Hernias

Millions of Americans are affected by hernias every year. Since June is National Hernia Awareness Month, it is time to start the conversation about what hernias are, whether they are dangerous or not, and what you can do to treat them.

A hernia is any protrusion of an organ or tissue through the surrounding muscle or connective tissue (fascia) that usually contain it. There are different kinds of hernias. They can occur in your abdomen and even in your groin. How we classify and describe each type of hernia is dependent on the specific location of the hernia. Some examples of hernias include hiatal hernia, umbilical hernia, incisional hernia, femoral hernia, and inguinal hernia. Sometimes you can tell if you have a hernia and other times, you may be asymptomatic or not be able to tell at all.

The most obvious hernia is one that pushes through your abdominal wall muscles and fascia. You can sometimes feel it yourself if you press on your abdomen. Most of these are classified as primary ventral hernias, which can include epigastric and umbilical hernias depending on the exact location. An epigastric hernia occurs in your upper abdomen just below where your ribs meet your sternum. An umbilical hernia occurs around your “belly button”. These are usually caused by increased pressure within your abdomen that may be caused by obesity, pregnancy, and many other factors.

Other hernias of your abdominal wall can be caused by previous surgeries or procedures to your abdomen. These are called incisional hernias and occur where a surgeon may have had to make a surgical incision. For example, if you have had a cholecystectomy (removal of your gallbladder) or an appendectomy (removal of your appendix), your surgeon had to pass through the abdominal muscles and tissue in order to get to the root of your problem. Not all abdominal surgeries lead to hernias, but your doctor would certainly take that information into account if you were to tell him or her that you were having abdominal pain and feel a bulge in your abdomen.

Many times, hernias are what we call “reducible” or that you can just push the protruding tissue back into the abdominal cavity. Hernias become dangerous if they become incarcerated or worse, strangulated. An incarcerated hernia is one that is stuck in the defect of your abdominal wall and can no longer be “reduced”. An incarcerated hernia can lead to a strangulated hernia, which is when the blood supply to that particular tissue or organ has been cut off due to compression of the blood vessels. This becomes a medical emergency and you should call 911 if you are having severe pain or discoloration of your abdomen.

If you suspect that you have a hernia, but you are not having severe pain or other signs of a strangulated hernia, contact your primary care physician to help you decide what the next best step may be. This may lead to reassurance that you do not have a hernia, further imaging, or a referral to see a surgeon.

Dr. Trinh is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community