Hernia Complications and How to Deal With Them

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Hernia Complications

In recent years, we have seen numerous instances of rising hernia cases in India. People generally do not emphasize on the importance of early detection of the disease for timely treatment. It has become quite mechanical to choose home remedies as the method of treatment over professional healthcare services. However, the effect of home remedies is usually limited to mitigating the intensity of the symptoms and does not prove effective as a treatment. A prolonged hernia can cause serious complications and can even prove fatal.

Many of us may already be familiar with hernias. A hernia occurs when an organ such as the intestine tends to protrude out of the belly due to a weakness in the abdominal wall. The only effective way to deal with a hernia is to seek medical care. An untreated hernia can result in complications including severe ones like gangrene and incarceration. Surgical treatment is the only way to treat severe complications related to the hernia. Surgeons consider laparoscopic hernia surgery as the most successful and effective procedure for the treatment of a hernia. It is generally called hernia repair surgery or herniorrhaphy. 

Complications of untreated hernias 

Hernias are distinguished into six different types with inguinal hernia being the most common type followed by umbilical and hiatal hernias. Umbilical hernias are more common in infants and usually go away on their own. and do not lead to any major complications. Pregnancy is a very delicate period for a woman and pregnancy is again one of the factors that progresses hernia. Therefore, it is important to consult the doctor and be aware of the symptoms surrounding hernia for both the mother and the unborn infant. Abdominal wall hernias that include inguinal and hiatal hernias can cause several complications such as obstruction, strangulations, and incarceration. 

  • Obstruction – Prolonged hernias can become obstructed when any organ, say, a part of the intestine gets stuck in the muscular layer and pushes through. An obstructed hernia usually leads to bowel obstruction which does not allow the bowel contents to pass through the herniated area. This can result in cramps, absence of defecation, and vomiting. An obstructed hernia can be identified by the following symptoms:
    • Nausea
    • Vomiting
    • Abdominal pain
    • Painful lump in your groin area
  • Strangulation – A strangulated hernia occurs when the part of the intestine or organ is trapped in the hernial sac in such a way that the protruded portion does not get enough blood. Strangulations can cause tissue death or gangrene due to insufficient blood if the hernias are left untreated for a long time. Eventually, the intestinal tissue will become infected and die. Strangulated hernias are associated with a fatality rate (6%–23%) and therefore require immediate medical treatment. Symptoms of strangulated hernias are – 
    • Fever
    • Nausea
    • Vomiting
    • Abdominal pain
    • Inability to pass stool or gas
    • The bulge tends to grow quickly and hardens
    • The color of the bulge under the skin turns red, purple, or dark
  • Incarcerations – Incarcerated hernia refers to an irreducible hernia that cannot be reduced or pushed back manually. Surgeons often stress the need to detect hernia at the initial stage to prevent further complications such as obstruction, inflammation, or ischemia. Sometimes, the contents of a hernia such as intestines can protrude out of the abdominal sac and the testicles. Therefore, surgical repair for incarceration is more urgent to prevent further strangulations. Symptoms of incarceration are as follows – 
    • Nausea 
    • Vomiting
    • Abdominal Pain
    • Inability to pass gas or bowel movement
  • GERD (Gastroesophageal reflux disease) – Unattended hiatal hernias can cause GERD where the stomach’s contents flow backward, up into the esophagus or food pipe. A GERD may also be called acid reflux, heartburn, reflux, etc. If hiatal hernias are not treated for a long time, the top part of your stomach gets pinched causing the stomach acid to flow back up (reflux) through the opening. This can lead to several symptoms such as- 
    • Nausea
    • Vomiting
    • Chest pain
    • Frequent heartburn 
    • Difficulty swallowing
    • Sore throat or an irritated feeling in your esophagus

Elective approach for surgical repair of hernia

Hernia treatment is often recommended at an early stage to reduce the chances of complications. Early detection gives an edge to the surgeons as well as patients with a smooth treatment and faster recovery. If a hernia is detected at an initial stage, medications and watchful waiting can ensure fewer complications during as well as post-surgery. However, complicated hernias can only be repaired via surgery. There are several methods for the treatment of hernia among which laparoscopy is the most preferred choice of surgical treatment. 

