The organs in your body are surrounded by tissue that holds them firmly in place. However, this supportive tissue can sometimes weaken, allowing an organ to push through it. This condition is known as a hernia. The organ can push through either toward the outside of your body, creating a visible bulge under your skin, or toward another layer of muscle, in which case it won’t cause any visible symptoms.
Millions of Americans suffer from hernias, but less than 20% of those cases are diagnosed. While most hernias aren’t life-threatening, they can cause severe pain if undetected or ignored. In some cases, the flow of blood to the part of the organ affected by a hernia can be cut off, which could result in a fatal outcome. It is thus important to learn how to know if you have a hernia and when to seek treatment.
What Causes Hernias?
Hernias are a direct result of physical strain and muscle weakness. These two usually go hand-in-hand and can be caused by a variety of factors. Muscle weakness is most often age-related or caused by a congenital defect that leaves a small opening in the abdominal wall. It can also occur due to a chronic cough, as well as damage to the muscle caused by surgery or injury.
With your muscles weakened, many factors can put a physical strain on your body. These include:
- Persistent coughing
- Sudden weight gain
- Lifting heavy objects
- Abdominal fluid
Because it puts an unusual amount of pressure on your abdomen, pregnancy can strain your body and cause a hernia as a result. Chronic constipation can also cause a hernia, seeing as bowel movements put a lot of strain on your body. Surgical scars following a C-section may also contribute to a hernia.
Although anyone can develop a hernia, people who have a personal or family history of the problem may be more likely to suffer from it. Smoking is a major risk factor, seeing as it can cause a chronic cough. For the same reason, conditions like asthma, cystic fibrosis, and acid reflux can also be contributing factors.
What Types of Hernias Exist?
All hernias can be classified into two groups – external and internal. As the names suggest, an external hernia creates a noticeable bump on the outside of your body, whereas an internal hernia doesn’t cause any visible symptoms and can thus be very difficult to diagnose.
External Hernias
External hernias occur when a portion of tissue or intestine pushes through the abdominal wall. Based on the area of your body they affect, there are four types of external hernias:
- Inguinal hernias affect the top of the inner thigh (groin area).
- Femoral hernias are very rare and other parts of the groin area.
- Umbilical hernias affect the navel area around the belly button.
- Incisional hernias affect areas around incision sites for abdominal surgeries.
Internal Hernias
An internal hernia usually manifests itself as a hiatal hernia. It occurs when tissue pushes through the diaphragm, a thin layer of muscle that serves as a border between your chest and your abdomen. Not only does it allow for easier breathing but it also prevents stomach acid from shooting up to the esophagus. As the tissue pushes through the diaphragm, it can reach your chest cavity and obstruct your breathing. It also allows stomach acid to enter your chest cavity, thus causing acid reflux.
Whereas external hernias can affect people of all ages, internal hernias most often occur in people over the age of 50 and children born with an unusually wide esophageal hiatus, a hole in the diaphragm that the esophagus passes through.
How to Know If You Have a Hernia
An unusual bulge or lump in the groin or the abdomen is usually a tell-tale sign of an external hernia. Similarly, a hernia can also manifest itself as a bulge that grows over time but disappears when you lie down or push it back with your finger. This is particularly common in women and is one of the reasons, in addition to outdated ultrasound equipment, why women only account for 8% of all hernia diagnoses.
Men usually experience a bulge in the groin or scrotum area, which is usually accompanied by swelling, burning, and severe pain. Other common symptoms of an external hernia include chronic pain when you try to lift heavy objects, bend over, or cough, as well as weakness or heaviness in the abdominal area.
While it doesn’t typically cause any visible symptoms, an internal hernia will often contribute to the onset of gastroesophageal reflux disease or GERD for short. As such, any of the following symptoms of GERD may be a sign that you have an undiagnosed hiatal hernia:
- Bloating, pain, and discomfort in the stomach
- A burning sensation in your chest
- Sour taste in your mouth and throat
- Frequent burping
In addition, a hiatal hernia can sometimes cause severe chest pain. As you probably know, chest pain can be a sign of a number of health problems, ranging from anxiety and panic attacks to potentially life-threatening heart and lung problems. Whatever the case, it is not a symptom you should ignore, which is why you should reach out to your doctor the moment you start experiencing chest pain.
How Are Hernias Treated?
When you tell your doctor that you suspect you might have an external hernia, they will examine your groin and abdomen for any visible bulges that pop up when you stand up, cough, or strain your body.
If the standard physical test isn’t enough, or if you have an internal hernia, your doctor will recommend further tests. Depending on the reported symptoms, they could recommend a standard ultrasound, a barium X-ray to capture pictures of your digestive tract, or endoscopy. The latter involves the use of a tiny camera that goes down your throat into the stomach and esophagus, thus allowing the doctor to easily detect a hiatal hernia. In case of severe pain, your doctor may also recommend an MRI scan.
Depending on the size of the hernia and the seriousness of the symptoms, your doctor will decide if you need treatment or if it’s enough to just observe the hernia for possible complications. The standard treatment for all types of hernia is surgery, during which doctors will sew the hole in your abdomen shut using surgical mesh, thus strengthening the abdominal wall and preventing further incidences of hernia.
If you have a hiatal hernia accompanied by GERD, a combination of dietary changes and physical activity may be enough to keep your symptoms under control. In addition, antacids, proton pump inhibitors, and other over-the-counter or prescription stomach acid medications could also help relieve your symptoms.
A Hernia Won’t Go Away on Its Own
Anyone can develop a hernia, regardless of their age, gender, or health status. If you notice the symptoms of a hernia – either internal or external – you shouldn’t ignore them. A hernia never goes away on its own and can cause a lot of complications – some of them life-threatening.
As such, it is important to visit your doctor at the first sign of the problem. They will look at your symptoms and run all the necessary tests to determine the best treatment. In addition, they may recommend a combination of lifestyle changes and medication to keep your hernia under control.
References:
https://www.bcm.edu/healthcare/objects/pdfs/BC_Healthletter_Hernia3.pdf
https://medlineplus.gov/hiatalhernia.html
https://www.ncbi.nlm.nih.gov/pubmed/19826867
https://www.nytimes.com/2011/05/17/health/17brody.html
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