At this time of year, after we’ve maybe piled on a few pounds over Christmas and we’re feeling motivated to get fit, we can sometimes push ourselves a bit too hard. The number of sports-related and gym-related hernias rises in January.
So, what is a hernia and how can you avoid one?
Hernias occur when an organ or fatty tissue is squeezed through a weak spot in the surrounding muscle or connective tissue, called the fascia.
There are different types of hernia. The most common are:
- inner groin hernias (inguinal) – 96% of all groin hernias are inguinal and they are most common in men. Normally part of the intestine or bladder protrudes through the abdominal wall.
- outer groin hernias (femoral) – these occur most often in pregnant women.
- hernias of the belly button (umbilical) – these are common in newborn babies and women who have had several children or who are obese. A section of the small intestine protrudes through the abdominal wall near the naval.
- hernias resulting from an incision (incisional) – these occur most commonly in people who are older or overweight. Normally they happen when people are inactive after abdominal surgery.
- hiatus hernia – part of the upper stomach squeezes through the opening between the diaphragm and the oesophagus.
Read more about different Types of Hernia
Causes of hernias
Hernias are caused by a weakness in the muscle or fascia combined with pressure which forces an organ or tissue through this weak spot. Sometimes people are predisposed to muscle weakness but lifestyle choices like smoking, obesity and poor nutrition can also weaken muscles.
Anything that puts pressure on the abdominal area can increase the risk of hernia including:
- lifting heavy objects
- diarrhoea or constipation
- persistent coughing or smoking
Among the symptoms of hernia to look out for are:
- a bulge or lump in the affected area
- pain or discomfort particularly when lifting, coughing or bending over
- weakness, pressure or heaviness in the abdomen
- a burning or aching sensation in the area of the bulge
- in the case of hiatus hernia, acid reflux, chest pain, difficult swallowing
If you suspect you may have a hernia, you need to visit your GP, or a specialist gastroenterologist that has experience with hernias.
The doctor will carry out an examination of the affected area. In the case of a hiatus hernia you will be referred for a barium X-ray or endoscopy.
It is important not to leave a hernia untreated as they can grow and become more painful. If sections of the intestine become trapped in the abdominal wall it can obstruct the bowel, causing severe pain, nausea and constipation.
The type of treatment recommended will depend on the type of hernia and its severity. In the first instance your doctor may recommend:
- Lifestyle changes: in the case of a hiatus hernia, for example, this might include eating smaller, more regular meals, avoiding lying down after a meal and keeping your body weight within healthy perameters
- Medication: this can have a beneficial effect in some cases, for example, with hiatus hernias. You may be advised to take antacids and/or H-2 receptor blockers and proton pump inhibitors.
- Surgery: if the hernia is increasing in size or causing pain, you may be referred for surgery. These days, surgeons operate laparascopically wherever they can. This uses a tiny camera and surgical equipment to repair the hernia using only a few small incisions. Recovery times are much faster than with traditional open surgery, however, not all hernias are suitable for laparoscopic repair.
You can take some simple steps to protect yourself and avoid giving yourself a hernia in the first place.
- Do not try to lift weights that are too heavy for you. Build up gradually.
- Bend your knees. Lift objects with your knees and not your back.
- Don’t smoke.
- Maintain a healthy body weight.
- Try to avoid straining when you go for a poo.
- Treat a persistent cough.