Hernia
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
Further,
it can be classified as:
- Bulging
- Sliding
It
can also be classified as:
- Reducible – which
get back easily to original position
- Non-reducible –
which will not get reduced due to strangulation or obstruction
According
to region
- Inguinal
- Femoral
- Umbilical
- Epigastric
- Hiatus
Inguinal
hernia – is
the most common hernia occurring in the groin (the lowest part of abdomen or
pot belly near the junction of thigh). Weakness, ageing, strain and pregnancy
are the major precursors for this type of hernias. Inguinal hernia can be
classified further into
- 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.
Femoral
hernia –
Even though it can occur in any sex, fat women above the age of 40, who have
given birth to multiple children, are more vulnerable to femoral hernia. This
type of hernia lies below the pubic tubercle whereas inguinal hernia lies above
it. When attempting for reduction, it goes first medially, then backwards and
then upwards.
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.
Prevention
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
Give
support to the part
- With hand while
coughing or passing stool or urine to avoid increase in size
- Truss / bandage /
padding / belt can be used as a supporter
General
treatment
Other than
umbilical hernia in infants, no other hernia heals on its own. Hernia
management ultimately depends on the nature of site, its intensity, pain,
reducible characters and risk factors. Even though hernia can be managed and
supported well with truss / hernia belt / padding, they can in no way cure it.
For curing, one should opt for surgery.
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.
for
new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
Clinic : +91-452-233-8833 |
E-mail: drcheena@gmail.com
(Disclaimer: The
contents of this column are for informational purpose only. The content is not
intended to be a substitute for professional healthcare advice, diagnosis, or
treatment. Always seek the advice of healthcare professional for any health
problem or medical condition.)