Hernia

On Wednesday I went to gym, and at the very end of my workout, while doing situps, a few more than I intended doing, I felt a lump a third of the size of a tennis ball, pushing through my abdominal area just to the right of my sternum. For a second I froze, and then the alien like head sank back into my guts. There was no residual painfilled sensation. But I have never experienced anything of the sort.

I am concerned that it is something fairly serious because:
a) I have been under all sorts of stress for the last few months. A fairly constant, high level of anxiety
b) I've felt a fair amount of discomfort in the upper and lower abdominals - almost a sort of bloated feeling
c) Just a sense of 'not being myself' - feeling weaker and less ohysically capable than in the past.

Thus I have turned to Google to find some answers. Here are some. Relevant info has been highlighted.

Almost all hernias in the muscle of the abdominal wall are the same thing, namely a 'window of weakness' that has opened up in the wall tissue.
The name, more than anything else, relates to the location of the hernia.

The effects of these hernias and the ways they are repaired are very similar in principle and we will now cover how they occur, what they do to you, which ones can be dangerous and the very different ways they are being repaired these days, depending upon who you go to.

The more you know and understand about hernia,
the better your chances of getting the best repair.

What is a Hernia?
A hernia (rupture) is usually noticed as a lump, commonly in the groin or the umbilical region. It appears when a portion of the tissue which lines the abdominal cavity (peritoneum) breaks through a weakened area of the abdominal wall.

This can give rise to discomfort as the hernia enlarges and can sometimes be
dangerous if a piece of intestine becomes trapped ('strangulated') inside.


I appear to have an epigastric hernia.

The most common location for hernia is the abdomen. The abdominal wall - a sheet of tough muscle and tendon that runs down from the ribs to the legs at the groins - acts as 'nature's corset'. Its function, amongst other things, is to hold in the abdominal contents, principally the intestines.
If a weakness should open up in that wall, and it does not really matter how or why it happened (more on this later), then the 'CORSET EFFECT' is lost and what pushes against it from the inside (the intestines) simply pushes through the 'window'. The ensuing bulge, which is often quite visible against the skin, is the hernia.

These 'windows of weakness' commonly occur where there are natural weaknesses in our abdominal wall - such as where the 'plumbing' goes through it. Examples of these are the canals (inguinal and femoral) which allow passage of vessels down to the scrotum and the legs, respectively. The umbilical area (navel) is another area of natural weakness frequently prone to hernia. Another area of potential weakness can be the site(s) of any previous abdominal surgery.

What to do about a HERNIA

The ONLY way to stop a hernia getting worse is to repair the defect surgically. There are, however, several ways of doing this and the results vary widely. What follows explains most of them and describes various aspects related to the different types of hernia.

How do Hernias happen?

The wall of the abdomen, comprising muscle and tendon, performs several functions, one of which is to provide strong support to the internal organs which are exerting significant outward pressure. The opening of a gap in the tissue can occur of its own accord at a point of natural weakness, or by over-stretching a part of the tissue. Overexertion can cause it, but so could a simple cough or sneeze.

Can Hernias get better?

The opening of a hernia cannot heal itself, neither can any medicine be used to cure the condition.
The long term course, therefore, is for a hernia to become steadily worse as time goes on, sometimes slowly and sometimes quickly.

The only remedy for the condition is to repair the hernia surgically, but that no longer means you have to be an invalid afterwards ...

A number of surgeons felt that none of the above methods was entirely desirable and over several years an altogether different technique was devised. This formed the basis for the method now perfected at The British Hernia Centre over thousands of cases.
Under local anaesthesia, a small incision is made over the site of the hernia. The peritoneal bulge is returned to where it belongs, as before, but the repair is achieved by placing a piece of fine (inert and sterile) mesh at the opening in the tissue. This is firmly held in place and the outer incision closed. The whole operation takes minutes to perform.

Unlike other techniques, even those now using mesh, our approach does not require any stitching together of the muscle tissue at all, thus eliminating the tension induced by other methods.

The healing process starts to take place immediately in that - sensing the presence of the fine mesh - the muscle and tendon send out fibrous tissue which grows around and through the
mesh, incorporating it in a way similar to the placing of the steelwork inside reinforced concrete.
It is not a 'patch' stuck on the outside, but a total, tension-free reinforcement inside the abdominal wall.

The results are also similar to the concrete analogy, in that the 'mechanical load' is spread over the whole area, precisely at the area of weakness, rather than on high pressure points of stitching through the deep, sensitive tissue with older methods. When performed correctly, this technique requires no bed, even after the operation. The patient is able to walk away from the theatre immediately after surgery.

The technique was originally devised as a much-needed alternative to re-stitching failed hernia operations (ie recurrences) done the old way. It was then realised that, as the technique was so very successful with recurrent hernias, it should be used for 'first-time' repairs and thus avoid recurrences altogether.



Information provided by www.hernia.org