Could that pain be a hernia?

Wednesday, July 11, 2018

If, when you think of a hernia, it brings to mind a condition only your father or grandfather needed to be concerned with, you're not alone. There are many misconceptions about hernias, and the failure to seek a proper diagnosis can lead to unnecessary suffering and risk of complications. Hernias actually affect an estimated 2 percent of the adult population and 4 percent of infants, while the estimates for adult, white males can be as high as 20 percent. While there are several types of hernias that can occur in various areas of the body, inguinal hernias are by far the most common.

An inguinal hernia occurs when tissue -- such as part of the intestine -- protrudes through a weak spot in the abdominal wall. While inguinal hernias are not necessarily dangerous, it's best to explore treatment options with your physician. The hernia will not improve on its own, can be quite painful, and can lead to complications when not treated.

Common signs that you might have a hernia include:

• A bulge in the area on either side of your pubic bone

• A burning or aching feeling at the site of the bulge, especially when you bend, cough or lift a heavy object

• Heaviness or "dragging feeling" in your groin area, especially at the end of the day

• In some cases, pain and swelling around the testicles

While some hernias have no apparent cause, others might occur as a result of chronic and/or severe coughing, straining during bowel movements, or strenuous activity. And although inguinal hernias are far more common in men than in women, they can affect people of any age or gender.

Some key risk factors include:

• Being male -- Men are eight times more likely than women to develop inguinal hernia

• Being older -- Abdominal muscles weaken as you get older

• Family history -- Your risk is higher if an immediate family member has had a hernia

• Pregnancy -- Being pregnant can weaken abdominal muscles and increase pressure inside your abdomen

• Chronic cough or constipation -- Both create a pattern of pressure on the abdominal walls

• Premature birth or low birth weight -- Where the abdominal wall may not have had sufficient time to develop in the womb

In some people, abdominal wall weakness occurs at birth when the abdominal lining doesn't close properly for one of various reasons. In others, hernias develop later in life when muscles weaken due to aging, strenuous activity, or as a result of an injury or abdominal surgery.

If you have pain or a noticeable bulge in any area around your groin or pubic bone, make an appointment with your primary care physician. The physician will most likely ask you to stand, and the examination will include feeling for a bulge or reaction when you cough or strain your muscles. In the case of an inguinal hernia, the bulge may disappear when you lie down on the exam table. Imaging studies are typically not necessary, but if the examination isn't conclusive, you may be prescribed an ultrasound or CT scan for a more definitive look at the cause of your discomfort.

Most inguinal hernias are not medical emergencies, but there are exceptions. In the case of an incarcerated hernia or strangulation, there is the potential for life-threatening complications. A hernia does not get better over time, and there are no exercises, medications or physical therapies that can reverse the condition. While some hernias are considered small or mild enough to be left untreated, most cases are best resolved surgically.

Hernia repair surgery is one of the most common general surgeries performed in the U.S., with more than 600,000 procedures performed each year. If you are deemed a candidate for surgical repair, your surgeon will explain the pros and cons of the conventional open method vs. the less invasive laparoscopic hernia repair method, and which approach is more appropriate for your situation. Most hernia operations are performed on an outpatient basis, which means you can expect to return home on the same day the surgery is performed. With laparoscopic surgery, you should expect some soreness the first couple of days after the procedure, but to be back to your normal activities within a week or so.

If you have concerns about any type of abdominal area pain or discomfort, don't suffer needlessly or risk allowing a minor problem to worsen -- make an appointment with your primary care physician. If you are looking for a primary care physician, visit NW-Physicians.com.

Jack D. Alston, M.D., and Patrick Schiefelbein, D.O., are general surgeons at Surgical Associates of Siloam Springs. They perform a variety of surgical services including laparoscopy, biopsy, colonoscopy and more. For more information, visit SAofSS.com or call 479-215-3040.

General News on 07/11/2018