Laparoscopy is an advanced procedure for the surgical repair of a hernia. It is a minimally invasive surgical procedure that involves incisions similar to the size of the keyhole near the abdomen or groin. The whole procedure is painless as it is done under general anesthesia. The surgeon inserts a medical device called a laparoscope through one of the incisions and locates the epicenter of the disease through the camera attached to the other end of the laparoscope. The surgeon visualizes the images on the external monitor and with the help of his surgical instruments, pushes the protruded part back into the abdomen. The incisions are shut with the help of sutures. 

Sometimes, there are chances of recurrent hernia. This usually occurs when the abdominal wall loses its strength due to several factors such as multiple pregnancies, injury during any previous abdominal surgery, age factor, etc. In such instances, the surgeon places a 3D surgical mesh at the point of protrusion inside the abdomen. A surgery involving a surgical mesh is called hernioplasty. The surgical mesh acts as a reinforcement and gives additional strength to the abdominal wall, thus preventing recurrence of the hernia. 

Laparoscopic hernia repair surgery or herniorrhaphy offers minimal blood loss due to small cuts which in fact, helps with faster recovery. The patient can resume work within a week after the surgery with almost no post-surgical complications. Laparoscopic hernia repair surgery is an outpatient surgery which means you can go home on the same day of surgery after consulting the doctor. Some of the advantages of laparoscopic hernia repair surgery are as follows-

  • Minimal cuts 
  • Minimal scars
  • Faster recovery
  • Almost no blood loss
  • Chances of recurrence are almost nil
  • The patient can resume work after a week

Complications during the surgery

Any major surgery entails certain chances of risks and complications. However, the probability of any complication during the surgery depends primarily on the surgical expertise and experience of the general surgeon along with the condition of the patient. However, the chances of complications during elective hernia repair surgery (15%) are far less than people who undergo emergency hernia repair surgery (25%). Some of the complications around the surgical hernia repair can be – 

  • Infection
  • Recurrence 
  • Bladder injury 
  • Long-term pain
  • Intestine resection complication

Post-surgery complications

Hernia repair surgery is considered a safe and effective treatment by many renowned surgeons. Faster recovery and minimal post-operative care make laparoscopic hernia surgery preferable among patients. There can be complications involving excessive bleeding during open hernia repair surgery. Successful surgery depends on the surgical expertise of the surgeon and how sincerely the patient follows post-operative care. However, there can be several factors that can result in post-surgery complications. Some post-surgery complications are – 

  • Some male patients can experience painful swelling in the testicles due to incarceration or gangrene that may have led to perforation of the bowel. 
  • Some patients may complain about numbness at the surgical site along with potential recurrence after hernia surgery. 
  • A surgical mesh is generally made of animal tissues. The surgeon may choose to put dissolvable mesh that may cause allergic reactions in some individuals resulting in the rejection of the mesh by the body. A patient may experience swelling and pain in the area where the mesh was placed. 

Conclusion: 

A hernia repair surgery is one of the most common surgical procedures performed across the world. It is always better to treat a hernia in time before it leads to complications. There are several factors that progress hernia such as excessive weightlifting or anything that adds pressure to the abdominal region. Therefore, it is important to be aware of the symptoms and plan the necessary course of action before further damage. Laparoscopic treatment for a hernia is one of the most advanced and effective surgeries for hernia repair that involve almost no risks and fewer chances of occurrence. However, there can be instances of possible risks and complications which may need elective or emergency repair. It is best you be aware of the symptoms of a hernia and get medical assistance as soon as you can. Your doctor will guide you through the pros and cons of surgery and provide you with post-surgery restrictions for an effective recovery.

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