The hernia occurs when an organ comes out of the cavity in which it is located. In the case of an inguinal hernia, it is a soft tissue – most often part of the intestine – that comes out of the abdominal wall. In fact, there are “weaker” areas in this wall, which are crossed by arteries and veins. This is where the hernia develops. The part of the intestine that “escapes” forms a bulge, a sort of small sac, which can be painful.
A weakness of the abdominal wall often involved
Inguinal hernias usually affect men more than women. It can occur in case of:
- increased pressure in the abdomen,
- exertion during bowel movements (in the case of chronic constipation, for example),
- chronic cough,
- overweight,
- activities requiring heavy lifting,
- pregnancy …
But most of the time, it is related to a weakness in the abdominal wall, sometimes present from birth in those who have it. It also develops particularly when muscles weaken, due to aging, strenuous physical activity or cough associated with smoking.
It would also concern between 2 to 5% of children, mainly boys. Sometimes their peritoneo-vaginal canal remains open instead of closing before birth, leaving the opportunity for a portion of the intestine to enter the breach. The hernia is therefore present from birth, and will have to be operated on.
What are the symptoms ?
In the majority of cases, the bulge is felt by the patient in the abdominal wall. There are thus some signs of an inguinal hernia:
- A lump on each side of the pubic bone;
- A burning sensation or pain in the area of this bulge;
- A feeling of discomfort, pain, heaviness in the groin, especially when bending over, when coughing or when weights are carried;
- A feeling of pressure or weakness in the groin area;
- A feeling of tightness in the lower abdomen, accompanied by digestive disorders;
- In men, pain and swelling of the scrotum around the testicles – the hernia then descends into the scrotum.
If the affected person is not able to push the bulge inside the body, it is an emergency that requires getting to the hospital without delay. The inguinal hernia is then trapped in the abdominal wall. This condition may be accompanied by nausea, vomiting, fever, rapid heartbeat, and sudden pain that intensifies rapidly.
A physical examination is therefore necessary to diagnose the pathology. Some hernias do not cause symptoms, and are discovered by chance during routine examinations. The doctor will check for a lump in the groin area or not, asking the patient to stand up and cough.
What are the risks ?
Inguinal hernia is not particularly dangerous. On the other hand, if it does not go away on its own, it can be the cause of complications:
- The increase in the size of the hernia can put pressure on the surrounding tissues;
- A bowel loop can get trapped in the “weak spot” of the abdominal wall, causing severe pain and discomfort to the bowel. The hernia is then “stuck”;
- When the hernia is ‘stuck’, blood flow to that blocked part of the intestine may be reduced. The hernia is then “strangled” which can even lead to the death of the affected intestinal tissue. This condition, called strangulation, requires immediate surgery.
In which cases to resort to surgery?
A small inguinal hernia causing no discomfort does not require any intervention, simple monitoring is sufficient. A compression belt can be proposed, to keep the hernia sac in the abdominal area.
However, a growing hernia requires surgery to prevent possible complications and relieve pain. There are two types of operations: herniorrhaphy and laparoscopy. Regardless of the technique, the recurrence rate is less than 2%. About 200,000 adults are operated on each year.
The right actions to prevent inguinal hernia
If it is impossible to prevent a congenital malformation (present from birth) – the preventive action can focus on the factors that favor its appearance. People who are susceptible or have already developed an inguinal hernia are therefore advised to:
- Maintain a healthy weight;
- Favor a diet rich in dietary fiber (legumes, whole grains, fruits, vegetables) to avoid any risk of constipation and abdominal tension;
- Drink 1.5 L of water per day, always to prevent an intra-abdominal thrust;
- Stop smoking, to limit coughing;
- Reduce activities that involve heavy lifting.
Read also :
- Inguinal hernia: a baby operated on from the wrong side
- Doctor, I have a lump in my groin
