Inguinal Hernia Definition, Reason, Symptoms, Treatment & Prevention
Understanding
An inguinal hernia or descending hernia is a condition when fatty tissue or intestinal connective tissue passes through the inguinal canal to the groin area.
This condition eventually causes a lump or protrusion or swelling in the groin area or enlargement of the scrotum (sac of the testicles).
A lump caused by an inguinal hernia is usually painless. However, pain can be felt mainly when the patient bends over, coughs, and lifts heavy objects.
The inguinal canal is at the base of the abdomen, in both men and women. That’s why, everyone can experience an inguinal hernia. However, this condition is more common in men.
In addition, inguinal hernias are divided into two types, namely indirect and direct.
- Indirect inguinal hernia (indirect) is a type that often occurs in premature births, where the inguinal canal is not fully developed
- Inguinal hernia direct (immediate) often occurs in adults. The cause is weakened muscles due to repetitive pressure, such as lifting heavy objects frequently
Symptom
An inguinal hernia will usually be seen as a bulge in the groin.
The bulge will usually enlarge when there is pressure on the stomach (such as when standing, lifting movements, or coughing), and disappear when lying down.
Other inguinal hernia symptoms that can appear include:
- Pain when coughing, exercising, or bending over
- Burning sensation
- Sharp pain
- A sensation of fullness or heaviness in the groin area
- Swollen scrotum in men
- Severe pain, nausea, and vomiting in incarcerated hernias
Meanwhile, the symptoms of an indirect inguinal hernia in infants may be most noticeable when crying, coughing, or straining during bowel movements.
Babies may also be fussier and have less appetite.
Reason
The main cause of an inguinal hernia is an area of weakness or defect in the abdominal wall in the groin area. The condition can be triggered by:
- Increased pressure in the stomach
- A pre-existing weak point in the abdominal wall
- Straining during bowel movements or urination
- strenuous activity
- Pregnancy
- Chronic coughing or sneezing
In most cases, weakness of the abdominal wall occurs in the baby at birth.
Meanwhile, other genetic disorders develop later in life when muscles weaken or deteriorate due to aging, strenuous physical activity, or the cough that accompanies smoking.
Abdominal wall weakness can also occur later in life, especially after injury or abdominal surgery.
Risk Factors
Several risk factors can also increase the likelihood of an inguinal hernia, namely:
- Family history
- Prior history of hernias
- Man
- Low body mass index
- Systemic connective tissue disease
- History of radical prostatectomy
- History of radiation therapy
- Chronic cough
- Premature birth
Diagnosis
Doctors can determine the diagnosis of inguinal hernia based on symptoms and physical examination. The patient will be asked to lie down during the examination. The doctor will try to reinsert the hernia in the abdomen.
If this procedure doesn’t work, you may have an incarcerated or even strangulated hernia.
In an incarcerated hernia, the tissue is trapped in the groin area, so it can’t be returned to the stomach area.
Meanwhile, in a strangulated hernia, intestinal tissue is pinched, limiting blood flow to the intestine and can cause tissue death. This condition can be dangerous and life-threatening.
The doctor will also check the hernia when you stand up or cough to find out the largest size of the hernia.
In women, additional examinations are often needed in the form of ultrasound. In addition, other tests can also be carried out in the form of a CT scan, MRI, herniography in certain cases.
Treatment
Small, painless inguinal hernias may not need treatment, although they do need to be monitored.
In cases of larger, painful inguinal hernias, surgical procedures are needed.
Hernia surgery has a high success rate when performed by a surgeon.
Inguinal hernia surgery can be done by herniorrhaphy (open surgery) or laparoscopically (using tools). The difference between the two is the surgical wound.
Herniorrhaphy is done by making a long incision in the groin area. While laparoscopy requires several short incisions to insert the tool.
The advantages of laparoscopy are shorter healing time, quicker return to activities, less pain, and less risk of recurrence.
Meanwhile, indirect hernia surgery in infants and children is usually quite safe. The hernia sac is removed from the scrotum and other sensitive areas, then closed with stitches.
Prevention
Inguinal hernias caused by heredity cannot be avoided. However, inguinal hernias due to other factors can be avoided in the following ways:
- Maintain ideal body weight
- Eat high-fiber foods
- Do not smoke
- Avoid lifting heavy weights
It should be noted that inguinal hernias can also recur. You can also do the tips above to prevent hernia recurrence.
Complications
Inguinal hernias can become trapped (incarcerated), that is, the contents of the hernia that protrude through the abdominal wall cannot be massaged back into the abdominal wall.
If this condition is not treated, a strangulated hernia can occur, which means that the blood flow to the hernia is cut off.
This can cause tissue death within the hernia. This condition can be life-threatening.
When to See a Doctor?
Immediately see a doctor if you find the following symptoms: