The Bariatric and Hernia Institute
7500 Greenway Center Drive
Greenbelt, MD 20770
Should You Be Worried About a Hernia?
Hernias are a common cause for concern among patients. A hernia develops due to a weakness in the abdominal wall that allows a bulge to form under the skin at the area of weakness. The bulge often represents fatty tissue or intestines pushing through that weakness. For example, a common hernia is an umbilical hernia (“belly button” hernia) that results from fatty tissue pushing through the navel to create a bulge.
Hernias may occur in many locations including the navel, the groin, the front of the abdomen, the side of the abdomen and even in the back. The hernia results from a weakness in the abdominal wall that is either a natural weak spot or a weakness created by a tissue injury as typically occurs from previous abdominal surgeries. The hernia is often made obvious by activities that generate a lot of pressure in the abdomen such as coughing, straining, lifting heavy loads or working out in the gym.
Hernias can often be pushed back into the natural position in which case they are said to be reducible. If the hernia cannot be pushed back into its natural position then it may be trapped and is considered incarcerated. Incarcerated hernias may lead to problems with blood supply of the trapped tissue, especially so if the intestine is the trapped tissue. This would require emergency surgical treatment.
Many hernias are noticeable but do not cause any problems. Those hernias are said to be asymptomatic. Other hernias, however, may cause problems such as pain, progressive increase in size, or limitation of daily activities. In severe cases, the hernia is incarcerated containing trapped intestines in the bulge causing intense pain and/or vomiting. This is considered an emergency.
Many asymptomatic hernias can be observed. If the hernia is small and there are no major symptoms then it is often reasonable to simply observe. For large and symptomatic hernias, patients benefit from surgical repair to eliminate the associated pain and to restore normal functioning as it relates to daily activities. Surgical repair will also reduce the risk of an emergency situation.
In emergency situations, where there is trapped tissue with associated intestinal obstruction or risk for loss of blood supply, surgical treatment is mandatory.
Management decisions for hernias are influenced by factors such as the location, size, symptoms of the hernia and medical condition of the individual.