Inguinal Hernias—20 Important Life-Saving Facts

INTRODUCTION  

An inguinal hernia takes place when tissue or part of an organ (e.g., the intestines, the stomach, etc.) abnormally pushes through a weakened part of a muscle/wall, thus now protruding into another hitherto inaccessible area, such as the inguinal canal (in inguinal hernias) or outside the human body (in umbilical hernias). 

The bulge or mass that goes though such impromptu, unnatural opening can be uncomfortable, aesthetically troublesome and, yes, painful—especially when bending over, engaging in strenuous activities, straining (such when defecating), lifting heavy objects or even coughing.

 IMPORTANT LIFE-SAVING FACTS YOU SHOULD KNOW  

--Although an inguinal hernia is generally not dangerous or life-threatening, it can be rather burdensome and something that you may not be able to hide for very long; it can also escalate, in time, to something that is dangerous and even life-threatening (if it becomes incarcerated or strangulated). 

 --Inguinal hernias don’t heal themselves or get better with time; at best, they may remain stable (i.e., not grow by much) for a time. 

 --Whether your doctor recommends surgery will depend on many factors, including whether you have additional medical conditions (diabetes, heart problems, etc.) that can make surgery dangerous, unless it is absolutely necessary. 

 --If your hernia is very large, interfering with your work responsibilities or daily activities, very painful/uncomfortable, or simply affecting you in a negative way (such as by making you feel like a “freak” for having something that is often impossible to hide) psychologically, then your doctor will most likely suggest surgery. 

 --If surgery is suggested, keep in mind that inguinal hernias are very common and something that surgeons today are very familiar with and highly experienced in fixing; additionally, inguinal hernia surgery is considered to be a very safe procedure and one that, barring complications, will allow you to go back to your regular activities in a relatively short time. 

--The symptoms & signs of an inguinal hernia include: 

• An aching or burning sensation at the protruding mass (the hernia)
• An abnormal, palpable and usually-visible bulge or mass on either of your pubic bone’s 2 sides; it generally become more noticeable when coughing, straining or standing
• A dragging or heavy sensation in the groin area
• A troubling pressure or weakness in the groin area
• Possibly, swelling and/or pain in the vicinity of the testicles or inside the scrotum, if parts of the intestines descend therein
• Aesthetically-troubling psychological considerations

 --In some cases, you may be able to push a hernia back where it belongs, especially lying down, but this isn’t necessarily recommended; at best, this is only a stop-gap quick fix that doesn’t last for very long. 

--Two things that can bring some relief (until you get surgery) are applying ice packs (for the swelling) and lying down while keeping the pelvis higher than your head. Of course, these are only stop-gap measures, not permanent solutions!

 --In babies or newborns inguinal and umbilical hernias (two of the most common hernias seen in infants) can come about as a weakness in the abdominal wall still developing after birth.  In these cases, hernias may only be visible when the child is coughing, crying or straining (such as if attempting to have a bowel movement).  The child may exhibit irritability or a diminished appetite.  Of course, noticing these things can be very valuable since, after all, babies can’t communicate what they feel. 

 --Fortunately, older children can communicate how they feel, though they may not know how to put it into words.  You may, therefore, have to depend on what you observe yourself, including a mass or bulge that is more apparent when the child strains to defecates, cries or coughs, even if the bulge disappears when the child is lying down or is otherwise relaxed.  The fact that the bulge disappears for a while doesn’t mean that it isn’t something to keep a close eye on. 

 --If you can’t push the hernia back into place, it may be due to the fact that the mass/bulge has gotten trapped or lodged in your body’s abdominal wall.  While tissue incarceration isn’t necessarily life-threatening, it can set the stage for something that is potentially fatal: “tissue strangulation.” 

--If the mass/bulge becomes trapped to the point of not getting proper amounts of oxygen & nutrition-carrying blood (what is called “strangulation”), then things like infection, gangrene and necrosis can set in.  To put it in simple terms, these things mean that the affected tissue is spiraling downwards, biologically speaking, toward irreversible cellular death.  Unfortunately, if this process (which will have a domino effect unless reversed or stopped) isn’t dealt with promptly and effectively, you can die. 

--As a general rule, seek immediate medical care if you experience one or more of these symptoms after being diagnosed with any kind of hernia: 

• Vomiting or nausea or both
• A fever
• Intensifying pain
• A bulge/mass that becomes noticeably darker or that changes color
• Difficulty emitting flatulence or defecating 

 --By all means, consult a doctor if you see or feel a mass or bulge on either of the two sides of your pubic bone in the groin area.  This mass usually becomes more noticeable if you are standing, straining or engaged in strenuous activities.  

