Hernia A Big Threat to Life if Ignored
Hernia Treatment Without Surgery?
Hernia is a very common disease and can be a big threat to life if not treated in time. It appears like swelling or bulge and can be life-threatening too if left untreated. In addition, I will brief here about Hernia Symptoms Causes and Treatment Options. Also, if there is an option available for hernia treatment without surgery.
What is Hernia
The definition of Hernia is a defect or weakness of muscles that can lead to an abnormal protrusion of abdominal organs through it. Therefore, these weak muscles create a passage for the abdominal content to protrude out through the abnormal opening. In conclusion. intestine, omentum, and abdominal muscles are involved in a hernia.
Types of Hernia
It can be categorized into different types as per the site of hernia and its presentation. Mostly, hernias are developed on the ventral surface of the abdominal wall. The high-level classification of hernia can be done as:
- Based on Presentation
- Based on the Site of the hernia
Types of Hernias Based on Presentation
1. Reducible Hernia
Firstly, the Hernia which is reduced on standing or by pushing back into the abdomen to the normal position is called a reducible Hernia. If it’s left unnoticed by patients, can be converted into an irreducible hernia.
2. Irreducible Hernia
Secondly, when the swelling or bulge is not reduced even after trying to push back is called an Irreducible Hernia. In addition, it can be divided further into 2 categories.
A. Non-Obstructed Hernia
The content of Hernia cannot be pushed back into the normal position. The ring of Hernia (muscular Opening surrounded to hernia) is relaxed and as a result, allows content to move in and out. However, it doesn’t hamper the blood supply to the distant organ or hernial sac at this stage. But, there can be mild to moderate pain or discomfort in such Hernias.
B. Obstructed Hernia or Strangulated Hernia
The ring of Hernia obstructed or strangulated hernia is too tight. Resulting, it obstructs the blood supply to the hernial sac and the content of the Hernia. The reason for hampering blood supply can be strangulation of the hernial content, that’s why it’s called strangulated hernia also. This type of hernia is called Irreducible obstructed Hernia.
In other words, obstructed irreducible Hernia is a medical emergency and a life-threatening condition. This is the sign to rush to the emergency to avoid the rupture of the hernial sac.
Types of Hernia based on site
The classification of Hernias based on site is the most commonly used term. Following are the types of Hernia based on their site.
- Inguinal Hernia
- Umbilical Hernia
- Incisional Hernia
- Femoral Hernia
- Epigastric Hernia
- Hiatus Hernia
Symptoms of Inguinal Hernia
Firstly, the abdominal content, such as intestine, omentum, and peritoneum herniates into the inguinal canal. Secondly, the inguinal canal fills with abdominal content which is called an inguinal hernia. The inguinal canal is a short passage that is extended from the lower part of the abdomen towards the base of the penis and scrotum on both sides.
The inguinal hernia can be reducible or irreducible, based on its presentation. This hernia is the most common type of hernia. Male are more prone to inguinal hernias.
The patient starts feeling a bulge or swelling in the inguinal region which increases with coughing, standing, weight lifting, or straining. This swelling can be with or without pain. Most importantly, if it’s painful and obstructed then this is a medical emergency and should be reported to your doctor immediately.
Symptoms of Umbilical Hernia
An umbilical hernia is very common in infants and young children. Obesity can also be another cause of Inguinal Hernia. Consequently, the abdominal content protrudes out from the abdomen to the inguinal sac. The cause of umbilical hernia is weaker abdominal muscles around the umbilicus or belly button.
The patient feels and observes swelling in the umbilical region. If the abdominal content goes back by pushing it into the abdomen, it is called a reducible umbilical hernia. If the abdominal content doesn’t go back, it is called an Irreducible umbilical hernia.
The swelling or bulge can increase with coughing, sneezing, standing, weight lifting, or straining.
If the umbilical hernia is associated with pain then it’s a medical emergency and should not be left untreated otherwise it also can be a life-threatening condition.
Symptoms of Incisional Hernia
If abdominal contents are protruded out through an incisional line is called an incisional hernia. The incision line is a scar mark that was developed post-surgery. Muscles around the incision line become weak post-surgery. Abdominal content is pushed out of the pressure within the abdomen increases due to any reason.
The abdominal content is pushed through the incisional line into the hernial sac. It’s is called Incisional Hernia. The most common site of incisional hernia is in the abdomen. It’s also called a ventral hernia. Females are more prone to incisional hernias. The most common site of incisional hernia is the cesarean section incision line in females.
Symptoms of Femoral Hernia
A femoral hernia is not a very common type of hernia. The patient has swelling or bulge just above the thigh towards the inguinal canal is called a femoral hernia. This hernia is left unobserved and can be a risk to life if not treated in time. The symptoms of a femoral hernia are the same as an inguinal hernia.
The patient feels and observes swelling in the umbilical region. This can be a Reducible or Irreducible hernia and if obstructed then can lead to complications.
The hernia swelling or bulge can increase with coughing, sneezing, standing, weight lifting, or straining.
Symptoms of Epigastric Hernia
The site of the epigastric hernia is the upper abdomen or epigastric region just below the sternum and above the belly button. The causes of epigastric hernia are the same as other hernias. The patient feels a bulge or swelling in the epigastric region, however, it’s not a very common type of hernia.
The common symptoms are bulge, swelling, pain in the epigastric region which can increase with coughing and sneezing. If an epigastric hernia is left untreated can lead to complications.
Symptoms of Hiatus Hernia
The hiatus hernia is not visible from the outside. The site of hiatus hernia is the stomach and the part of the stomach moves up into the chest. The patient starts complaining about more gas formation, heartburn, esophageal regurgitation, mild pain in the epigastric region, and discomfort. This is diagnosed with the help of endoscopy.
