Hernias are a common medical condition that impact millions of people per year – and some patients even battle recurring hernia problems. Not all hernias are created equally, though. Certain small hernias may go undetected, and some will never need treatment. But, for those hernias causing discomfort or potential complications – getting treatment from a team of experts is important.
In simple terms, a hernia is a hole in the muscle that occurs when either fatty tissue or an organ squeezes through weakened muscle or tissue. The muscle weakness can occur over time or more rarely, it’s present at birth.
Activities that put pressure on the abdomen can cause a hernia – such as lifting heavy objects without proper stabilization, diarrhea or constipation or persistent sneezing or coughing.
Other health problems that can contribute to weakening muscles include smoking, obesity or poor nutrition – all of which can increase the likelihood of getting a hernia.
In adults, hernias don’t just go away – they either stay the same size or they get larger, which is why it’s important to have them regularly monitored by a surgeon.
Types of Hernias
Hernias can occur in numerous areas of the body – from the thigh to the groin to the abdomen/belly button area. All hernias can cause increased pain when coughing, bending, straining or lifting. The most common types of hernias include:
An Inguinal hernia occurs when part of the intestine or fat bulges through the wall of the lower stomach or into the inguinal canal (in the groin area). Symptoms include a bulge on either side of the pubic bone, weakness, pain or pressure near the groin.
Umbilical hernias occur when fat or intestine passes through the abdominal wall at the base of the belly button. Signs include a protruding bulge at the belly button. In children, they’re typically painless and often go away on their own. In adults, they require surgery to repair.
Incisional hernias are common in those who have had previous abdominal surgery. In most cases, the most obvious sign is a bulge near any surgical scar.
Femoral hernias are more common in women (in particular, those who are pregnant or obese) and occur when fatty tissue or part of the intestine enters the area near the femoral artery. Signs include a lump near the inner thigh or groin that may be uncomfortable.
Hiatal hernias occur when part of the stomach or other upper abdominal organ squeezes through the hiatus, which is the natural opening in the diaphragm. Small hiatal hernias often go undetected, although larger ones can cause heartburn, acid reflux, difficulty swallowing, shortness of breath or chest/abdominal pain.
Treatment for hernias range widely based on the location, size and symptoms. In some asymptomatic cases, it’s possible to just watch a hernia and leave it untreated. In cases with symptoms, the threat of complications such as intestinal obstruction that come with hernias may mean surgery is recommended. Fortunately, many hernias can be repaired with minimally-invasive techniques.
When it comes to recovery and the prevention of future hernia reoccurrence, medicine has come a long way in recent years. Adjunct therapies such as abdominal wall rehabilitation can not only help patients recover more quickly, it can also help prevent future occurrences of hernia. By incorporating these newer therapies and enhanced surgical protocols, WakeMed is establishing a Comprehensive Hernia Center designed to help patients get the treatment they need and recover as quickly as possible.
Historically, hernia treatments were really thought of in terms of surgical interventions alone. What we’ve learned from literature and research is that a multidisciplinary approach to treating hernias is the most effective way to get patients treated and back to their lives as quickly and safely as possible. This may mean a combination of physical therapy before and after surgery, in addition to new protocols put in place just before and after surgery that have been proven to improve outcomes and reduce recovery time. We’re very excited about this new program and how we can enhance the way we care for patients suffering from a wide range of hernia problems.
Our new Comprehensive Hernia Center will include a team of general surgeons, physical therapists, and care team members all dedicated to getting hernia patients the highest level of care available. While the new program won’t officially “go-live” until 2021, our surgeons are already incorporating many of these elements to help patients today.
About WakeMed General Surgery
About Ian Villanueva, MD, FACS, FASMBS
Dr. Villanueva is a board-certified general surgeon whose clinical interests include advanced laparoscopic and DaVinci surgical robot-assisted techniques in all areas of gastrointestinal surgery, bariatric weight loss surgery, and minimally invasive hernia surgery.
Dr. Villanueva specializes in minimally invasive surgery as it is potentially less painful and often allows for a faster recovery than traditional surgical techniques.