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Hernia: Classification and presentation

 In general terms, a hernia is defined as the protrusion of an organ or a part through a defect in the wall of the body cavity (usually the abdominal cavity) in which it normally lies. There are several different types of abdominal hernias, which can be classified depending on the location where they occur (inguinal, umbilical, femoral, etc), as well as on the age at which they occur.

Congenital hernias are present at birth, while acquired hernias develop in adulthood and may be due to blunt or surgical trauma, or to a weakening from any cause in the muscle wall of the abdominal cavity. It is important to note that a defect or a muscle weakness in the abdominal wall is only a predisposing factor for the development of an abdominal hernia, but it doesn’t necessarily cause it. However, provided that a defect or a muscle weakness in the abdominal wall is present, any condition or event leading to increased abdominal pressure (including obesity, pregnancy, constipation, persistent coughing or sneezing and lifting heavy object) can greatly increase the risk of hernia.

 Regardless of the type of hernia, the classic sing of herniation is a swelling or a bulge under the skin where herniation has occurred. This bulge or swelling varies in size and consistency depending on the size and nature of the protruding abdominal contents (called hernial contents), and in most cases does not cause pain on palpation, unless there are some complications.

 When hernial contents are freely movable and can easily manipulated back into their natural position, the hernia is said to be reducible. However sometimes it happens that hernial contents remain fixed in the abnormal location through adhesions with the surrounding tissues. In the last case hernia is said to be incarcerated or irreducible and can lead to serious complications, such as obstruction of the herniated portion of the intestine or necrosis (tissue death) of the herniated contents which causes severe pain and require immediate medical attention.

Hernia: when surgery is necessary

 Hernias are always treated surgically, although not all hernias need to be repaired and treatment is usually required only when hernias cause symptoms, become larger or are incarcerated. The outcome of hernia surgery is most often good. 

 When hernias are triggered by increased abdominal pressure, their worsening or recurrence can be prevented by simply avoiding the triggering factors. Some effective measures include losing weight or staying at a healthy weight, eating a high-fiber diet to avoid constipation, treating any condition causing persistent coughing, quitting smoking, and finally lifting heavy objects carefully.

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*Always seek professional medical advise from a qualified doctor before undergoing any treatment.

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