Inguinal Hernia

Inguinal hernia

        Inguinal hernia is a very common type of hernia. Just like any other kind of hernia, it consists of parts of your abdominal cavity sliding into some other place of your body, a place where they have no reason being. When talking about inguinal hernia, your lower abdomen is the source of the problem: some of your abdominal fat, usually the one that forms your "tummy", and a part of the small intestine, known as the small bowel, penetrates the lower abdominal muscles due to a weakening of the muscle fibers of the inguinal ring (a ring of muscles that separates your inner abdomen from your pelvic area). Both the fat and the small bowel emerges in the groin area (between your abdomen and your thigh), forming a bulge on one or both sides of the groin.

       This type of hernia has no preference for age, occurring both in youngsters (as young as a few weeks old) and in fully grown adults, but it does appear more often in males than females (due to the anatomy of the genital area). One thing you must remember about inguinal hernia is that it grows in time, evolving from a slight bump into a scary and painful bulge.

       The pathology of inguinal hernia indicates clearly that there are two different subtypes of this disease:

• Indirect inguinal hernia: is considered a congenital defect, appearing mostly in males due to their in - womb development. When their spermatic cord and testicles form, they do so inside their abdominal cavity. At a certain time, they lower themselves, through the inguinal canal, into the scrotum (the sac that holds the testicles). This canal should close firmly shortly after birth, trapping the spermatic cords and the testicles below the abdomen. In certain males, it does not, allowing for the passage of the small bowel, thus generating inguinal hernia. When talking about indirect inguinal hernia in females, the problem is a little more complicated, since it is not their small bowel that slides through the inguinal canal. Instead, their reproductive organs (ovaries and uterus) as well as a larger portion of the small intestine can pass through a weakened inguinal ring. This kind of hernia is the most common type, especially in prematurely born children whose bodies have not had the time to finish the natural closing of the inguinal canal.
• Direct inguinal hernia: unlike its sibling, this type of hernia is man - made and, ironically, it affects only men. It appears in men who are known for doing a lot of physical work, overtaxing their body and their muscles. After a certain period of time of continuous twisting, lifting heavy objects, straining (due to constipation), weight gain and chronic coughing, as well as muscle injuries, the abdominal wall weakens and allows an enlargement of the diameter of the inguinal canal. Once this is opened, the hernia takes its natural course.

       There are some interesting facts you should remember about these two types of hernia: both indirect and direct inguinal hernias are "sliders", they can be persuaded to move back through the canal into your abdomen. Be careful, do not use sudden moves or you might cause more damage than you think. In this case, the gentle massaging of the area is the key.

Inguinal hernia pictures

       One of the most serious and well known complications of inguinal hernia is the incarcerated hernia: the small bowel and the abdominal fat get stuck in the groin area, not being able to move back into the abdomen. Due to the tight fit of the inguinal canal, the small intestine is no longer properly oxygenated and has a deficient blood supply, leading to serious pain and even the blackening of the bowel. However, the symptoms of incarcerated hernia are pretty severe, so it is hard to miss: if you feel extreme tenderness and redness in the area of the bulge, sudden pain that worsens in a short period of time, experience bursts of fever and an increase in heart rate, your inguinal hernia has just taken a turn for the worst.

Symptoms of inguinal hernia

        The outside signs of hernia are pretty straightforward and impossible to mistake for those of other diseases:

• The appearance of a small bulge on one or both sides of the groin: be careful, it can either increase in size or disappear when lying down. Men may notice a swelling of their scrotum as well.
• Sharp pain or light discomfort: it usually disappears or dulls when the intense physical activity that caused it (straining, lifting or exercising) is stopped.
• Weakness or pressure in the groin: the bulge applies pressure over your genital area and can cause serious problems.
• Burning or aching feeling around the bulge: the traumatized blood vessels pulse in the rhythm of the heartbeat. The patient can feel it due to the strain put on the flesh next to the vessel.

Treatment of inguinal hernia

        When inguinal hernias appear in young children, they are operated on immediately, to avoid the forming of the incarcerated version. In adults, if left untreated, it can cause the enlargement of the bulge and various other serious problems. The best treatment known today for hernia is surgery. This is not such a complicated procedure and it is often done on an outpatient basis, the recovery lasting between a few weeks to a couple of months, depending on the seriousness of the illness.

        The hernia surgeries are better left for your attending physician to explain, but you might want to know that there are two types of hernia interventions:

• "Open" hernia repair: your surgeon cuts open the affected area, moves the bowel and the fat back inside your abdomen and reinforces the abdominal muscles with a synthetic screen.
• Laparoscopy: performed under general anesthesia, it is a modern, though not necessarily better, version of the "open" repair.

        After the surgery, physical activity is seriously restricted for several weeks and pain medication is prescribed. A person can resume their normal activities only with the physicians' permission.