Hernias

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!