Hernias

Hernias

A hernia occurs when an organ or tissue protrudes through a weakened area in the surrounding muscle or connective tissue (fascia). In the digestive system, common hernias include hiatal hernias (stomach protruding through the diaphragm), inguinal hernias (intestine protruding through the abdominal wall in the groin), umbilical hernias (around the navel), and incisional hernias (at the site of previous surgery). Hernias can cause discomfort, digestive symptoms, and in some cases, serious complications if they become strangulated. At Blume Health, our gastroenterologists and surgeons provide comprehensive care for all types of hernias, from diagnosis to surgical repair using advanced minimally invasive techniques.

Treatable Condition
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CausesSymptomsDiagnosisTreatmentHome CarePreventionSurgery

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What Causes It?

Hiatal hernia: Weakening of the diaphragm muscle due to age, injury, or congenital factors

Inguinal hernia: Weakness in the lower abdominal wall, often at birth (congenital) or developing later in life

Umbilical hernia: Incomplete closure of the abdominal wall at the umbilicus during development

Incisional hernia: Weakness at the site of previous abdominal surgery

Increased abdominal pressure from chronic coughing, straining during bowel movements, or heavy lifting

Pregnancy and childbirth, which can strain abdominal muscles

Obesity, which increases pressure on abdominal tissues

Age-related muscle weakness

Chronic constipation causing repeated straining

Chronic obstructive pulmonary disease (COPD) causing persistent coughing

Ascites (fluid in the abdomen) creating pressure on the abdominal wall

Genetic factors affecting connective tissue strength (e.g., Ehlers-Danlos syndrome)

Signs & Symptoms

Hiatal hernia: Heartburn, regurgitation, chest pain, difficulty swallowing, and feeling full quickly

Inguinal hernia: Bulge in the groin area that may disappear when lying down, pain or discomfort, especially when bending, coughing, or lifting

Umbilical hernia: Visible bulge near the navel that may be more prominent when coughing or straining

Incisional hernia: Bulge near or at the site of a previous surgical scar, pain or discomfort in the area

General hernia symptoms: Feeling of heaviness, pressure, or weakness in the affected area

Pain or discomfort that worsens with physical activity

Burning or aching sensation at the site of the bulge

Digestive issues including nausea, vomiting, or constipation (particularly with hiatal hernias)

Signs of emergency (strangulation): Severe pain, nausea, vomiting, fever, rapid heart rate, or a hernia bulge that becomes red, purple, or dark

Some hernias may be asymptomatic and discovered during routine examinations

How We Diagnose

Our specialists use advanced diagnostic methods to accurately identify and assess your condition

Physical Examination

For many hernias, particularly inguinal, umbilical, and incisional hernias, a physical examination is the primary diagnostic method. The doctor may feel for a bulge in the affected area and may ask you to cough or strain to make the hernia more visible or palpable.

Upper Endoscopy

For hiatal hernias, an upper endoscopy (EGD) may be performed to visualize the stomach's position relative to the diaphragm and assess for complications like esophagitis or Barrett's esophagus. This involves passing a flexible tube with a camera down the throat into the esophagus and stomach.

Barium Swallow or Upper GI Series

A contrast X-ray study where you swallow a solution containing barium that coats the digestive tract, making it visible on X-rays. This can help identify hiatal hernias and other structural abnormalities of the upper digestive tract.

Imaging Studies

CT scans, MRI, or ultrasound may be used to confirm the diagnosis, assess the size and contents of the hernia, and plan for surgical repair, particularly for complex or recurrent hernias.

Treatment Options

Personalized treatment plans tailored to your specific needs and condition

1

Watchful Waiting

For small, asymptomatic hernias with low risk of complications, your doctor may recommend monitoring the condition rather than immediate intervention. Regular check-ups will help ensure the hernia isn't enlarging or becoming problematic. This approach is commonly used for small hiatal hernias and some inguinal hernias.

