Everyone knows that an overstretched part will normally give way or tear or burst. For example an overblown balloon can burst at its weak point. Likewise, in our body, due to overstretching or weakness, any part can give/tear and simultaneous propulsion of internal parts happens through them. This pop up is called hernia. Hernia is a protrusion of internal organs through an abnormal opening. It can occur in any weak part of the body which allows the part to protrude.
Incidences and causes – Hernia may develop in any part of the body; however, it occurs most commonly in the abdominal walls. Any increase in intra-abdominal pressure contributes for hernia formations. The incidences of tear mostly coincide with weakness of abdomen after obesity, pregnancy, multiple deliveries, diseases of the abdomen which makes it bulge or weakens it. Likewise, strain in lifting heavy objects, strenuous coughing, strain while passing stool or urine, standing continuously for a long time, putting on weight can also initiate popping of hernia.
Hernial sites – Even though hernia can occur anywhere, the commonest hernial sites (weak spots) are inguinal region, femoral region, umbilical area, epigastric area and in diaphragm (which splits chest from abdomen). According to the site, nature of sac, contents, covering may differ from one place to another. Normally, skin, superficial fascia, ligaments and fatty tissues are the coverings.
Types – Hernia can be classified in a different way:
- Congenital – by birth i.e., development disorders
- Infantile – during infant stage due to weakness
- Senile – due to weakness in elderly persons
- Traumatic – due to injury or strain
- Reducible – which get back easily to original position
- Non-reducible – which will not get reduced due to strangulation or obstruction
- Incomplete hernia – hernia which has not reached the scrotum
- Complete hernia – hernia that has reached the scrotum
- Direct hernia – hernia that comes directly forward. This type is more common in aged people irrespective of sex. It is usually bilateral and small. It will usually respond quickly to direct pressure and even just by lying down.
- Indirect hernia – hernia that passes through inguinal canal are called indirect hernia. It can occur at any age but can be seen only in men and it will be mostly unilateral. When attempting for reduction, it usually goes back into the abdomen by receding upward, backward and laterally.
Umbilical hernia – is also one of the commonest types of hernia occurring more commonly in infants irrespective of sex. This type of hernia protrudes through umbilicus. It commonly arises due to development defect, premature delivery and in children who cry a lot, who cough a lot, and who strain a lot at stool. In adults, weak umbilicus gives way to protrusion in obese and multi-para female.
Epigastric hernia – occurs in median line in epigastric region i.e. just in front of stomach Hiatal hernia – means protrusion of stomach into chest through diaphragm.
Incisional hernia – means hernia occurring at the site of surgical incision. It can be compared with worn out thread in the stitch. It occurs due to strain or improper healing.
Symptoms – Symptoms of hernia varies according to the site, contents, intensity and aggravating factors. Mostly symptom may appear on standing or at strained time and it may subside automatically after lying down. Usually, many of the hernias are symptomless, other than mere swelling. Occasionally, pain may occur in hernia as it increases in size. The pain may be tearing/pricking in character. Other than pain & discomfort, abdominal bloating, tenderness, gas trouble, vomiting, constipation, leg pain, scrotal pain, hydrocele (fluid collection in the scrotum) may occur.
Diagnosis – Hernia will be usually ascertained with the character of swelling i.e., its temperature, tension, tenderness, consistency, position, size, shape, margin, mobility, movement with respiration, pulsating nature, resonance on tapping, impulse on cough, presence of scar in hernia, etc. Examination of abdomen, groin area, spermatic cord, scrotum, testis, epididymis, should be done in standing posture and lying posture and also with cough or strained impulse (which increases abdominal pressure).
Complication – Patience and time takes one to natural healing for many complaints, but in the case of hernia, the delay will usually lead to increase in size, pain and pressure with chances of twist and its complications i.e., strangulation, obstruction, gangrene, necrosis, infection, adhesions, etc.
Avoid strain which can increase the abdominal pressure such as
- Weight lifting
- Chronic cough
- Passing urine with great difficulty (enlarged prostate)
- Straining at stool due to constipation, piles, fissure, etc.
- Gaining weight
- Taking full and heavy meal
- With hand while coughing or passing stool or urine to avoid increase in size
- Truss / bandage / padding / belt can be used as a supporter
Since hernia is treated as a surgical disorder, the patient will be forced to undergo surgery in either reducible or irreducible hernia to lead a peaceful life again. Also, as hernia gets worse over time and strain, it is better to opt for surgery in the initial period itself.
Surgery – According to the place and size, hernias are repaired surgically (i.e. Herniorrhaphy – with or without plastic / nylon mesh). This normally prevents intestinal damage and further complications. Surgical correction also relieves swelling, discomfort, and pain immediately. Surgery always outweighs the risk of strangulation, obstruction and other complications. Elective surgery is usually performed in cases of reducible and emergency surgery will be conducted in case of non-reducible hernias.
Homeopathic treatment – Homeopathy works well in chronic complaints and tumours. Lots of patients come for Homeopathy treatment for hernia fearing surgery. In fact, hernia is not at all a disease, it is just like a tear which surely needs to be stitched. More the tear, more will be the bulge and there will be more chances for strangulation and pain. But it is better to opt for surgery to avoid complications. Homeopathy can only treat pain and discomfort.
Many would like to manage than correct surgically since most of the time it remains a painless swelling and also it cannot be seen by others to cause embarrassment. Anyway, patients should be aware of hernia i.e. its type, content, need for surgery, risks, complications, etc., before leaving it untreated or opting for management. Regarding management, hernia in the initial stages can be managed well with care (restrictions) and medicines. Any way cure is impossible.
Also patients should be aware that even after surgery one should be careful (as before surgery) since it may recur. The stitched part will not be the same. Even though stitched, the surgical incision is a weak spot, so it needs to be taken care of or otherwise the tear may recur. Likewise, after surgery, many a time, people continue to strain at their job and ultimately end up in surgery again. So, they should go for a lighter job than persist with the previous one that makes them strain and get more complications.
Some times, in extreme cases, surgical repair may not be possible due to its extensive damage or unfavourable condition to perform the surgery. In such cases, medicines can be tried to support the muscles with supports and restricted habits to avoid complications.
Homeopathic medicine commonly used for treating hernia are Arnica, Causticum, Cascara, Cocculus, Colocynthis, Lycopodium, Mag carb, Nitric acid, Nux vom, Rhus tox, Silicea, Sulphur, Veratrum album, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.