How To Prevent Inguinal Hernia?

As always, prevention is better than cure. Are there any ways to prevent herniae from developing? Well, the answer is not yes with all herniae but with inguinal hernia you can to a certain extent by keeping in mind certain guidelines. In this post let’s see all about inguinal hernia and ways to prevent developing an inguinal hernia or prevent an inguinal hernia recurring. Before going into details about inguinal hernia, a quick question! What is a hernia? A hernia is the protrusion of a part or an organ or other bodily structure through the tissues normally containing it. There are about hundred types of herniae that may occur in different parts of the body and it may take a series to discuss all those. Let’s just confine our discussion to just inguinal hernia and the doubts enveloping it so that we are knowledgeable about it.

What is an inguinal hernia?

An inguinal hernia is an abnormal bulge, or protrusion, that occurs

in the groin area (the area between the abdomen and the thigh), when an organ such as intestine, protrudes through the abdominal wall into the inguinal canal. The inguinal canal carries the spermatic cord in men and a round ligament that is attached to the uterus in women. It can be felt in the groin area and is also known as groin hernia. It can occur on one or both sides of the groin and can occur in males or females, but mostly in males.

How many types of herniae are there?

There are two types of inguinal herniae:

Indirect inguinal hernia: This occurs when the internal opening of the inguinal canal, which usually closes around the time of birth, remains open. This allows a portion of the intestine to slip through the inguinal canal. These herniae often are diagnosed within the first year of life, but may not show up until adulthood.

Direct inguinal hernia: This occurs when a portion of the intestine protrudes through a weakness in the abdominal muscles along the wall of the inguinal canal. These are common in adults, but rare in children.

In adults, direct and indirect inguinal herniae look and feel about the same. A physician may not know which type of hernia a patient has until surgery is performed. However, both types of herniae are treated in a similar manner.

What is the difference between umbilical, inguinal and femoral herniae?

A hernia that occurs in the belly-button area is called an umbilical hernia.

A hernia that occurs in the groin area is called an inguinal hernia. In a femoral hernia (may be mistaken for inguinal hernia), a portion of the intestine protrudes through the passage that is normally used by large blood vessels (the femoral artery and vein) when they pass between the abdomen and the leg, into the upper thigh, just below the groin crease. It may cause a lump just below the groin extending into the upper portion of the thigh. Femoral herniae are most common in older, overweight women than in men. The cause of a femoral hernia is often difficult to determine.

What is the cause of developing inguinal hernia?

Inguinal hernia is caused by a weakness in the abdominal wall. In some people, this weakness is congenital. In others, it develops over time as a result of excessive weight gain or loss, physical activity that places pressure on the abdomen, pregnancy, straining during bowel movements because of constipation, straining during urination because of an enlarged prostate, or chronic and intense coughing. Because the abdominal wall is weak, the hernia occurs during abdominal strain.

Who gets inguinal hernia?

Inguinal hernia is more likely to occur in males than females. People who are obese, have lost a great deal of weight, or have had abdominal surgery are at higher risk for herniae. The risk also increases with age. People with a family history of inguinal herniae are more likely to also have them. The other risk factors include:

• Being moderately to severely overweight
• Pregnancy
• Lifting heavy objects
• Persistent coughing, such as smoker’s cough
• Sneezing a lot, which may be common in a person with allergies
• Straining during bowel movement, which may be caused by constipation or diarrhea
• For men, trying to urinate when there is a blockage caused by an enlarged prostate

What are the symptoms of inguinal hernia?

