Turn Your Head and Cough: The First Step in a Hernia Diagnosis
By Craig Zaretsky, MD, Virtua General Surgeon
For most of us, all we know about hernias is the slightly embarrassing moment in our doctor’s office when we're required to turn our heads and cough. But in fact, hernia repair is quickly becoming the most common surgical procedure in the United States, with 700,000 performed every year.
The following will help you understand what causes hernia and how you can help prevent and treat it.
What is a hernia?
Normally, the abdominal muscles form a thick wall that contain and protect the intestines and other internal organs. A hernia occurs when a weak spot forms in the wall and internal (usually intestinal) tissue starts to protrude through the wall. There are four major types of hernia based on where they occur:
- Inguinal: inner groin (most common)
- Femoral: outer groin
- Umbilical: belly button
- Hiatal: upper stomach
A hernia generally appears as a noticeable bulge under the skin. It may not be painful at first, and is usually more noticeable when you cough or strain. While hernias can occur in both men and women, they are generally more common in men.
What causes a hernia?
Hernias are caused by activities that put stress on the abdominal wall. These can include:
- Obesity: The abdominal wall is subjected to additional stress from the strain of carrying extra abdominal fat.
- Smoking: A persistent smoker’s cough can cause damage to the abdominal wall over time.
- Physical activity: Those in physically demanding professions where heavy lifting is required may be susceptible due to repetitive strain on the abdominal muscles.
- Incisional: If you’ve had your abdominal muscles cut due to surgery, a hernia can develop if the abdominal wall doesn’t heal properly over time.
For some, hernias are a hereditary condition that can occur naturally, due to genetic and individual factors. That means that even those who live a healthy lifestyle can develop them over time. That said, avoiding the risk factors only help prevent hernias from developing.
How is a hernia treated?
While ice and rest can help reduce the swelling in the area of a hernia, it will not heal on its own. Instead, a hernia will only get worse over time, especially if the hernia undergoes continued stress. If you believe that you have a hernia, your best course of action is surgery. Usually a primary care doctor or gynecologist can confirm this with a simple physical examination, and refer you for surgical treatment.
How involved is hernia surgery?
Actually, most people are hesitant to have hernia surgery because they think it’s more involved than it really is. In fact, most hernia surgeries are minimally invasive and performed on an outpatient basis. The most common method for hernia repair is laparoscopic surgery. The surgeon makes 3 small (1 – 2 cm) incisions in the area of the hernia, pulls back the protruding tissue and repairs the abdominal wall with surgical mesh. Robotic surgery is another option for hernia repair. The surgeon uses robotic technology with high definition, 3-D imaging and wristed robotic arms to more precisely repair the affected area. After laparoscopic or robotic hernia surgery, most patients go home the same day, and within 2 to 4 weeks they’re back to their regular routine without restrictions.
Updated December 19, 2017