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Inguinal Hernia



What is a hernia?

A hernia is the word we use to describe when an organ protrudes through tissue in an abnormal way, or through an abnormal opening. Hernia’s can occur in several areas of the abdomen, including the groin (inguinal), belly button (umbilical), diaphragm, femoral, and through surgical sites.

Image credit: https://www.laparoscopicsurgeon.melbourne/inguinal-hernia


What is the most common type of hernia?

The most common type of hernia is the inguinal hernia, which occurs within the groin, at an anatomical site known as the inguinal canal.


The inguinal canal is made up partially by the inguinal ligament, which runs from the anterior iliac spine (front of your hip bone), to the pubic symphysis (front of your pelvic bone). This small opening carries vessels and is a weak point within the abdominal wall.


There are two types of inguinal hernias


Indirect:

An indirect hernia is one that generally occurs in infancy, when an area of abdominal muscle tissue, called the inguinal ring, fails to close while the baby is in the mother womb. This developmental hiccup provides space for part of the intestine to slip through the inguinal canal, creating a hernia. These are generally noticed, and addressed, early after birth, but can show up later in life.


Direct:

A direct hernia occurs when part of the intestine protrudes through a weakness in the abdominal muscles and through the wall of the inguinal canal. This type of hernia predominantly affects adults.


Image credit: https://www.herniaclinic.co.nz/information/types-of-hernias/


Symptoms of a hernia

While initially the symptoms of a hernia may be quite mild, and may include:

  • Visible lump in groin or abdomen, which becomes more prominent when standing, coughing, or sneezing

  • Feelings of an increase in pressure within your groin, particularly near the pubic bone

  • Pain or discomfort into your groin or testicles, especially with bending over, coughing, or lifting

  • Burning and aching sensation in the groin or at the site of herniation

All symptoms will generally increase with an increase in abdominal pressure, such as coughing, sneezing, straining, or lifting.


Diagnosis

When visiting your doctor, or health care provider, they will review your symptoms and medical history. Doctors are generally able to diagnose hernias with a history and examination, though will generally request imaging, such as an ultrasound or CT scan, to confirm.


Risk factors

  • Being male - males are 8-9 times more likely to develop a hernia

  • Being older

  • Caucasian

  • Family history of hernias

  • Past medical history of hernias

  • Chronic cough, such as from smoking or fibrosis

  • Chronic constipation

  • Smoking

  • Pregnancy

  • Premature birth

  • Low birth weight


Prevention and Treatment

To reduce your risk of developing an inguinal hernia, you can:

  • Maintain a normal body weight

  • Avoid straining with defecating or urinating

  • Exercise regularly to strengthen your abdominal muscles


An uncomplicated inguinal hernia isn't necessarily dangerous, however, it may not improve on its own, and can lead to life-threatening complications.


If not addressed, there is a chance of the contents of the hernia becoming trapped (incarcerated) in the abdominal wall. An incarcerated hernia can become strangulated, which cuts off the blood flow to the tissue that is trapped. A strangulated hernia can be life-threatening if it isn't treated.


Signs and symptoms of a strangulated hernia may include:

  • Nausea

  • Vomiting

  • Fever

  • Sudden pain that quickly intensifies

  • Discolouration at the hernia site (red, purple, dark)

  • Inability to move your bowels or pass gas


If your hernia is small and not causing you any issue, your doctor may suggest to wait and watch the lump. However, as the hernia progresses or begins to give you issues, your doctor will generally suggest surgery to prevent complications and to relieve your discomfort. Surgical repair is a common procedure and can be done either via a laparoscopy or with an open hernia repair.


Why is it on our radar?

While we do not directly address hernias, they are on our radar as they can masquerade as biomechanical pain. Part of our role as osteopathic practitioners, involves identifying the likely cause of your presenting complaint, as well as the best course of action to help address your concerns, whether that is via conservative treatment, with further investigation (imagining) or with a referral to another practitioner or specialty.

Retrain Health is based in the Northern Rivers, NSW. From our Byron Bay and Ballina clinics, our team provides a range of quality healthcare services and products.


Retrain Health offers osteopathy, remedial massage, strength and conditioning, and PT sessions, with qualified practitioners.


If you are interested in finding out more information or would like to book an appointment, please contact the clinic by phone (02) 6680 7447, send us an email or click here to book an appointment online.

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