A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are enclosed in the thin membrane that naturally lines the inside of the cavity. Although the term hernia can be used for bulges in other areas, it most often is used to describe hernias of the lower torso (abdominal-wall hernias).
Hernias by themselves may be asymptomatic (produce no symptoms), but nearly all have a potential risk of having their blood supply cut off (becoming strangulated). If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency as the tissue needs oxygen which is transported by the blood supply.
Hernia Symptoms and Signs
The signs and symptoms of a hernia can range from noticing a painless lump to the painful, tender, swollen protrusion of tissue that you are unable to push back into the abdomen (an incarcerated strangulated hernia).
It may appear as a new lump in the groin or other abdominal area. It may ache but is not tender when touched. Sometimes pain precedes the discovery of the lump. The lump increases in size when standing or when abdominal pressure is increased (such as coughing). It may be reduced (pushed back into the abdomen) unless very large.
Types Of Hernia
Abdominal wall hernia: Also called an epigastric or ventral hernia; affects 1 person in 100 nationwide. Technically, this group also includes inguinal hernias and umbilical hernias. Indirect inguinal hernia: This affects men only. A loop of intestine passes down the canal from where a testis descends early in childhood into the scrotum. If neglected, this type of hernia tends to increase progressively in size (a "sliding hernia") causing the scrotum to expand grossly. Direct inguinal hernia: This affects both sexes. The intestinal loop forms a swelling in the inner part of the fold of the groin.
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Femoral hernia: This affects both sexes, although most often women. An intestinal loop passes down the canal containing the major blood vessels to and from the leg, between the abdomen and the thigh, causing a bulge in the groin and another at the top of the inner thigh. Umbilical hernia: This affects both sexes. An intestinal loop protrudes through a weakness in the abdominal wall at the navel (but remains beneath the skin). Hiatal hernia: This affects both sexes. A loop of the stomach when particularly full protrudes upward through the small opening in the diaphragm through which the esophagus passes, thus leaving the abdominal cavity and entering the chest. Incisional hernia: This is a hernia that occurs at the site of a surgical incision. This is due to strain on the healing tissues due to excessive muscular effort, lifting, coughing, or extreme pressure.
In general, all hernias should be repaired unless severe preexisting medical conditions make surgery unsafe. The possible exception to this is a hernia with a large opening. Trusses and surgical belts or bindings may be helpful in holding back the protrusion of selected hernias when surgery is not possible or must be delayed. However, they should never be used in the case of femoral hernias. Avoid activities that increase intra-abdominal pressure (lifting, coughing, or straining) that may cause the hernia to increase in size.
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