There are all different types of abdominal wall hernias. These can include things like inguinal hernias (which are hernias located in your groin), ventral hernias (which are hernias that occur anywhere around your abdominal cavity), umbilical Hernias (which are hernias in your belly button), there are incisional hernias (which are hernias that develop from a previous incision). When you look at all of those, they're all generally the same in that they are defects or holes in the abdominal wall, and the hole is allowing something to bulge out and either cause pain or to cause a visible bulge. There is a different type of hernia called a hiatal hernia, which is a completely different entity from the other hernias that I've mentioned. This involves the stomach and the esophagus and heartburn and reflux and has nothing to do with the typical hernias that we talk about when we think about a bulge from our abdominal wall. The most common symptoms of a hernia (regardless of the location) are usually pain or discomfort or a bulge that is visible.
A common question that I get from people is: What is a hernia? A hernia really is just a hole that is in any wall that is supposed to be holding something in. You can have a hernia that occurs in your chest, in your head, in your abdominal cavity - sort of anywhere where you have a cavity. Specifically, when we're talking about the abdominal cavity, there are multiple places where you can develop a hernia. The most common places that you would see a hernia would be in the groin region, either on the right side or the left side or also in the belly button region or the umbilicus. Those are common areas because they are areas where people are actually born with these hernias. They are congenital defects. So if you think about it in terms of your belly button, we are born with an umbilical cord that travels through our abdominal wall and therefore we're naturally born with an umbilical hernia. Now, after you are born and the umbilical cord is cut, that hernia should close up and seal up so that you don't actually have a hernia later on in childhood or adulthood. In the groin, we have the same situation where during our development as a fetus, there are structures that pass through the abdominal wall in the groin and as they do that, they leave holes in the abdominal wall. These holes are supposed to close up as we continue to form as a fetus. Occasionally, they don't completely close and as a result, patients end up developing hernias that they see either in their childhood or later on in adulthood. Hernias can also occur at other locations of the abdominal wall where you may develop a weakness. Another common site for a hernia is from a prior incision. So in patients that have had either open or laparoscopic surgery, they could have had a large incision, they could have a really small incision - but those incisions (because they are slightly weaker than other parts of the abdominal wall) can actually open up and become hernias themselves.
Hernias are typically discovered either by the patient who notices a bulge (generally while they're taking a shower and they don't have any clothes on) or they go in to see their doctor who performs an annual exam and says, "Hey, by the way, did you know that you have a hernia?" They are usually visible and usually what you see as a bulge. Occasionally hernias can be smaller and they don't have a bulge, but they do cause pain. Under further examination - either with an ultrasound or an MRI - we can tell that a patient has a hernia.
Hernias are quite common but are definitely more common in men than in women. In men, about 20-25% of men will develop a hernia during their lifetime. For women, it's about 9-10%. Specifically we're talking about groin hernias or inguinal hernias, as those are the most common types that we treat. Nationwide, as a country we perform somewhere around 800,000-900,000 hernia repairs a year.
Hernias come in all different shapes and sizes. Small hernias that don't have anything bulging out are generally fairly safe and don't carry much risk. However, as hernias become larger and you find that contents are bulging out (especially if it's your intestine) then they can become quite dangerous and even life threatening. So there's sort of a wide spectrum of what you can find with hernias.
It's important to know that hernias can't really be prevented from occurring. If it's something that you are born with (as in the congenital types of hernias) then it will develop regardless of what you do. I would say that in general, there really isn't a way to prevent you from forming a hernia.
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