What is a hernia

An abdominal hernia is a hole in the 'abdominal wall'  through which your insides can protrude.

Have a look at this great picture. http://www.herniainfo.com/all-about-hernias/what-is-a-hernia

If you want the ‘official’ definition –

‘A hernia is the protrusion of an organ through the wall of the cavity
that normally contains it’

So with abdominal hernias the ‘organ’ is usually a part of the intestine or gut; sometimes it can be bladder. Other organs are not usually mobile enough to protrude

 

What causes hernias?

There seem to be so many types of hernias

Classifying hernias

Recurrent hernias

Slipped disc

Hiatus hernia

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What causes hernias?

Is it heavy lifting, or straining to go to the toilet? 

No-one really knows the true answer to this question – in medicine we say the cause is ‘multi-factorial’. There are a number of possible reasons, and usually you need two or more of them at a time.  So for instance you may have an inherited or developmental weakness, but you won’t get a hernia unless you also lift a grand piano or push a broken down car.

The hole or defect that the hernia pokes through will have come about in one of two ways.  EITHER through a natural opening that should have closed during the time we develop and has now reopened –

OR a man made (surgeon made!) opening in the abdominal wall that was closed after an operation, and has now opened up (see 'incisional hernia').

So examples of the first type – natural holes that have reopened - will be inguinal and umbilical hernias.

The second type, through a previous incision, are all called incisional hernias.

There seem to be so many types of hernias

Doctors seem to use different names for the same hernia?  Yes – that’s what doctors do (unfortunately) – lets look at:-

Classifying hernias

Usually hernias are described by where the hole is in the abdominal wall.  So an inguinal hernia occurs in the inguinal or groin region.  An umbilical hernia – at the umbilicus or navel, and an epigastric hernia occurs in the upper abdomen – known as the epigastrium.

Anatomically our back is our ‘dorsum’ (dorsal fin of a shark) and our front is the ‘ventrum’.   So epigastric hernias are also called ventral hernias. It can get a bit confusing when some doctors refer to diastasis or divarication, or epigastric hernias as ventral hernias - and I will explain more later.

Recurrent hernias

And note - if a previous hernia repair opens up again it is called a recurrent hernia not an incisional hernia.

Two confusing hernias


Slipped disc

1. Confusingly, (particularly in continental Europe) the word hernia is used to describe a slipped disc in the back.  That’s because the word hernia really means something popping out of the space where it is supposed to be, into another area or space.  So in the back, the inside of one of the cushions or discs that lie in between the individual vertebrae (bones of our spine) slips (or ‘herniates’) through its covering, and presses on a nerve.  NOTHING at all to do with the hernias we are talking about.

Hiatus hernia
 

2.  A hiatus hernia is where the stomach – (the hollow organ into which you swallow your food) pops up through a hole (hiatus = hole in Greek) into the chest cavity.  Its definitely not supposed to be there.  More about hiatus hernia later.

A bit of anatomy

The abdominal wall – its not made of bricks but of a strong layer of muscle.  It forms the front wall of a space called the abdominal cavity.  It is like  a large room and contains your intestines or guts – small and large bowel, and other internal organs . (Actually, if you have a ‘6-pack’, the abdominal wall does look a bit like a brick wall).