Guide to Understanding Hernias do not heal by themselves and may continue to worsen if ignored. Let our specialists treat your before it becomes an emergency.

What Is a Hernia?

A hernia is a very common health condition in men and women and occurs when internal tissue or part of an organ bulges through a weak muscle into a place where it doesn’t belong. Hernias usually occur either because of a natural weakness in the or from excessive strain on the abdominal wall, such as the strain from heavy lifting, substantial weight gain or persistent coughing.

The most common types of hernias include:

Groin () Hernia The most common type of hernia, the , occurs when a structure in your — typically part of your or fatty tissue — bulges Not all hernias cause symptoms. However, if you have through your abdominal wall and into your inner groin. a hernia, you may experience any of the following Inguinal hernias most often occur in men. symptoms: Upper Thigh (femoral) Hernia • A bulge on one or both sides of your groin (the bulge More commonly known in women than men, a femoral may appear to go away while you’re lying down) hernia occurs when fatty tissue or part of the intestine • Pain in the groin area, particularly while you exercise, bulges through into your outer groin. lift, strain, have a bowel movement or (the pain or discomfort usually goes away when you rest) This happens when the upper part of your stomach • Sharp bulges into your chest through a small opening in your • Discomfort in the groin area, such as itching, aching, diaphragm (the muscle separating your abdomen from burning, heaviness or weakness your chest). Having a hiatal hernia can allow stomach • Swelling or pain in the acid to back up into your , which can cause • Difficulty urinating or having bowel movements heartburn and gastroesophageal reflux disease (GERD). • Heartburn • Problems swallowing Navel (umbilical) Hernia • Unexplained or This condition occurs when abdominal tissue or part of • Burning or pain in your throat or esophagus the intestine pushes through into the area around your • Chest pain navel. Although it’s most common in infants, it can also • Abdominal bloating, belching, pain or discomfort happen in adults. • Pain or pressure around a surgical incision site Abdominal (ventral) Hernia If a hernia is causing you pain or discomfort, you should This type of hernia can develop throughout the abdomen, talk to your doctor. Frequently, hernias are small when such as the site of a surgical incision from a cesarean they begin, but often enlarge. Treatment is generally section or an . recommended to avoid emergency surgery or other health problems. Risk Factors Usually, your abdominal muscles hold your intestines in place. But if you have a weak spot in your abdominal muscles, your intestines or other abdominal tissue may bulge out and form a hernia.

Most hernias result from pressure on a weak abdominal muscle. This weakness may be due to a problem you were born with or something that has occurred over time. A frequent cause of pressure is heavy lifting (e.g. by construction workers or weightlifters).

Factors that may contribute to the development of a hernia include:

• A family history of hernias • Computerized tomography (CT) scan: These scans • Age use a combination of X-rays and computer technology • Chronic to create images. They sometimes include a special • Chronic cough (common in smokers) dye that you drink, or that is injected into a vein, to • Heavy lifting show additional details. • • Abdominal : This test uses sound waves • to create images of your abdominal area on a computer • Smoking screen. • Straining to urinate as the result of having an enlarged • Upper endoscopy: During this exam, your doctor prostate, which can interfere with urination passes a thin scope with a tiny camera into your esophagus to visually inspect the upper part of your Diagnosis digestive tract. • Barium swallow: During this test, you swallow a Doctors diagnose hernias by speaking with you about compound known as barium sulfate, which allows your symptoms, your work and and abnormalities in the upper digestive tract to appear performing a . You may be asked to on X-rays. stand up and cough while your doctor feels for a bulge • Esophageal manometry: Thwis is an exam in which caused by the hernia. Your doctor may also recommend a thin tube is passed through your nose and esophagus one or more of the following tests: and into your stomach to check the strength of • X-rays, including a chest X-ray or an abdominal muscles lining the upper digestive tract. X-ray: X-rays use small amounts of radiation to create images of internal organs and structures.

By The Numbers

INDIRECT HERNIAS 2% 25% 1 million+ Age 2x HERNIA SURGERIES 40+ Direct hernia

Indirect hernia

Develop an INGUINAL HERNIA 800,000 200,000+ Hernias usually MORE COMMON in their lifetime. INGUINAL HERNIAS OTHER OCCUR IN MEN THAN DIRECT HERNIAS Call (434) 584-5082 to make an appointment or visit vcuhealth.org/cmh-hernia for more information.

Treatment Meet Our Team If you have a hernia, your doctor may recommend Our board certified surgeons have experience treating lifestyle changes, such as quitting smoking, avoiding many types of hernias, including inguinal, femoral, heavy lifting or losing weight. However, if symptoms umbilical and ventral hernias. persist or your hernia requires repair, your doctor may recommend surgery. We repair hernias using the following surgical procedures:

Laparoscopic surgery: Your surgeon inserts surgical tools into your abdomen via several very small incisions, and repairs your hernia using sutures or . Because it’s minimally invasive, laparoscopic surgery results in less pain and faster recovery than open repair.

Open repair: Your surgeon performs via a Dr. Jose DeMoya Dr. Desiderio Rimon larger incision in your abdomen. The repair is made either with a surgical mesh (a strong mesh-like material) or sutures (stitches). Open repair may be necessary when hernias are infected or are causing potentially serious complications. Why VCU Community Memorial Hospital? Dr. Michael Tozzi Dr. Yi Wei Zhang We are part of an award-winning health system and one of the country’s leading university-based institutions, Virginia Commonwealth University. We are proud to provide our patients with treatment options from surgeons who are leaders in their field. We boast:

• A brand-new, state-of-the-art facility • Expert surgeons: Our surgeons are board-certified general surgeons • Patients get personalized care through our team approach which results in better patient outcomes • Experience: We have performed thousands of hernia surgeries