General and Gastrointestinal Surgery

Treatment

Hernias should be repaired surgically at a convenient time after they are discovered.  Like any medical problem you may have, Murphy's Law dictates that it will bother you when it is most inconvenient.  Unfortunately, there is no other treatment other than surgery that has significant success.

Can a hernia go away by itself?

No.  Once a hernia has developed it will not go away.  In fact it will get worse with time. The constant pressure on the area makes the hernia get bigger.  This leads to more frequent,  more intense and longer periods of discomfort.

Is there any treatment for a hernia other than surgery?

You may have heard of a truss. A truss is a belt with a large pad on it that applies pressure to the site of the hernia with the aim of keeping the bulge from popping out. Overall, a truss is not a good idea even though it may at times work. The truss does nothing to repair the hernia. It just minimize symptoms by preventing significant herniation through the defect in the abdominal wall.  As a result, the hernia will continue to get larger. In addition, there will be scar tissue formed that provides no strength to the area.  Both of these factors, enlargement of the hernia and scarring, make the surgical repair of the hernia more difficult and later recurrence more likely.  Therefore, a truss should only be used as a short term measure until surgery can be performed.

Why should I get it repaired?

Two obvious reasons for getting your hernia fixed are the frequent episodes of pain aggravated especially by prolonged standing or heavy lifting and the cosmetic deformity produced by having a bulge in your abdomen.  The main reason to have your hernia repaired is that there is always a chance that intestine will get trapped in the hernia and not be able to get out.  This produces a bowel obstruction.  A hernia whose contents will not come out is called an incarcerated hernia. An incarcerated hernia is almost always associated with unrelenting discomfort.  When bowel obstruction ensues, patients will usually have groin pain, abdominal distention and vomiting. If the bowel remains in the hernia too long, the blood supply can become compromised and the intestine can die. This leads to a catastrophic and occasionally fatal strangulated hernia. Years ago, hernias were the most common causes of bowel obstruction.  Today, with early treatment of hernias with surgery, incarcerated and strangulated hernias are rare.

What can I do before surgery to feel better?

Limiting your activity and any lifting may offer temporary relief.  You should avoid exercise, especially any that places strain on the anterior abdominal wall muscles. A truss may also offer temporary relief but should not be used for a long time.

Is hernia surgery a common operation?

Yes.  Each year approximately hundreds of thousands of Americans undergo a hernia repair.  It is among the most frequently performed procedures in this country.

Are there different types of surgery to repair an incisional hernia?

Yes.  There are two broad groups of surgical approaches to hernia repair, each having variations within it.  These are the traditional method of open hernia surgery and the newer method of  laparoscopic hernia surgery. In addition, different types of anesthesia can be provided for the hernia repair. These include local anesthesia, spinal or epidural anesthesia and general anesthesia.

Learn more about hernias