Bulging Out

Hernias are painful and sometimes life-threatening, so it’s helpful to know the symptoms and what causes them.

A hernia is a bulge caused by tissue pushing through the wall of muscle that’s holding it in. Most cases occur in the stomach or groin areas.

Anything that causes increased pressure in the abdomen can give rise to a hernia, including lifting a heavy object without stabilising the abdominal muscles, diarrhoea or constipation, and persistent coughing or sneezing.

The more common types of hernia are inguinal, femoral, incisional and paraumbilical.

• Inguinal hernia
  An inguinal hernia affects the groin or scrotum. It usually occurs when tissue bulges through the abdominal muscles and into the groin, and often feels like a round lump. It may form over a period of weeks or months, or it may occur suddenly, such as after you have been lifting weights, coughing, bending, straining or laughing.
  
  Men are eight times more likely to get inguinal hernia than women.
  
• Femoral hernia
  Femoral hernia occurs in the groin area when abdominal tissue bulges through a weakness in the abdominal wall and moves into the upper part of the thigh. The hernia follows the femoral canal, a narrow passage that carries blood vessels to the leg.
  
  Femoral hernia can be difficult to diagnose and is often mistaken for inguinal hernia, a lymph node or a benign fatty tumour. It is more common in women, especially those who are obese or pregnant.
  
• Incisional hernia
  In incisional hernia, the intestines push through the abdominal wall at the site of a previous abdominal surgery. It most often occurs along a vertical incision and can happen months or even years after surgery.
  
  This type of hernia is more common in the elderly, those who are obese, and those who have had lung problems or a wound infection after surgery.
  
• Paraumbilical hernia
  Where umbilical hernias are common in infants, paraumbilical hernias apply to adults. This happens when weakness in the muscles or ligaments around the navel allows abdominal contents to push through.

For all types of hernias, the most serious complication that can occur would be when the intestines bulge out and get trapped. The blood supply to the intestines can be compromised, thus killing the intestines. Should its contents spill out, serious infection and even death can occur.

No medication is suitable; the only treatment option is surgery to repair the defect and/ or strengthen the muscles.

Any hernia whose contents bulge out, becomes painful and cannot be pushed back requires emergency surgery, hopefully before the intestines turn gangrenous and severe infection sets in.