 --While a hernia isn’t necessarily an emergency or something you need to be running to your doctor about, it is something to be taken seriously, especially if it

• feels painful & uncomfortable,
• it is interfering with your daily (work, school, social, etc.) activities,
• it is getting noticeably larger,
• it turns a darker color, or,
• most important of all, it feels as if it has become tightly lodged in place—something termed “incarceration”; while incarceration is generally not life-threatening, it is a good reason to have surgery soon. Untreated, incarceration can escalate to strangulation, which is life-threatening and does require immediate surgical intervention.  

--Although inguinal hernias don’t always have a clearly-delineated cause; some risk & contributing factors and known causes can include: 

• The pressure normally present within the abdominal cavity increasing suddenly or gradually
• A congenital defect in the abdominal wall that rendered a section in the wall relatively weak
• The likely possibility of a congenital-defect weakened wall & increased abdominal pressure
• Highly strenuous activities & exercises
• A chronic or persistent cough; sneezing fits
• Pregnancy
• Lifting excessive amounts of weight 

 --For many people, the abdominal wall’s weakness that allowed or precipitated an inguinal hernia to occur has most probably been around since birth, if the abdominal lining or peritoneum didn’t close when (or in the usual manner) it was supposed to.  Then again, muscular walls can also weaken because of disease, excessively strenuous activities, chronic coughing, or simply getting older.  

 --The abdominal walls may also succumb to structural weakness because of trauma or after having undergone one or more abdominal surgeries, especially the type that didn’t heal properly, got infected or didn’t include a mesh or other substances meant to strengthen an area operated upon because of a hernia. 

--When it comes to men, the weakened area is usually near the inguinal canal, the place where the spermatic cord normally descends into the scrotum.  For women, the inguinal canal normally houses a special ligament that helps to keep the uterus in its proper location; a hernia can occur (or the stage can be set for one) when the uterus’ connective tissue becomes attached to the pubic bone’s tissue.  

 --The risk factors that can contribute to your possibly one day developing an inguinal (or other types of hernias) include: 

• Aging (muscles weaken as you get older)
• Being a man (males are 8 times more prone to inguinal hernias than women)
• Being Caucasian (apparently, inguinal hernias are statistically more common in whites than in other races)
• Having a history of hernias in the family (in other words, there is a genetic predisposition)
• Chronic coughing (maybe from smoking) or abnormal sneezing fits
• Chronic or persistent constipation
• Pregnancy (being with child can both weaken abdominal muscles & lead to greatly increased abdominal pressure)
• Obesity (being overweight can also be a contributing factor)
• Low birth weight & being born prematurely
• Previously being operated, especially for a hernia; this includes operations that occurred during childhood

 --Some of the most common complications for an inguinal hernia include:

• Incarcerated hernia (if the mass/bulge gets trapped to the point of not being able to freely move in and out of the hole it went through)
• Abnormal pressure being put on surrounding tissue or organs; this can lead to damage of nerves, blood vessels, etc., if, for example, there is constant friction and/or excessive pressure
• Strangulation--this is, by far, the worst symptom you may experience and one that usually requires immediate surgical intervention; in best case scenarios, such a thing may make it hard to go to the bathroom, but, if tissue damage is occurring because of a cut off blood supply, then your life may be in danger, unless you seek immediate medical assistance! 

 CONCLUSION 

An inguinal hernia doesn’t have to impede you from enjoying your life or meeting work and family responsibilities.  It also doesn’t generally threaten your life, unless, of course, complications arise, you fail to have the hernia properly monitored (and if necessary) and treated, or strangulation becomes a looming possibility.

For your part, don’t take any chances, once you discover or are told that you have an inguinal hernia.  By all means, have the situation assessed by a physician. In most cases, a treatment plan can be developed which should alleviate, if not completely resolve, the issue to your advantage.  

Copyright, 2018.  Fred Fletcher.  All rights reserved.  

REFERENCES 

https://www.abingtonhealth.org/healthy-living/health-news/library/articles-related-to-general-health/6-facts-about-hernias/#.WkE0JlWnGM8

https://www.mayoclinic.org/diseases-conditions/inguinal-hernia/symptoms-causes/syc-20351547

https://www.healthline.com/health/direct-vs-indirect-hernia

https://www.healthline.com/health/inguinal-hernia#prevention-and-outlook

http://luminbariatric.com/inguinal-hernia/what-is-inguinal-hernia/