hernia

As hernia This is an opening in the abdominal wall, which can contain soft tissue, fatty tissue or parts of the internal organs. Treatment is essential, and hernias rarely cause serious consequences.

What are the characteristics of a hernia?

The symptoms of a hernia are clear. This leads to a bulge in the area of ​​the abdominal wall, which is accompanied by burning pain.
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A hernia, too Soft tissue fracture or Abdominal wall herniacalled, are openings in the abdominal wall. Through this, tissue or organs from the inside of the body can turn outwards, which can lead, for example, to so-called jamming.

There are different types of hernias. For example, inguinal hernias that occur above the groin, umbilical hernias that arise directly behind the navel and simple incisional hernias. There are also leg fractures and epigastric fractures in the area around the navel. Despite the name, such breaks are not to be equated with fractures. Rather, it is openings that often arise over years or as a result of serious illnesses.

Colon cancer, chronic cough or constipation can be triggers. In most cases, surgery will fix the hernia, and diagnosis of the triggers is also an important part of therapy.

causes

Hernias can have many different causes. They often arise after a lifting trauma, i.e. an injury as a result of excessive stress.Chronic cough, constipation or colon cancer can also cause soft tissue ruptures. Likewise, sudden weight gain, pregnancy or various liver diseases. Above all, diseases that are associated with ascites promote the development of a hernia. The same applies to weak connective tissue.

In general, hernias are more common with age. The exact causes are often uncertain, which makes targeted treatment difficult. In addition, most hernias are congenital. The gaps in the abdominal wall develop during the embryonic period and enlarge in the course of life. This type of hernia mainly affects men.

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Symptoms, ailments & signs

The symptoms of a hernia are clear. This leads to a bulge in the area of ​​the abdominal wall, which is accompanied by burning pain. Those affected suffer from severe discomfort, especially during the development of the hernia. There are, however, exceptions. If the resulting hernia is particularly large, pain can be completely avoided.

Only when it comes to a so-called incarceration, i.e. the clamping of tissue, does severe pain occur. If the bowel is trapped by one or more hernias, the stool cannot escape and causes severe pain and vomiting. Since the blood supply is also interrupted, the trapped areas cannot be supplied with nutrients and oxygen and, in the worst case, die. If this happens, action must be taken immediately to avoid long-term consequences.

Clear signs of a hernia are the bulges that appear in the abdomen and groin area. These can usually be felt or even seen. If they are touched, the symptoms increase.

Diagnosis & course

Hernias can be clearly diagnosed through a physical exam. The patient is examined closely and, in particular, the abdomen is scanned. In addition, suspicious areas of the body are monitored with the stethoscope. An ultrasound exam gives a close look at the soft tissue fractures, while strong light sources make it easier to illuminate the affected area.

The tests mentioned are used to determine how big the hernia is, where the hernial canal is, whether and which tissue is emerging from the hernia and what measures can be taken. The doctor decides whether “repositionability” is possible, ie whether the gap can be closed again without surgery.

In addition to the physical exam, the doctor takes a medical history with the patient. Within this, he determines since when the symptoms have existed, what the living conditions are like and whether diseases such as chronic cough exist. Then the diagnosis can be made. The course of a hernia is generally to be assessed as positive. An operation is possible at any age and is almost always successful.

A plastic reinforcement, which is placed on the affected area during the operation, prevents another hernia from occurring. Serious health problems can only arise in the event of non-treatment and the resulting deadlock. In the worst case, it can lead to an intestinal infarction and death as a result.

Complications

The hernia causes the patient to experience extremely severe pain. These pains are usually burning and mainly affect the abdominal wall. The persistent pain often leads to depression and other psychological upsets. Furthermore, the pain can also occur at night and lead to sleep problems that extremely reduce the patient's quality of life.

If the intestines are trapped, vomiting can occur, which is accompanied by extreme pain. Likewise, there may be an insufficient supply of oxygen to the affected areas, so that the affected organs are damaged or die off completely. A transplant is usually necessary for the patient to survive. In most cases, the diagnosis of the hernia is relatively quick and clear, so that early treatment is possible.

The treatment is carried out by a surgical procedure, whereby there are no particular complications or complaints. Life expectancy is also not reduced if treatment is started early. If internal organs have already been damaged by the symptoms of the hernia, a transplant may be necessary.

When should you go to the doctor?

If a bulge is suddenly noticed in the area of ​​the abdominal wall, possibly combined with severe pain and an increasing feeling of illness, a hernia is suspected. A doctor should be consulted if the symptoms are particularly intense and do not go away on their own within one to two days. If symptoms such as vomiting or fever occur, an immediate investigation is necessary. If the bulge does not cause pain, a doctor must be consulted after a week at the latest.

