A hernia is when some of your insides bulge outside their normal place. They are common in the tummy or abdomen when they usually cause a visible lump or bulge on the front of your tummy or in the groin region. They are given different names depending upon where they are. The most usual hernia in the groin is called an inguinal hernia. Femoral hernias also affect the groin. Hernias around the belly button are called umbilical or paraumbilical, and hernias in the middle above the belly button are called epigastric. A hernia that comes out through a weakness in the tummy wall where a previous operation was performed is called an incisional hernia.
Hernias can also happen inside the body when organs move from one area to another. These are not visible on the outside. A hiatus hernia occurs when some of the contents of the tummy cavity move up into the chest through an opening in the diaphragm called the hiatus. A hiatus hernia commonly affects the area where the gullet (or oesophagus) joins the stomach. This type of hernia often does not cause any symptoms but it can cause acid reflux.
The main problems that hernias cause are pain or discomfort in the area where the bulge comes out, and some people find the appearance unsightly. Symptoms are usually worse when you are more physically active. Hernias often ache more after a long day on your feet. Exercise that tenses the tummy muscles (such as weight lifting) or straining on the toilet will make a hernia come out more. Some people find that the hernia makes them avoid certain activities because of this.
Occasionally, the insides can push in to a hernia and get stuck. If the hernia contents get stuck and pinched in a hernia, this can block or damage the internal organs. If bowel gets stuck, this can cause a blockage in the bowel, which is an urgent medical problem. This can be life threatening and requires emergency management. If your hernia comes out and becomes painful, tender to touch and firm, you should seek emergency medical attention.
The options to manage a hernia are:
· Wearing a support
Once a hernia has developed, it will not go away on its own. The only way to get rid of a hernia is to have an operation to repair the affected area.
Making your mind up about having an operation is a personal decision. This depends upon the pros and cons of leaving the hernia alone, against having it repaired. If a hernia is small and / or is not causing any symptoms, it may be preferable to monitor it and not have it repaired. If a hernia is causing you bother and affecting your life, you may wish to have an operation to fix it.
A hernia operation carries benefits and risks. The benefits of a hernia repair are to get rid of the symptoms and appearance, and to get rid of the risk of having an emergency problem, such as bowel obstruction. These benefits are balanced against the risks. All surgery carries some general risks, like bleeding, infection, clots on the legs or lungs, the risk of damage to nearby tissues and the risks of having an anaesthetic. Depending upon where you have a hernia, there will be particular risks relating to which tissues are nearby. For example, with hernias in the groin, particular risks include: damage to nerves nearby, leaving you with numbness, tingling or lasting nerve pain; in males, there is also the risk of damage to the blood supply to the testicle or the tube that carries sperm from the testicle. Any hernia can come back (or recur) after surgery. Modern anaesthesia is generally very safe, but there are some risks related to having an anaesthetic. Your surgeon will discuss the risks of surgery particular to you, considering your hernia and your general health.
Another option is to wear a support or truss. These can be bought over-the-counter, or a bespoke support can be bought that has been carefully measured to provide support in the right place. For some people, a support can provide good symptom relief. Supports can be particularly useful if you do not want to have surgery, or there are reasons why the risks of surgery are particularly high.
We provide assessment and treatment for the following types of hernia:
· Groin hernias – inguinal and femoral
· Belly button hernias – umbilical and paraumbilical
· Other abdominal hernias – epigastric, Spigelian
· Hernias from previous abdominal surgery – incisional
We can repair these hernias using key-hole or open surgical techniques.
We also treat hiatus hernias which may be associated with gastro-oesophageal reflux disease.