A hernia occurs when there is a tear or weak area in a muscular wall that contains an internal organ. This causes the organ to push through the muscle and protrude out into other areas. Hernias are common in the abdomen around the hip and chest areas.
There are different types of hernias that patients may experience. Inguinal hernia, epigastric hernia, incisional hernia, hiatal hernia and umbilical hernia are the most common types of hernias in Singaporeans.
| Types of hernia | Causes of hernia |
|---|---|
| Inguinal hernia | Occurs when organ pushes through weak spot in muscular wall, causing it to bulge outwards |
| Epigastric hernia | Occurs when a part of the intestine pushes through opening in stomach or abdominal muscles |
| Incisional hernia | Occurs when a surgical wound has not healed properly, resulting in protrusion of tissues such as an intestine or organ |
| Hiatal hernia | Occurs when part of the stomach bulges through the diaphragm to move towards the chest |
| Umbilical hernia | Occurs when a part of the intestine pushes through a hole in abdominal wall near belly button |
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Hernias can be present in children and adults in Singapore. They tend to be due to weakened muscles that are present since birth or weakened due to trauma. Pregnancy or being overweight may put a strain on the abdominal area. Due to the pressure, a gap may form causing an organ to bulge out through the muscular wall separating it from other organs.
A hernia can disappear or be pushed back in when the patient is lying down or in a certain position. However, it is important for hernias to be addressed immediately as they can be life-threatening.
Hiatal hernias will not show signs outside the body as the hernia is occurring internally, unlike inguinal hernias or umbilical hernias.
Some causes of hernias may include:
| Type of Hernia | Symptoms |
|---|---|
| Inguinal hernia | Bulge and pain near the groin area when bending, coughing, or lifting |
| Epigastric hernia | Nausea or vomiting and/or difficulty urinating |
| Incisional hernia | Burning sensation at bulging area and/or constipation due to blockage at intestines |
| Hiatal hernia | Heartburn due to buildup of acid from stomach to esophagus and/or black stool due to bleeding in the intestines |
| Umbilical hernia | Sharp pain in abdomen and swelling and/or discoloration at belly button area |
Hernias are typically disruptive to daily life as they tend to worsen if left untreated. They can become life-threatening as they can cut off blood supply to the tissues. This is because the hernia has become strangulated due to the organ bulging through the muscular wall.
Hernias will present mild to severe pain as well as difficulty in exerting yourself physically. There will be a sensation of pressure or an ache that is intermittent or constant.
In children and babies, a hernia can lead to necrotizing enterocolitis (NEC) which is the inflammation of the intestines. It is not only extremely painful but also dangerous.
Hernias can only be repaired through surgery to close the tear or gap in the muscular wall.
Hernias are a common condition in Singapore but the following groups of people are more susceptible:
Hernias tend to present in older age groups due to trauma to the abdominal area or weakened muscles. With that said, hernias can also be present in children as young as 0 to 5 years old.
In Singapore, men have a higher risk of developing hernias than women. If they are older, the risk is increased.
Smokers are also susceptible to developing hernias. This is because nicotine is responsible for weakening the abdominal wall. Smoking also decreases collagen formation which makes it difficult to heal from a surgery to remove a hernia. There may also be recurrences in developing a hernia.
It is important to be aware of any symptoms you are experiencing that may suggest a hernia. This is to ensure you can receive medical attention immediately and prevent complications from occurring.
A hernia can be diagnosed through a physical examination. It is easy to spot hernias because of the protrusions of the organ outside your body. You can visit a specialist to discuss a surgery to fix the hernia. Hernias can become larger and more painful if you do not seek treatment as soon as possible. They also do not go away on their own.
Hernias can be treated through open surgery or laparoscopic surgery. These procedures repair the abdominal wall and put the organ back into its position. Patients are put under intravenous sedation or general anaesthesia depending on the size of the repair.
A traditional method of surgery for hernias is open surgery. During this procedure, a cut is made in the affected area such as the groin. The hernia is then pushed back into its position and the abdominal wall is made stronger with stitches or synthetic mesh. The incision is later closed with stitches to ensure that a hernia does not happen again.
Laparoscopic surgery is a minimally-invasive surgery. The surgeon will use a laparoscope which is a telescope-like instrument and insert it through an incision at the belly button. Incisions will be closed with stitches. This procedure is less painful than an open surgery and has a much shorter downtime.
Hernias will not resolve with medications and the possibility of serious complications like obstruction of the intestines can occur. Besides, the discomfort from the hernia often impedes the individual in carrying out activities like lifting loads, long walks and hiking, gym exercises and even travelling.
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