Hernia

A hernia develops when an organ or tissue pushes through a weakness in supporting muscles, encroaching on other organs or body structures. There are dozens of different hernias, but those involving the small intestine are the most common. These include:

• Abdominal, in which a portion of small intestine pushes through the abdominal muscle wall.
• Femoral and inguinal, in which the small intestine protrudes into the musculature of the groin, the scrotum in men, or the vagina or other parts of the genitalia in women.
• Rectal, in which the small intestine protrudes into the wall of the rectum.

Other common hernia types include:

• Diaphragmatic, in which the stomach or some other abdominal organ pushes through the diaphragm into the chest.
• Incisional, which develops at the site of an old surgical wound. Umbilical, a swelling near or within the navel, usually in a baby.

Not all hernias are obvious, but those protruding through the abdominal wall usually produce a visible swelling. Mild pain at the site of swelling is common. Men with inguinal hernias may also have swelling in the scrotum.
Most hernias are not serious. But one can be life threatening if a protruding portion of intestine becomes trapped or strangulated and the blood supply is cut off, thus leading to tissue death.

Hernias are more prevalent in premature infants, the elderly, the obese, and people with chronic coughs. A person with bulimia may develop a hernia from repeated vomiting.

Diagnostic Studies and Procedures

A hernia can usually be detected by physical examination. A doctor will press it to determine whether it can be manipulated back to its normal position. X-rays and an ultrasound examination may be ordered to rule out other causes of swelling.

Medical Treatments

Even if a hernia is not producing significant symptoms, doctors generally recommend surgical repair to avoid its enlargement and serious complications. The exception is an umbilical hernia, which almost always disappears on its own by the age of four. Hernia surgery involves removing the hernia's sac and repairing and strengthening the weakened muscle wall. In certain cases, the muscle will be knit together with permanent non-absorbable stitches. Some hernia surgeries can be performed on an outpatient basis. Sometimes, however, a short hospital stay is necessary.

Alternative Therapies

Alternative therapies are of little value in treating hernias involving the small intestine. If obesity is a factor, a weight-loss diet combined with an exercise program may have a preventive effect.

Physical Therapy. Once recovery from surgery is complete, a physical therapist or sports medicine specialist can design an exercise routine to strengthen abdominal muscles, which will help prevent recurrence. These practitioners also teach posture and lifting techniques to avoid straining the abdominal and back muscles.

Self-Treatment

Do not wear a hernia truss unless instructed to do so by a doctor. If your hernia protrudes while you await surgery, gently push it back into place. This is best done when lying down. Avoid heavy lifting, straining, and sudden movements. Try to suppress sneezing and coughing; if that is impossible, tightly hug a firm pillow or a rolled-up piece of clothing to your abdomen until the coughing or sneezing spell passes.

Other Causes of Hernia Symptoms

Severe abdominal pain and swelling may be due to an intestinal obstruction. Abdominal pain and swelling in a woman could be caused by an ovarian cyst. Both conditions are potential medical emergencies.