2

Lifestyle Modifications

For hiatal hernias, lifestyle changes similar to those for GERD are often recommended, including dietary modifications, weight loss, avoiding eating before lying down, and elevating the head of the bed. For other hernias, avoiding heavy lifting and straining may help prevent enlargement.

3

Medications for Symptoms

While medications don't repair hernias, they may help manage symptoms. For hiatal hernias, acid-reducing medications like proton pump inhibitors or H2 blockers can alleviate reflux symptoms. Pain medications may provide temporary relief for discomfort from other hernia types.

4

External Support

In some cases, particularly for patients who are poor surgical candidates, a truss or binder may be used to hold the hernia in place and prevent it from enlarging. This is generally a temporary measure or used when surgery isn't an option.

Home Remedies

Dietary Modifications for Hiatal Hernia

Avoiding foods that trigger reflux symptoms, eating smaller meals, avoiding lying down after eating, and maintaining a healthy weight can help manage hiatal hernia symptoms. Spicy foods, acidic foods, chocolate, and caffeine are common triggers to avoid.

Core-Strengthening Exercises

Gentle exercises to strengthen abdominal muscles may help support the area around some hernias, but should only be done under professional guidance to avoid worsening the condition. Improper exercises can increase abdominal pressure and aggravate hernias.

Avoiding Constipation

Maintaining regular bowel movements helps prevent straining, which can worsen hernias. A high-fiber diet, adequate hydration, and regular physical activity can help prevent constipation. Over-the-counter fiber supplements may also be beneficial.

Proper Lifting Techniques

When lifting is necessary, use proper technique: bend at the knees, not the waist; keep the object close to your body; avoid twisting while lifting; and exhale during the lift rather than holding your breath, which increases abdominal pressure.

Symptom Management

For minor discomfort, applying an ice pack to the hernia site may provide temporary relief. However, persistent or increasing pain should prompt medical evaluation, as it may indicate complications requiring immediate attention.

Prevention Tips

Maintain a healthy weight to reduce pressure on abdominal tissues

Lift heavy objects properly, using leg muscles rather than abdominal muscles

Strengthen core muscles through appropriate exercises recommended by healthcare providers

Avoid or manage chronic coughing by treating the underlying cause

Prevent constipation through high-fiber diet, adequate hydration, and regular exercise

Quit smoking, which can lead to chronic coughing and weaken tissues

Manage conditions that increase abdominal pressure (like COPD or chronic constipation)

Use proper form during strength training exercises

For patients with previous hernias, follow post-surgical instructions carefully to prevent recurrence

Consider wearing an abdominal binder during activities that increase intra-abdominal pressure if recommended by your doctor

Surgical Solutions

Advanced surgical procedures performed by our expert specialists

Open Hernia Repair

Traditional surgical approach involving a single incision over the hernia site to push the protruding tissue back into place and strengthen the weakened area with stitches or synthetic mesh. This approach may be preferred for certain complex or large hernias, or when minimally invasive approaches aren't suitable.

Laparoscopic Hernia Repair

Minimally invasive approach using several small incisions through which a camera and specialized instruments are inserted to repair the hernia. This technique typically results in less pain, faster recovery, and smaller scars compared to open surgery. Our surgeons are experienced in advanced laparoscopic techniques for various hernia types.

Robotic-Assisted Hernia Repair

Advanced minimally invasive technique using robotic technology to enhance precision and control during the procedure. This approach combines the benefits of laparoscopic surgery with improved visualization and maneuverability, particularly beneficial for complex hernias requiring intricate dissection and repair.

Hiatal Hernia Repair with Fundoplication

For symptomatic hiatal hernias, surgical repair involves returning the stomach to its proper position below the diaphragm, repairing the diaphragmatic opening, and often performing a fundoplication (wrapping the upper part of the stomach around the lower esophagus) to prevent reflux. This can be performed using open, laparoscopic, or robotic approaches.

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