Hernia

A hernia is an abnormal protrusion of part of the intestines through a weak part of the abdomen, that is, part of the guts are poking through the abdominal wall. Normally, the front of the abdomen has several layers comprising of skin then fat then muscles and broad ligaments. Underneath all these lie the intestines (guts). If, for any reason, there is a weak point in the muscles or ligaments, part of the intestines push through. You can then feel a soft lump under the skin.

The most common site is in the groin as the groin is often the weakest point of the abdomen. However, hernias can be found sometimes at other sites eg. next to the navel (belly button) or under an old operation scar.

Sometimes they are noticed after a strain, for example, lifting a heavy object. Sometimes they come on for no good reason and a small lump may be noticed, usually in the groin area. Usually, at first, the lump can be pushed back, but may pop out after straining again. Coughing is a common strain that brings them out. They are not usually painful, but many people feel an ache over a hernia. In time they might become bigger as the gap in their muscle or ligament tissue becomes larger. Sometimes in men they track down into the scrotum.

Usually not. However, treatment to fix them is usually advised for 2 reasons:

• They may gradually become bigger and more uncomfortable.
• There is a small chance they might strangulate. A hernia strangulates when too much intestine has come through the gap in the muscle or ligament and then it becomes squeezed. This cuts off the blood supply to the portion of intestine in the hernia. This can lead to severe pain and some damage to the part of the intestines in the hernia. These strangulated hernias are uncommon and are usually dealt with by emergency surgery. However it is preferable to have the hernia fixed by routine rather than emergency surgery.

Hernias can be fixed by a small operation. It is one of the most common operations performed by surgeons. Most people only stay in hospital for a very short period of time (sometimes they are even done as day cases). Newer techniques mean that people tend to be off work for much shorter periods than in the past and even workers in heavy work can often be back in 2 weeks.The operation is usually successful. However, they can recur in a small number of people when a further operation may be advised.

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