His and Hers Hernias

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It's a problem you probably associate with men, but women can suffer from hernias too.

Getting the right diagnosis can take time, however, because symptoms often mimic pelvic pain and may worsen during menstrual periods.

So how do you know when its a hernia and not something else? Below, William Huether, MD, and Jean Miner, MD, general surgeons, at AdventHealth, explain what you need to know.

What Is A Hernia?
A Hernia is an area commonly in the abdominal wall that becomes thin, weak or separated, allowing fatty tissue or internal organs to push through the small opening often leading to tremendous pain.

Hernias are classified by their location in the body. The various types include:

  • Epigastric hernia: occurs between the navel and breastbone
  • Hiatal hernia: develops when a portion of the stomach protrudes through the diaphragm.
  • Incisional Hernia: forms at the site of a previous abdominal surgery.
  • Umbilical hernia: found in the belly button area and is more common among women, especially after pregnancy .
  • Inguinal hernia: occurs in the groin when the torso meets the thigh (called the inguinal crease)
  • Femoral hernia: develops just below the inguinal crease toward the inner thigh. These tend to be more common in women because of the wider bone structure of the female pelvis.

Am I At Risk For A Hernia?
Anything that increases pressure on the abdominal area can contribute to your risk, such as pregnancy and vaginal childbirth; chronic cough from smoking, asthma, bronchitis, postnasal drip or gastroesophageal reflux disease frequent constipation with straining; heavy lifting; or being overweight.

Additional risk factors include:

  • genetics (hernias tend to run in families)
  • aging, because tissues weaken over time
  • smoking
  • history of abdominal surgery, such as a C-section or abdominal hysterectomy

What Are The Warning Signs?
In men, a hernia usually created a visible bulge that's easily detected, but in women, hernias are often very small, deep in the abdomen and rarely cause any bulging, which may be why they're harder to diagnose.

Some women may have chronic deep pelvic pain, or bouts of acute, stabbing pain that comes on quickly and lingers. Sometimes, these symptoms mimic gynecological conditions such as endometriosis, cysts or fibroids.

A hernia typically causes discomfort, burning or sharp pain in the affected area. Pain worsens when there's an increase in abdominal pressure, such as when you bend over, cough or lift heavy objects and can be reproduced by pressing directly on the spot. The pain generally improves when you lie flat on your back. If there is a distinct bulge, it usually will go away when you lie down.

The pain can be constant if the piece of fat or tissue is caught in the hernia defect or occasional if tissue gets pinched (for instance, during certain activities).

If you have any of these symptoms, see your physician and ask whether the problem could be a hernia. You may be referred to a general surgeon for further evaluation.

Help For Hernias
Once a hernia develops, it won't resolve itself. Ideally, conservative methods, including medications and physical therapy, may help the pain and symptoms. If those fail, open, laparoscopic or robotic surgery may be used to repair the weakened area and typically mesh is used to strengthen and reinforce the tissue.

Most patients heal from laparoscopic or robotic surgery in about two weeks and are able to resume normal activities with no lingering pain.

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