By Jessica Reynolds, MD
Surgical Associates of Northwest Ohio
Blanchard Valley Health System
What is a hernia?
Hernias can happen anywhere on the body, but abdominal hernias are some of the most common. Abdominal hernias occur when there is an irregular hole in the fascia, or if the hole it is abnormally large, causing organs, fat and other parts of the abdomen to bulge through the hole. Symptoms may include a bulge, swelling, or pain in the abdomen, pelvis or testicle. Discomfort in the abdomen is also a common symptom, which is why consistent cramping or tension in one particular area of the abdomen is sometimes a sign of hernia. While some may believe the size of the bulge is the most critical part of a hernia, it is actually the size of the hole that reveals how serious a hernia may be.
What is fascia and why do holes in it occur?
Think about a steak or roast. The muscle is somewhat soft and easily separated. The meat is not strong by itself; rather, the strength results from the tough silvery layer around it that keeps it in bundles. That is fascia. Your entire abdomen has a layer of fascia on the inside and the outside of the muscle to keep all of your organs contained. Everyone has holes in their fascia at their bellybutton and groins. Some people are born with holes other places as well, usually found around the vertical midline of the abdomen. Others obtain holes when they receive abdominal surgery or an injury. As long as these holes remain small, there is no problem. However, over time the holes can become larger, which can lead to a bulge.
Are hernias dangerous?
If the hole in the fascia is large enough for a loop of bowel to slip into it, that bowel can sometimes become stuck, which can be an emergency. Large hernias are actually at lower risk for this, since the bowel can more easily go in and out of the hernia. Likewise, small hernias are not at risk because the hole is not big enough for the bowel to fit. In general, as long as the bulge can easily be pushed back in and is not painful, it is not dangerous.
What should I do if I have a hernia?
There are many actions you can take to help keep your hernia from getting bigger and to ensure a positive outcome if you choose to get it repaired. The most beneficial action is to quit smoking. Smoking reduces blood flow to the fascia and muscles, which makes them weaker and less likely to heal. Additionally, exercise can help. Being overweight puts abundant force on the fascia, making the hole larger. Exercising will not make your hernia worse, but rather it will help strengthen your muscles to better support your abdominal wall. Finally, talk to a surgeon about a minimally invasive repair. Thanks to advanced technology, even large hernias can be repaired through a few tiny incisions using a robot. This reduces recovery time so that most surgeries can be completed as an outpatient. Ask your provider for more information on how to reduce your risk of hernias, or for tips on the best course of action to repair a hernia.
