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Inguinal hernia: Treatment, symptoms, advice and help

About Inguinal hernia

Inguinal hernia is a protrusion of abdominal cavity contents (intestine or fatty tissue) through a weakness in the abdominal wall. Inguinal hernia can be of two types namely direct (intestinal loop protrude through a fold in the groin) and indirect hernia (intestinal loop passes through the inguinal canal).

Inguinal hernia: Incidence, age and sex

Inguinal hernia is very common (life time risk is 27% for men & 3% for women) and affects an individual of any age. Indirect hernia is more frequent than direct hernia and affects only men. However, direct hernia can affect both sexes and especially the elderly individuals.

Signs and symptoms of inguinal hernia: Diagnosis

The patient complains of swelling and/ or discomfort in the groin or pain which gets referred to the testicle during heavy work or on doing strenuous exercise. The affected individual may also experience a feeling of heaviness in the groin region.

The affected individual should be examined in a standing position. The doctor looks for a swelling in groin region which may become obvious on coughing. The diagnosis of inguinal hernia is clinical only and does not require any investigations.

Causes and prevention of inguinal hernia

The hernia usually occurs as a result of weak lower abdominal musculature. Predisposing factors include smoking and jobs involving straining and heavy lifting. Other factors like pregnancy, aging and straining while defecating may also contribute to weakening of abdominal muscles. Damage to the ilioinguinal nerve which may occur during appendix surgery is another cause. Patients prone to hernia are advised to stop smoking and avoid activities that increase intra-abdominal pressure (heavy weightlifting) and maintain ideal weight.

Inguinal hernia: Complications

An untreated hernia will gradually increase in size. The swelling may become irreducible, the contents may become inflamed (Incarcerated hernia) or the lumen of the visceral content may obstruct leading to intestinal obstruction. The most serious complication is the strangulation of the intestinal loop wherein the blood supply of affected intestinal loop is cut off. This is a medical emergency which must immediately be handled.

Inguinal hernia: Treatment

Surgery is the treatment of choice which can be either by open or by laparoscopic approach. The surgery involves dissecting out and opening the hernial sac and reducing the contents and then transfixing the neck of the sac and removing the remainder. It is sufficient for the treatment of hernia in the young. General anaesthesia is needed in both open and laparoscopic surgical approach. The surgery of inguinal hernia is safe and usually the individual recovers completely within a week.