Could that painful bulge be a hernia?

hernia1Your time at the gym has been cut short because of a stabbing pain in your abdomen. And when you bend down to pick up your gym bag, you notice a peculiar bulge in your stomach. It protrudes when you’re straining and retracts when you’re standing still.

This unusual bulge could be a hernia. They occur in at least two percent of men, according to a report published in the archives of the US National Institutes of Health’s National Library of Medicine. Abdominal wall hernias, which are the most common type of hernia, occur in approximately 15 out of 1000 Americans each year. More than 700,000 hernias are repaired each year in just the US, and more than 20 million are repaired around the world annually.

Although this is a seemingly common medical condition, it can be very painful and potentially life-threatening if not evaluated and taken care of in a timely manner.

Scott & White Bariatric Surgeon, Robert O. Carpenter, MD, MPH, Scott & White – Temple, explains why hernias occur and how these troublesome bulges can be prevented.

What is a hernia and how does someone develop one?

A hernia occurs when an organ protrudes through the cavity that contains it. This can occur in many different places inside the body, but is most common in the abdomen.

Hernias occur over time as increased pressure is applied to the abdomen. This pressure can come from several different sources, including:

  • Constipation
  • Prostate problems – straining during urination
  • Obesity
  • Heavy Lifting
  • Smoking

Although many of these factors can cause a hernia or make an existing hernia worse, sometimes the potential for a hernia can begin in utero.

“The gonads, which will become the testicles in a man, start basically way up inside the body behind the abdominal cavity where your kidneys are as an adult. Over time, as the fetus grows, they come to rest in the pelvis. Then the testicles are drawn out through a deep layer of muscle, which creates a hole in the abdominal wall,” Dr. Carpenter said. “Sometimes that hole never closes and you end up with a hernia in childhood, which is called a congenital hernia.”

If the hernia doesn’t occur in childhood, sometimes a lifetime of hard work, constipation, obesity and other risk factors can wear out that hole to the point where the lining of the abdominal cavity and even the contents of the abdominal cavity can come out through that hole and create a bulge.

“You can also tear the floor of that muscle through hard work or pressure, and instead of the hernia coming through that natural hole it sort of explodes through the floor of the muscle.”

Can hernias be prevented?

“Anything that you can do to reduce the pressure inside the abdomen or avoid sustained periods of pressure in your belly will lower your risk of developing a hernia,” Dr. Carpenter said. “The single best thing you can do to avoid a hernia is to maintain a healthy, normal weight and avoid being overweight.”

When someone is overweight, they are actually experiencing pressure 24 hours a day, seven days a week, the surgeon said. And adding the increased pressure of coughing, sneezing and general straining can increase the patient’s risk of developing a hernia.

“Another factor in developing a hernia has to do with tissue degradation,” he said. “And the number one risk for that is still smoking and tobacco use. Nicotine and by-products of tobacco are known for decreasing your ability to heal and decreasing the integrity of the connective tissue in the body.”

The muscles in your body are largely made up of connective tissue. If these tissues are weakened because of tobacco use, you could be at a higher risk for not only developing a hernia, but not being able to heal properly after treatment.

What should a patient do if they think they might have a hernia?

“If they think they might have a hernia, I would recommend that they see their primary care doctor initially,” Dr. Carpenter said. “If they don’t have a primary care doctor and they have a bulge that won’t go back inside the body and is very painful, then they should seek treatment at the emergency department immediately.”

For more information about hernias, visit the American College of Surgeons’ site or make an appointment with a Scott & White surgeon.

About the author

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Jessa McClure holds a degree in journalism and mass communication from the University of Mary Hardin-Baylor in Belton, TX, where she is currently an adviser for student publications. She has been a writer in the health care field since 2009.

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Could that painful bulge be a hernia?