At first, an inguinal hernia either may not cause any symptoms or may cause only a feeling of heaviness or pressure in the groin. Some people may notice a slight bulge or protrusion in the groin area that can be pushed back in. This is called a reducible hernia. Symptoms are most likely to appear after standing for long periods or when engaged in activities that increase pressure inside the abdomen, such as heavy lifting, persistent coughing or straining while urinating or moving the bowels. As the hernia grows, it eventually causes an abnormal bulge under the skin near the groin. Other inguinal hernia symptoms include constipation and blood in the stool, a bulge in scrotum for males, a bulge in the large fold of skin (labia) surrounding the vagina for females, heaviness, swelling, and a tugging or burning sensation in the area of the hernia. The bulge may appear gradually over a period of several weeks or months, or it may form suddenly after lifting heavy weights, coughing, bending, straining, or laughing.

When a hernia cannot be pushed back into place, it means a piece of the intestine has become trapped, or incarcerated, in the inguinal canal. When a portion of the intestine is incarcerated, its blood supply can be cut off, which means the intestinal tissue will die. This condition is called a strangulated hernia and warrants immediate medical attention and treatment.

How is inguinal hernia diagnosed?

Usually, the hernia can be felt by placing the hand directly over it and then bear down. A physician’s physical examination is often enough to diagnose a hernia. Sometimes hernia swelling is visible when the patient stands upright. The doctor will look for a bulge in the groin area and may ask the patient to cough as he puts light pressure on the area. Coughing causes the hernia to bulge out further. Ultrasound may be used to see certain types of herniae, and abdominal x-rays may be ordered to identify a bowel obstruction.

Treatment and prognosis of inguinal hernia:

If the hernia bulge can be pushed back in and the symptoms are tolerable, the patient may not need surgery. Physician may suggest wearing a special belt, called a truss, to support the area to prevent it from bulging, and avoid heavy lifting. Patients should also avoid any activities that cause abdominal strain. If the inguinal hernia symptoms are painful, the treatment is elective surgery. It is preferable to elect surgery to repair inguinal herniae to avoid the possibility of a strangulated hernia. The procedure to repair a hernia involves pushing the piece of intestine back into place and repairing the abdominal wall so that the intestine cannot push through again. Hernia surgery, called herniorrhaphy, earlier used to involve a large incision and a long recovery period. However, inguinal hernia repairs can now be performed through laparoscopic surgery. The surgeon may use a procedure called hernioplasty to reinforce the entire inguinal area with synthetic material, like a tire patch. One of the advantages of laparoscopic hernia surgery is that it can be performed on an outpatient basis too depending upon the condition of the patient. The other advantages of laparoscopic surgery include smaller incisions, less risk of infection, less pain and scarring, and a more rapid recovery.

Incarcerated and strangulated herniae require emergency surgery and hospitalization. Laparoscopic surgery may not be recommended for very large herniae.

How to prevent inguinal hernia?
Although there is no way to prevent hernia due to a congenital weakness or family history, one can help reduce the risk of developing an inguinal hernia or prevent a hernia from recurring by following the simple guidelines below:

• If you are overweight, follow your physician’s advice for losing weight. Being overweight creates greater abdominal pressure and increases the risk for developing an inguinal hernia. Maintain a healthy weight through diet and exercise.
• Avoid rapid weight loss such as in crash dieting. Rapid weight loss programs may be lacking in protein and vitamins that are needed for muscle strength, causing weakness in the muscles of the abdomen.
• Avoid lifting, pulling, and pushing heavy objects. Use proper lifting, pulling, and pushing techniques when needed. Bend at your knees and lift using your legs rather than your back.
• Stop smoking. Chronic coughing from smoking increases the risk of developing a hernia. (Smoking is bad for heart too).
• Use deep breathing techniques to help control coughing. Obtain a medical prescription to treat the condition causing cough.
• Take medication to reduce allergies and sneezing.
• Avoid constipation and straining during bowel movements and urination. Straining causes increased pressure inside the abdomen. Eat foods that are high in fiber, drink plenty of fluids. Using stool softeners or drinking a natural stimulant beverage such as prune juice may be of help. Use laxatives or enemas only if recommended by your physician.
• For males, wear a jockstrap or similar groin support.
• Adjust your occupational duties, if necessary.

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