What is a Hernia?

A hernia occurs when an organ or fatty tissue squeezes through a hole or a weak spot in a surrounding muscle or connective tissue called fascia. The most common types are inguinal (inner groin), incisional (resulting from an incision), femoral (outer groin), umbilical (belly button), and hiatal (upper stomach).

Ultimately, all hernias are caused by a combination of pressure and an opening or weakness of muscle or fascia: The pressure pushes an organ or tissue through the opening or weak spot. Sometimes the muscle weakness is present at birth; more often, it occurs later in life. Poor nutrition, smoking, and overexertion all can weaken muscles and make hernias more likely. Anything that causes an increase in pressure in the abdomen can then cause a hernia, including obesity, lifting heavy objects, diarrhea or constipation, or persistent coughing or sneezing.

If a hernia can be pushed back (reduced), surgery can be done at the person’s convenience. If it cannot be pushed back, surgery should be done sooner, because there is a danger that the hernia sac can become strangulated and have it’s blood supply cut off.  This can result in tissue death, release of the contents of the intestines (stool), widespread abdominal infection, and even death.

During surgery, the hernia sac is removed and occasionally a couple of stitches are used to close the opening of the defect in the muscular and/or connective tissue layer. Most hernia repairs are done as outpatient surgery. Hernia repair is the second most common surgery performed in the world (Cesarean section ranks first.)  Anesthesia can be local, spinal, or general.

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