What is a Hernia?

The word hernia comes from the latin “prolapse” or to come out, and its discussion in the medical literature has been around since ancient Egypt in the 1500s BC. In short, a hernia in humans is defined as weakness or an opening in the abdominal wall. This often results in things that are on the inside of your abdomen such as fat or intestine finding their way to the skin. How a hernia develops is very similar to how a bulge in a damaged tire appears, where the inner tubing protrudes through a weakness in the tire.

Hernias can develop for many reasons, but they mostly develop in places of weakness on the human body. One such place is near the belly button or the umbilicus, where the umbilical cord came out of us as babies. This is a natural weakness which can open up and develop into an “umbilical” hernia over time. Another natural weakness is in males, where the blood vessels to the testicles go. This can result in a groin hernia or an “inguinal" hernia.

Another common way we can develop hernias is after any incision from a previous surgery. This incision weakens the natural tissue and over time can open up and develop into an “incisional” hernia.

How are Hernias Diagnosed?

The best way to diagnose a hernia is with a good history of the problem and a physical exam. Most of the time hernias are straightforward medical problems to diagnose. In certain cases your surgeon will want to get imaging studies to get a better look at the anatomy of your abdominal wall such as an ultrasound or CT scan. In some cases when the hernia is not able to be felt on exam, additional studies may be ordered to see if a hidden hernia is present.

How do Hernias Develop?

Hernias are quite common and over 20 million hernias are repaired each year all around the world. Hernias can occur for many number of reasons but there are some risk factors to developing them including:

  • Chronic Cough

  • Constipation

  • Obesity

  • Smoking

  • Repetitive Heavy Lifting

  • Connective Tissue Diseases

Hernias do not usually develop immediately but most often they occur over time. First, the abdominal wall loses strength in areas of natural weakness such as near your belly button or groin. Then over time and with repetitive stress, that area of weakness opens up, a small area at first that becomes larger. Then intestine or fat can get stuck in this opening, potentially leading to this getting damage.

Incarcerated hernias are when hernia contents such as intestine or fat get stuck in the hernia and cannot be reduced.

Strangulated hernias are when hernia contents get damaged from being stuck.

Both incarcerated and strangulated hernias are surgical emergencies and you should seek help right away.