How can you tell if you’ve got a hernia and need treatment?

By Ken McEntee

For most people, the worst thing about a hernia might be the unsightly bulge that may protrude from a person’s groin or navel area. But left untreated, some hernias may develop increased risks of a dangerous condition, say Christopher Bohac, MD, and Liming Yu, MD, general surgeons at University Hospitals Geauga Medical Center.

A hernia, the doctors explain, is a hole or gap in a person’s abdominal muscles or connective tissue. The hole can be so small that a person never realizes he or she has a hernia. But sometimes the hernia is large enough to allow fatty tissue—or even loops of colon or intestines—to poke through, creating a bulge in the skin.

“What we worry about with hernias at the belly button or groin areas is that the portion of intestine that pushed through the hernia could get twisted, strangulated or perforated,” Dr. Bohac explains.

“That could become a life-threatening situation that most likely would require emergency surgery.”

Hernias, Dr. Yu says, are common and although they may be more common as people age, and their abdominal tissue weakens, children also can have a hernia. In fact, he says, children under the age of four or five are generally the only group in which an umbilical hernia may close on its own.

Hernias can be caused by naturally weak spots in the abdominal wall, or by trauma or injury after lifting heavy objects or participating in strenuous exercise. They also can develop around surgical incisions.

Types of hernias are identified by their location on the body. For example, an umbilical hernia is on the navel, while an inguinal hernia occurs in the groin, close to the pubic area.

“If you don’t see a bulge, any dull achy pain after physical activity could be a symptom of a hernia,” Dr. Yu says. “Doctors can diagnose hernias during a physical exam. For obese patients, CT scans or other imaging tools might be used to detect a hernia.”

Dr. Bohac says hernias with no symptoms pose little risk of a strangulated intestine.

“If you have even mild symptoms, your risk goes up significantly,” he says. “It’s still rather small, but it’s at that stage where treatment is recommended. It’s better to treat hernias when they are small and more easily manageable.”

Umbilical hernias that are larger than one centimeter are usually treated by closing the hole with suture, and placing a mesh to strengthen the area, Dr. Yu explains. Smaller hernias may not require mesh.

“There are some techniques where mesh isn’t used, but, in general, the rate of recurrence improves when mesh is used,” Dr. Bohac says. “Because the hernia is caused by some sort of derangement in the connective tissue around the musculature, the mesh reinforces that tissue much like the rebar in concrete.”

Hernia repair is usually outpatient surgery done under general anesthesia.

“The procedure is usually laparoscopic, using three small incisions,” Dr. Bohac says. “It’s a lot less painful and quicker to recover from than an old-fashioned incision.”

Following surgery, a patient can usually return to normal activity in about a week, but is advised not to lift anything heavier than 10 pounds for a week to six weeks, depending on the location of the hernia.

The surgeons at UH Geauga Medical Center are specially trained to provide the most advanced hernia management and treatment.

Visit UHhospitals.org/Hernia to learn more or call 440-901-1894 to schedule an appointment with a hernia specialist at UH Geauga Medical Center. The medical center is located at 13207 Ravenna Road in Chardon.