Causes and types of hernia

What are the common causes of a hernia?

• Muscle weakness: Impaired function which can result in the development of a hernia include signs such as chronic coughing, congenital defects whereby the abdominal wall or inguinal ring does not close properly in the womb, age, damage due to surgery or as a result of injury.
• Strains / pressures in the body: In combination with muscle weaknesses, strains which can also result in a hernia include pregnancy, constipation, diarrhoea, ascites (presence of fluid in the abdomen), sudden weight gain, persistent coughing, sneezing pressure (experienced persistently), obesity, effects of smoking, poor nutrition and lifting heavy objects.

What are the different types of hernia?

Based on their predominant causes, hernias are classified as the following types:

• Inguinal hernia: The most common of all, up to 70% of cases are inguinal hernias. This type occurs when a portion of the intestines or bladder is forced through a weakened area or tear in the lower abdominal wall (also known as the inguinal canal) near the groin. This hernia type is common amongst men affecting the spermatic cord which passes between the abdomen and scrotum area, and holds up testicles. A male’s testicles descend through the inguinal canal soon after birth. Naturally, the canal closes on its own. If not, it creates a weakened area which may be more susceptible to hernia. The inguinal canal in females holds the uterus in place. The hernia (bulge) that develops can be painful, particularly when bending over, lifting heavy objects or even coughing. Complications as a result of the bulge getting larger and more painful can be life-threatening if not effectively treated. Surgery is often recommended in this instance.
• Hiatal hernia: This type of hernia occurs when a portion of the stomach pushes through an opening in the diaphragm (hiatus) and into the chest. The diaphragm is the muscle responsible for helping a person to breathe, supporting breath through the inhaling and exhaling function. The hiatus is a natural opening allowing the oesophagus (‘food tube’) to connect to the stomach. The diaphragm is located between organs in your chest and abdomen, separating these areas of the body. A common complication of this type of hernia is GERD (gastroesophageal reflux disease). Many hernias of this type can be treated with medication and self-care methods (being mindful of what you eat which may cause reflux). Where the hernia is particularly large, surgery may be required.
• Umbilical hernia: This type of hernia affects infants younger than 6 months of age, as well as young children. It can also affect women who are obese or those who have carried many children (had multiple pregnancies). With this type, the intestines push through the abdominal wall in the area of the bellybutton (navel). A sign this has happened is a visible bulge near the bellybutton. This bulge which causes a pronounced protruding bellybutton, is even more visible when a child or baby is crying. This type of hernia is mostly regarded as harmless. If the hernia doesn’t appear to resolve by the time a child is 4 years of age, seek medical attention. It is also possible that this type of hernia may require surgical intervention.
• Incisional hernia: This type is a common complication following an abdominal surgical procedure. A healing scar can serve as weakened tissue, which intestines can push through causing a hernia at (or near) the site of incision. This type is commonly seen with inactivity following surgery, especially if a person is overweight or elderly.
• Femoral hernia: This type is common in ladies who are either obese or pregnant. A hernia develops when a portion of the intestine is forced through the canal carrying the femoral artery near the upper thigh. This type is also known as femorocele.