The epigastric hernia is left undiagnosed in most cases. It’s found as an incidental finding in most cases when a gastroenterologist performs endoscopy. If the size of the hernia is small it doesn’t trouble you. The symptoms only come when the size of the hiatus hernia is big. If the size of the hernia is big then medical attention is needed.
Causes of Hernia
The cause of hernia depends on its type and size of hernia but the symptoms are almost the same in most types.
- Congenital causes – If the development of abdominal wall and muscles is defective which leads to weak abdominal muscles.
- Chronic Constipation – Straining cause pressure on the abdomen and can lead to a hernia
- Strenuous exercises and Heavy weight lifting – When we pull more weight it causes a reassure on the abdomen which can cause a hernia
- Chronic cough/Sneezing – Chronic cough and sneezing causes pressure within the abdomen which can also cause a hernia
- Chronic Diseases – Chronic diseases like tuberculosis or other diseases that cause muscle weakness
- Aging – With the growing age the muscles become weaker that’s why hernias are also developed in older age
- Overweight or Obesity – Obese people have less strength in the muscles which causes hernia
- Multiple pregnancies – Multiple pregnancies also causes abdominal weakness, and LSCS (Lower segment cesarean section)
- Abdominal Surgeries
- Damage from an injury
- Chronic smokers
- Premature or underweight babies
Diagnosis of Hernia
The diagnosis of hernia is based on the physical and clinical examination of the patient. A doctor can diagnose you accurately based on your clinical history and physical examination. In addition, a confirmatory diagnosis of hernia can be made through some radiological investigations.
- CT Abdomen
- MRI Abdomen
Treatment options of hernia
Do we have any option for hernia treatment without surgery? This question is very tricky. The answer to this question can be YES and NO both.
The type of treatment depends on the type and the site of the hernia. There can be an option to treat a hernia without surgical intervention but this is not true for all. In conclusion, the following can be the options for hernia treatment without surgery at home.
How to choose a treatment option
The hernia is a defect that can be corrected with some intervention only. For example, if water is leaking out from your roof. What you will do? I am very sure your next question will be the quantity and the cause of leakage.
So if leakage is very minimal. It can be fixed without any repair by applying some adhesive/ant-leakage fix like Dr. Fixit. But if the defect is big then you will have to go for the repair of the defect. This repair can be a brick replacement too. Similarly, the treatment option can be surgical or hernia treatment without surgery.
Hernia treatment without surgery
Small Umbilical and inguinal hernias can be treated without surgery by pushing back the content into the abdominal cavity. We put continuous pressure on the abdomen wall from outside to avoid the recurrence of the hernia. This type of treatment falls under the hernia treatment home category or hernia umbilical treatment or hernia treatment nonsurgical because all this can be done at home easily.
Therefore, an abdominal belt or inguinal supporter helps to prevent such small hernias. This is very effective in children. A coin-shaped leather piece is placed on an umbilical hernia. An abdominal belt is placed around it for 3-4 months.
As a result, you will see a tremendous result after 3 months. A hernia will disappear because muscles were in a growing phase. Moreover, children can strengthen their muscles when they give support. Strong muscles help in repairing hernias.
The same techniques help in young adults for small non-obstructed hernias. Small Umbilical, incisional and inguinal hernias can be treated without surgery. But, there can be differences in success rates comparing to children. Good results have been observed by this technique in adults too. You need to be vigilant during the non-surgical treatment of hernia.
If any symptoms of obstruction or strangulation, urgent medical attention for surgical management is advisable.
The surgery or correction of the defect is the best option to treat a hernia. It takes lesser time to correct the defect and the chances of complications are also very less. The repair of hernia or surgery is named Hernioplasty or Herniorrhaphy.
The repair of hernia with the help of Mesh is called hernioplasty. All the abdominal content is repositioned into the normal position in the abdomen. A mesh is placed over it and stitched with the muscles.
Mesh can be either dissolvable and non-dissolvable type. The cost of surgery can vary as per the type of mesh. Dissolvable or absorbable mesh is recommended because of its dissolving nature into muscles. Once the mesh is absorbed, no discomfort or chances of bleeding after that.
Hernioplasty is preferred where muscles are too weak and support is needed to avoid recurrence of hernia e.g. in old age people.
The Herniorrhaphy is advised when muscles are strong enough. Muscles are stitched up after placing back the content into the abdominal cavity, without a mesh. Herniorrhaphy is preferred in children and young adults because muscles are strong enough to regrow without mesh in children.
Which one is the best: Open Hernia Surgery or Laparoscopic Hernia Surgery?
There is always a big question in the patient’s mind about if any option for hernia treatment without surgery is available. Whether open hernia surgery is good or laparoscopic hernia surgery is better?
Hernia surgery can be done in two ways either hernioplasty or herniorrhaphy and you will understand the pros and cons of both.
Open Surgery Versus Laparoscopic Hernia Surgery
Open Hernia surgery
Open surgery is outdated now and only recommended if laparoscopic surgery is not feasible to perform. The incision size is very big in open surgery and it requires 5-7 days of hospitalization even blood loss is also more in open hernia surgery.
Laparoscopic Hernia Surgery
Laparoscopic hernia surgery is an advanced technique and always preferable to opt for. The hospitalization days are very few, patients can go home within 24 hours of surgery. Blood loss is very minimal and the risk of post-surgery complications is also very less.
Hope you like the article, if you have any question or query please write to me or leave a comment in the comment box. I will try my best to address your query with the best possible answer.
Thanks for Reading
Dr. Musharraf Husain