Don't Bust A Gut! Your Hernia And You.

A hernia occurs when a weakness, natural or otherwise, in the wall of the tissue holding in your guts gives way and lets a little slip out. You can tell it’s a hernia, as it will cause mild to major “discomfort,” and there will be a little bump where your intestines have slipped through the weak pocket. This can mean a lump on your belly, or a little intestinal slippage into your scrotum. When the intestine gets strangulated (circulation is cut off to the tissue) in the little bubble of tissue underneath the skin (the peritoneum), that is when the discomfort and downright pain usually kicks in. You will notice swelling and sensitivity to the touch, and you will want to get it looked at immediately so that the tissue does not die.

The weakness in your tissue can be caused by a tear from everything from heavy exertion to a simple sneeze. If you pull the tissue, it can weaken the tight hold your abdomen has on your intestines and POP! Usually hernias occur in areas where the tissue is already slightly weakened, for example, where vessels are running from your torso to your legs and scrotum, or in your belly-button area (called the umbilical hernia).

Groin hernias are often seen in athletes like soccer, football or rugby players who tear or pull groin muscles during the play of their game. While not all pulled groin muscles will result in a lumpy hernia, if you damage your groin, be sure to carefully nurse it back to health to prevent a hernia from taking advantage of the weakened muscle tissue.

Treatment
Once you have a full-blown hernia, it is likely to continue getting worse until you have it repaired. This can take years, however. If you are able to push on your hernia and it moves (called a reducible hernia), then it is not too serious. It is when you can no longer budge the bulge that you know the hernia has worsened and that more pressure is being placed on the weakness. It is not an ailment that will just go away on its own, nor will it become less painful over time. Chances are high that it will keep getting worse and affecting your everyday life until you go to the doctor and find out your options for treatment.

Hernia cannot be fixed with a pill, nor will they correct themselves. You are going to have to undergo a procedure in which the intestine is pushed out of the pocket and the weak pocket is reinforced so that the slippage does not recur. Having said that, there are several types of procedures that you may have to choose from.

Traditionally, the only way to fix a hernia was to cut you open, poke your guts back in and stitch you up. As with any invasive surgery, this required general anaesthetic and a 4-6 week recovery period. This type of treatment, with it 1-2 day hospital stay and longer recovery period is not the only option available to hernia sufferers anymore. After the surgery, came the same stitching procedure, except it was performed by laparoscopy. This procedure can be done as day surgery, although it also requires a general anaesthetic. The doctor basically knocks you out then makes three incisions in your belly. Through one incision, the doctor passes a camera into your stomach to guide his or her hands through the procedure of tucking and stitching. This process, also called Keyhole surgery, has been shown to be a little riskier, although the recovery time is much less than completely slicing you open.

The problem with stitching the tissue together over the weakness is two-fold. First, the patient has to take it easy for a few weeks or risk tearing the tissue around the sutures and causing even more pain and damage. Second, when you stitch, scar tissue forms around the sutures, which can cause lasting discomfort.

Two new options have emerged as viable ways to repair a hernia with minimal impact of the patient and quick recovery time. The first is the use of a mesh screen to reinforce the weakened area of tissue. This procedure can be done under local anaesthetic. A small incision is made just above the bulge, and the screen is placed across the weakened area of tissue, between the peritoneum and the area of the defect. The mesh is held in place by a single stitch. (This procedure can also be done by laparoscopy, but that would entail general anaesthetic).

The beauty of the mesh is that your tendons and muscle tissue will sense it and begin to envelop the mesh in fibrous tissue, basically integrating it into the supportive structure of the abdominal wall. Because the mesh is integrated, it does not run the risk of strain, tearing, or even scar tissue that stitched tissue does.

Along the same logic as the mesh patch is the mesh plug. This is the same idea, but the plug is inserted in the tear, and then a patch is used to cover it and keep it in place. Both the mesh patch and plug have very quick recovery times. It is day surgery that will have you in and out of the hospital in one day. You can pretty much just get up after the surgery and walk away. As with any invasive surgery, even minor, you will need a couple of days for your body to get over the shock of being operated upon, but it shouldn’t take any longer.

The best part about the new mesh techniques (called tension-free techniques) is that chances are will not have to worry about that particular weakened area of your body. The mesh will add reinforcement, lowering your chances of recurrence, as opposed to the previous practise of stitching, which offered much higher chances of relapse.

There is no reason you can’t go on to have a relatively hernia-free existence after this surgery.

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