What is it?
The abdominal wall is a sheet of muscle that acts like a human corset to stop the organs of the abdomen - principally, the intestines - from falling out. When a weakness or tear occurs in this muscle, part of the intestine bulges through and appears as a lump under the skin.
In the past, hernias were often called ruptures. They are most common in the groin (inguinal hernias).
Causes
Anything that raises the pressure within the abdomen, such as heavy lifting (for example, weights or building materials), coughing, even straining on the toilet, can cause a weakness or tear in the abdominal wall.
Vigorous exercise often results in hernias
Vigorous exercise often results in hernias. Just look at how many professional sportsmen suffer: Gazza, Alan Shearer, Jeremy Guscott, to name but a few.
Sometimes the weakness is already present - for example, from birth around the umbilicus (umbilical hernia) in children or under the scar of an operation (incisional hernia).
Symptoms
When a hernia first occurs you may have a feeling that something has given way and may experience a little pain. This soon wears off. Later, a lump appears. This doesn't hurt and may get bigger when you cough.
Although in most cases hernias just cause discomfort and are a bit of a nuisance, the real worry is that they will strangulate. This means they get stuck and their blood supply is cut off, which requires an emergency operation.
Diagnosis and treatment
If you suspect you may have a hernia, you should get a doctor to confirm the diagnosis.
In the past, trusses where used to keep the hernia in place, but these days it's better to have a simple operation to repair the weakness before further problems arise.
The NHS performs more than 100,000 hernia repairs every year. Most operations are done in under an hour and you can go home the same day.
A special mesh material is used for the repair and, depending on the local hospital arrangements and your own fitness, it may be done under local or general anaesthetic and sometimes by keyhole surgery. With some advanced techniques you can be back to work in under a week, although this depends on your job and what the surgeon advises.
Prevention
Of course, prevention is always better than cure. Try to maintain your ideal weight and lift correctly, bending at the knees and keeping your back straight.
Stopping smoking will help to prevent excessive coughing and eating a good, high-fibre diet (with plenty of water) will help to avoid constipation and the need to strain on the toilet.
This article was last medically reviewed by Dr Rob Hicks in December 2005.
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