Hernia, commonly known as a hernia, is the sliding, dislocation, and protrusion of the tissue or muscles that keep the organ in place in its natural cavity. Although abdominal hernias come to mind when hernia is used alone, lumbar disc herniation, namely herniated disc and cervical disc herniation, ie neck hernia, are also common conditions in the society.
Hernia, which negatively affects the daily life of a person, is defined as the emergence of a part of the internal organs, mostly a part of the intestine, out of its natural environment, causing swelling under the skin. Waist and neck region hernias occur as a result of the discs between the vertebrae losing their natural position.
The most common types of hernia with many types and varieties; abdominal, waist and neck hernias. Abdominal hernias are generally examined as inguinal, umbilical and surgical incision hernia. Untreated abdominal hernias grow over time due to pressure and the chance of treatment decreases. In waist and neck hernias, it affects the quality of life of the person negatively and manifests itself with symptoms such as loss of sensation, pain and weakness in the arms and legs as well as the hernia region.
Abdominal hernias are the stiff membranes called the muscle and fascia that make up the abdominal wall protruding from a weak point from the abdominal cavity. Usually, as a result of weakening of the muscles in the abdominal wall, an organ or tissue emerges from this weak spot in the abdominal cavity and creates a hernia. Hernias can occur spontaneously, due to trauma and as a result of incisions in previously operated areas. It can be examined in three groups as inguinal hernia, umbilical hernia, and surgical incision hernia.
It is a type of hernia that occurs with the increase of intra-abdominal pressure seen on the right, left or both sides of the groin area. Since the opening, called the internal ring, through which the spermatic cord in men and the ligamentum rotundum, which is one of the ligaments that holds the uterus in place in women, is weaker than the abdominal wall, the hernia mostly occurs in this area. Excessive straining as a result of chronic constipation, enlargement of the prostate in men, heavy lifting, straining to urinate, asthma and persistent cough due to chronic bronchitis are the most common causes of inguinal hernia, which causes an indirect inguinal hernia and a part of the intestine to cause swelling under the skin. A direct inguinal hernia occurs on the inner side of this weak area, in the upper middle region of the abdomen. Hernia formation here also occurs with the increase of intra-abdominal pressure for similar reasons. In boys, it is usually formed in the space in the abdomen as a result of the testicles that complete their development in the abdomen coming down and return to their normal place, and if the area is large, some of the intestines will slide into this area and form a hernia. However, if there is no large area left for the intestines to fit, a hernia may also occur as a result of fluid accumulation. The risk of hernia is generally seen in newborn men. The risk is higher in premature babies. Family history of hernia and being overweight are risk factors as it increases intra-abdominal pressure. People who have had a hernia before are likely to develop a hernia on the other side of the groin.
There are 3 different veins in the umbilical cord, that is, the umbilical cord, which provides the feeding of the baby in the mother’s womb. An umbilical hernia occurs when the umbilical region, which is strengthened by binding and closing by the surrounding muscles, remains weak after birth. When it occurs in infancy, a hernia may swell and become visible during crying. In a few years, the hernia in babies can close by itself, but if it does not close, surgical intervention is required. Umbilical hernia may occur in individuals who reach childhood in cases where the navel is not fully closed or is overly forced. Above the belly button, the adipose tissue covering the upper part of the intestines and a part of the intestine cause hernia formation. In adults, about 8% of those who present with hernia complaint are umbilical hernia. It is more likely to occur in overweight women who have given birth, men with a history of prostate, people with overweight or sudden weight loss, heavy lifting, and chronic cough. Even if there is no visible swelling or deformity, in some cases the hernia can be felt with the finger. Surgery is the only treatment option for an umbilical hernia in adults, and it is easier to operate when the hernia is in the initial stage and when it is small. The surgery can be performed either closed or open, depending on the patient’s condition.
It is a type of hernia that occurs in the incision areas of previous abdominal surgeries. It may occur as a result of insufficient tissue recovery after surgery and weakening of tissues after years. Incision hernias that can develop in more than one area; It can also be observed with the formation of swelling in the area of the scar while standing, coughing or straining. However, as this type of hernia can grow rapidly, it should not be expected if such a situation is noticed. It is treated with open or closed surgery.
Lumbar disc hernia, also known as herniated disc, develops between the vertebrae on the spine. The gel-like connective tissue, also known as the disc, which is located between the vertebrae that connects to each other and acts as a pillow by providing flexibility, begins to lose its function due to dehydration due to aging. As a result, it leaves its natural position and creates a lumbar hernia. Lumbar hernia occurs mostly in the last two discs in the lumbar region and is characterized by low back pain, pain and numbness in the legs, and weakness in the feet. Lumbar hernias are treated non-surgically in some cases and the treatment is rearranged according to the result. These treatment methods usually include rest, anti-inflammatory and pain medication, exercise, physical therapy, steroid injection. All medications should be used as prescribed, and if improvement is not observed, the doctor should be consulted again. Lumbar hernias, in which surgical treatment is also applied, is performed by partial discectomy or discectomy methods. Operations performed under local, spinal or general anesthesia are performed through a small incision on the herniated disc. In some cases, pressure may occur on the nerve roots leading to the leg area, loss of power may be experienced and urgent surgery may be required.
Cervical hernia, vertebrae on the spine are connected to each other by discs. The gel-like discs between the vertebrae allow neck movements. In some cases, it loses its natural position as a result of distortion, damage and tear on the disc and comes out of the vertebrae; it slides into the channel through which the nerves and spinal cord pass. In this condition, which is called cervical disc herniation, pain, aching, loss of sensation and weakness occur in the arms. Rarely, weakness can be seen in the legs. It is diagnosed and treated by a neurosurgeon. For diagnosis, detailed history is listened, physical examination and radiological imaging are performed. Mostly, the patient gets better with physical therapy and medications without the need for surgical intervention. However, in non-healing cases, surgical intervention is performed by discectomy method. Many patients return home within 24 hours following the operation.
Hernia symptoms vary according to the region where the hernia occurred. Generally, in hernias in the abdominal region, pain and swelling under the skin are seen due to tearing of the muscles. Although the pain decreases as the swelling grows, treatment becomes more difficult. In neck and lumbar hernias, in addition to symptoms such as weakness, pain and loss of sensation in the extremities, pain is also felt in the area of the hernia.
The treatment method varies according to the region where the hernia occurs. In some cases, exercise, physical therapy and medication are used, but surgical operation is performed in advanced hernias that do not respond to these treatment methods. If you have such pain, it is recommended that you see a specialist physician and have your check-ups as soon as possible. Please stay away from wrong methods so that you do not get harmed in the future.
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