
go away on their own - you must talk to your doctor and receive
treatment. Over time, your hernia may become larger and more
painful, and in some cases of hiatal hernia, a piece of the
intestine could become trapped (this is known as
incarceration
). In a true surgical emergency, the blood supply could be cut off
to the incarcerated intestine (this is known as
strangulation
). This situation is painful and dangerous because it can cause
infection and may cause the strangulated tissue to die, so it's
important to call your doctor.
If you've had a hernia operation and you notice redness or
discomfort around your incision (the area where the cut was made to
perform the operation), be sure to let your doctor know. It could
be a sign of infection that will require further treatment.
Can Hernias Be Prevented?
Here are a few tips for keeping hernias from hurting you:
-
Stay at a healthy weight for your height and body
type.
Talk to your doctor or a dietitian about a healthy eating and
exercise program if you think you are overweight or obese.
-
Make fruits, veggies, and whole grains a
"regular" part of your diet.
Not only are these foods good for you, they're also packed
with lots of fiber that will prevent constipation and
straining.
-
Be careful when weight lifting or lifting heavy
objects.
Make sure you
lift weights safely
by never lifting anything that's too heavy. If you have to
lift something that's heavy, bend from your knees, not at
your waist, or don't lift it at all.
-
See your doctor when you're sick.
If you have a persistent cough from a cold or you sneeze a lot
because of
allergies
, see your doctor about cough or allergy medicines.
-
Quit smoking.
Smoking
can cause persistent coughing, and this can strain your abdominal
muscles. The risk of getting hernias is just one more reason to
kick the habit!
Reviewed by:
T. Ernesto Figueroa, MD
Date reviewed: September 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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