Those affected should also watch out for unusual symptoms and seek medical advice immediately in the event of acute cramps, sweating or severe discomfort. People who suffer from chronic cough, constipation, weak connective tissue, or colon cancer are particularly prone to soft tissue fractures.

An increase in body weight, various liver diseases, pregnancy and old age are also possible triggers of a hernia. If the mentioned symptoms and complaints occur in combination with one of these points, a doctor's visit is indicated. In addition to the family doctor, a gastroenterologist or a specialist in internal medicine can be called in. In the event of acute complaints, it is best to go to the nearest hospital directly.

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Treatment & Therapy

A hernia does not necessarily have to be treated. Small soft tissue fractures can be observed as they often persist for many years without growing any further. Larger openings are closed surgically. If this does not happen, the aforementioned incarceration may occur, which can have serious consequences for the patient.

In addition to the actual treatment, therapy also focuses on diagnosing the triggers. If the hernia is not congenital, it must be determined which diseases or lifestyle habits caused it and how they can be remedied. This is a long-standing process that comes with preventing further hernias.

Outlook & forecast

The prognosis for surgical interventions for hernias is usually good, with timely diagnosis and prompt surgery. It largely depends on the type and size of the hernia, as well as the ability to reduce the risk factors associated with developing hernias.

Older age, longer, larger hernias and the longer duration of irreducibility are risk factors for acute complications such as strangulation and bowel obstruction. About 5% of primary inguinal hernia operations are performed in the emergency room.

Abdominal hernias usually do not occur in children. However, they recur in about 10 percent of adults. An operation is seen as the only chance of recovery. Further surgical intervention for the hernia recurrence is less successful than the first surgery.

If the diagnosis is made early in childhood, the prognosis for children who have had a surgically treated inguinal hernia is very good. There are only occasional complications associated with inguinal hernias that can potentially lead to death. However, these are rare. Most often this is the case in children whose hernias were diagnosed too late or whose hernias were strangled, which ultimately leads to organ failure.

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prevention

Hernias are difficult to prevent as they often arise without a specific trigger or are even congenital. However, a healthy lifestyle with sufficient exercise and a balanced diet with little stress can reduce the risk of development many times over. Refraining from alcohol and nicotine also has a fundamentally positive effect.

Otherwise, existing illnesses such as chronic cough or constipation should be treated early so that the pressure on the abdomen does not persist for too long. From an advanced age, regular check-ups are a good way to prevent hernias and other diseases that are not noticeable externally.

Aftercare

A hernia that has not been operated on must be checked at regular intervals. If the symptoms worsen or the hernia enlarges, surgery is necessary in many cases. Follow-up care for surgically treated hernias is also necessary. Basically, the patient can walk slowly and climb stairs immediately after the operation.

However, a grace period of two weeks must be observed postoperatively. In addition, strong physical stress should be avoided. Under no circumstances should the patient lift or carry heavy loads after a hernia operation. If the operation could not be performed in a minimally invasive manner, the grace period is extended to a period of six to twelve weeks.

In order to promote optimal wound healing, patients should refrain from swimming and going to the sauna for fourteen days after the operation. In the case of open proceedings, a longer waiver is often necessary. The exact period should be clarified in consultation with the doctor treated. In addition, it is advisable not to consume tobacco after the operation, as smoking can disrupt and delay the process of wound healing.

Mild pain relievers may be taken to treat pain, especially for the first three days after surgery. Cooling the affected areas can also have a pain-relieving effect. In addition, an operated hernia must be checked via ultrasound after two weeks. At this point, the sutures are pulled if necessary. Rehabilitation measures and / or physiotherapy units are usually not necessary for hernias.

You can do that yourself

A soft tissue hernia does not necessarily have to be operated on. However, if the symptoms are severe and the hernia is very large, so that there is a risk of life-threatening complications, an operation should be performed promptly. If you have a known hernia, it is advisable to carefully monitor physical changes and to attend regular preventive examinations.

If the hernia is not congenital, another disease is the cause. This should be determined by a specialist. To do this, we recommend visiting an internist or gastroenterologist.

To prevent worsening or recurrence of hernias, no heavy objects should be lifted. A healthy lifestyle also has a preventive and healing effect. This includes a balanced diet rich in vital substances, regular exercise in the fresh air and avoiding alcohol and nicotine.

All measures that serve to reduce stress also have a fundamentally positive effect: Yoga and Chi Gong or autogenic training. They strengthen the immune system and reduce the risk of additional stress on the organism. If the cough is chronic, it should be treated urgently.

In addition to classic antibiotic therapy, natural remedies such as grapefruit seed extract or tea and lozenges made from rockrose are also recommended. These have a germicidal effect and thus act like an antibiotic from nature. The supportive treatment of the intestine with probiotics also helps with respiratory diseases by supporting the work of the immune system.