Hernia: Types, Symptoms, Treatment and Complications
A hernia is the result of an organ, intestine or fatty tissue being squeezed through a hole or a weak spot in the connective tissue or surrounding muscle where it’s usually held in place. Hernias are sometimes visible, typically as an external bulge when straining or bending down. The most common hernia types are inguinal hernias, hiatal hernias, umbilical hernias, incisional hernias, ventral hernias, and femoral hernias.
The combination of pressure and an opening or weakness of muscle or connective tissue causes most hernias. The pressure pushes an organ or tissue through the opening or weak spot. Any increase in abdominal pressure can cause a hernia. Common causes include: obesity, persistent sneezing/coughing, lifting heavy objects, diarrhea, and constipation. Overexertion, poor nutrition, and smoking can also weaken muscles and contribute to the likelihood of a hernia.
If left untreated, your hernia may grow and become more painful. A portion of your intestine could become trapped in the abdominal wall. This can obstruct your bowel, causing severe pain, nausea, and constipation. An untreated hernia can also put too much pressure on nearby tissues, which can cause swelling and pain in the surrounding area. If the trapped section of your intestines doesn’t get enough blood flow, the intestinal tissue may become infected or die. A strangulated hernia is life-threatening and requires immediate medical care.
Symptoms & Treatment
The most common symptom of a hernia is a bulge or lump in the affected area, pain or discomfort in the affected area, a feeling of heaviness in the abdomen, acid reflux, nausea, and vomiting. In some cases, hernias have no symptoms.
How your hernia is treated will depend on the severity of your symptoms and the size of your hernia. Your doctor may simply monitor your hernia for possible complications, a process referred to as “Watchful Waiting.”
Another treatment option for a hernia could be lifestyle changes. The symptoms of a hiatal hernia can often be treated by changing your diet. Avoid eating heavy meals, lying or bending over after a meal, and keep your body weight in a healthy range. If dietary changes don’t eliminate the discomfort, surgery may be needed to correct the hernia.
Open or laparoscopic surgery can repair a hernia as well. Using a tiny camera and small surgical equipment, laparoscopic surgery can repair a hernia using only a few small incisions. Laparoscopic surgery is less damaging to the surrounding tissue and has a much shorter recovery time. However, the risk of your hernia reoccurring is higher and not all hernias are suitable for laparoscopic repair.
Open surgery requires surgeons to make an incision near the hernia to repair the weak muscle area and requires a longer recovery process.
Using Surgical Mesh to Treat Hernia Complications
Surgical mesh can provide additional support to tissue that has been weakened or damaged. Most surgical mesh devices are constructed from synthetic materials or animal tissue.
Surgical mesh made of synthetic materials comes in both woven and non-woven sheets. The synthetic materials used can be absorbable, non-absorbable or a combination of both.
Animal-derived mesh is made of animal tissue that has been processed and disinfected. The most common tissues used are intestines and skin, typically from cows and pigs. These types of mesh are absorbable.
Non-absorbable mesh is considered to be a permanent implant and will remain in the body indefinitely. It is used to provide permanent reinforcement to the repaired hernia, whereas absorbable mesh will degrade and lose strength with time. It is not intended to provide long-term reinforcement.
According to the Food and Drug Administration, the most common adverse events related to hernia repair surgery include pain, bleeding, infection, hernia recurrence, adhesion, mesh shrinkage, fistulas, Seroma, intestinal blockage, organ perforations, nerve damage, Autoimmune reactions to mesh, mesh migration and rejection, and tenderness at the implant site.
Lastly, the FDA has announced several manufacturer recalls, and the agency issued a Safety Communication in 2014 to warn the public of adverse events linked to hernia mesh. Some recalls were for packaging errors, but others were for poor mesh performance or reports of adverse events. Patients injured by hernia mesh have filed lawsuits against manufacturers claiming the mesh is faulty and poorly designed and that the devices’ makers hid the risks.