Injury blog: Abdominal hernias

Mention the word ‘hernia’ and most people will think of something painful sticking out of the belly region. You’ll be pleased to know this is not always the case. Many cases are completely pain-free and are only noticeable on a person when they are in a particular position. At other times there may be no other visual sign that a hernia even exists! Read on for more information...

What is a hernia?

A hernia is a protrusion of the abdominal contents (i.e. intestines) through a weakened or damaged part of the muscle or tissue that holds it in place. Hernias are commonly found in the abdominal region of the body; that area between the bottom of the rib cage and the hip / pelvic area. Abdominal hernias can be broken down into two locations:

• Abdominal wall location: Hernias that occur through the wall of the abdomen on the front of the belly region
• Groin location: Hernias that occur lower down in the abdomen around the groin region

 Abdominal wall location

There are a few different types of abdominal wall hernias with the most common being:

• Incisional: These hernias occur in and around a scar or ‘incision’ left over from a previous abdominal surgery. During surgery, the muscles of the abdominal wall are cut to allow the surgeon to access the inside of the abdomen. This leaves a weakened area of the wall which is a potential site for herniation to occur. This type of hernia accounts for approximately 10-15% of all abdominal hernias.

• Umbilical: This is a protrusion at the belly button which is regularly seen from birth. Over time these usually dry up and disappear altogether. It is possible to get these hernias as an adult too, usually as a result of being overweight or pregnant.

• Epigastric: There is a tough, fibrous piece of tissue that spans from the tip of the rib cage to the pelvis in the mid-line of the body known as the ‘Linea Alba’. This forms an area of muscular attachment of the abdominal muscles. Due to a weakness in the abdominal wall above the belly button, a hernia can occur. This is common in infants, but again may happen later in life.

Groin location

• Inguinal: This is the most common type of abdominal hernia accounting for approximately 75% of all cases. The opening for this hernia is a region known as the ‘inguinal canal’ which allows for the testicles and spermatic cord to descend into the scrotum during male development. After this event, the canal should tighten, but in some males the muscles responsible for this do not respond as well as expected, leaving an area of weakness. As females do not forego this part of development, it rarely affects women.

• Femoral: There is a space in the floor of the abdomen for a vein and artery to pass through and down into the leg, known as the femoral canal. In females this canal is wider which results in this type of hernia being more common in women than men. It accounts for approximately 10-15% of all abdominal hernias.

Treatment

Treatment of abdominal hernias depends on the severity and symptoms associated with them. Sometimes with a hernia, the abdominal contents inside them can become trapped and ‘strangled’, ’which can lead to loss of blood supply and ultimately death of tissue. These complications can possibly be fatal if left untreated. In these cases, and with most uncomplicated cases, surgery is the best course of action to ensure a full recovery.

There is also a place for physical therapies like physiotherapy. Physio is particularly helpful following a surgical procedure to aid with strengthening of the abdominal muscles and surrounding area, supporting the area and reducing the risk of re-herniation. Scar tissue following surgery can affect our ability to move efficiently, however exercise as well as hands-on therapy can help to reduce the effect of this.

If you have an abdominal hernia and would like advice on how to manage it, please get in touch today by going to our online booking website https://www.myhealth1st.com.au/find/physiotherapists/nsw/nsw-region/north-sydney/back-in-business-physiotherapy or by calling us on 02 9922 6806 to book a face-to-face or Tele Health appointment. If you require the opinion of a doctor or specialist, we'll ensure you are placed in the best possible hands.

References

1. MSD Manual. 2020. Hernias of the Abdominal Wall. [Online]. Available from: https://www.msdmanuals.com/en-au/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/hernias-of-the-abdominal-wall. [Accessed 08 April 2020]
2. Melbourne Hernia Clinic. 2018. What is a Hernia? [Online]. Available from: http://hernia.net.au/what-is-a-hernia/. [Accessed 08 April 2020]
3. MedicineNet. 2020. Hernia (Abdominal Hernia) 9 Types, Symptoms, Causes and Surgery. [Online]. Available from: https://www.medicinenet.com/hernia_overview/article.htm. [Accessed 08 April 2020]
4. Healthline. 2019. Everything You Want to Know About a Hernia. [Online]. Available from: https://www.healthline.com/health/hernia. [Accessed 08 April 2020]

Uploaded : 28 April 2020