Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
Hernias can be a real issue for a lot of people.
Sommer said, “It is when the small intestine, it pushes through the your abdominal wall, usually there’s a weakening in the muscles, and it can be caused by a number of things, but you have to be careful, because it could become what’s called incarcerated or strangulate, which then it becomes an emergency.”
Hernias don’t heal on their own – surgery is required.
Sommer said, “There are people that live with hernias, they don’t bother them. They said they’ll pop out every once in a while. They can push them back in, but when you can’t push them back in, or you have, like, excruciating pain, it’s time to get that fixed.”
What are the types of hernias?
Sommer explained, “The most common ones are in the groin. They’re called inguinal hernias or femoral hernias. They could be in the groin, the upper thigh, in the scrotal or labia area. Other common one is an umbilical or naval hernia. Your belly button used to be innie and now it’s an outie. A ventral or incisional, sometimes, when you have abdominal surgery after healing, the walls are weakened, and as it heals, if you do a lot of heavy lifting, you can get what’s called a ventral hernia. Then hiatal hernias are in the diaphragm, and usually if you have an upper endoscopy, a lot of times you might be told you have a hiatal hernia.”
What are the causes of hernias? One is strenuous lifting.
Sommer said, “You can also have a family history of hernias. Obesity is a big one. If you’re overweight, that’s a lot of pressure that you carry in the trunk area, if it’s pulling on your muscles and it weakens them as you get older. Chronic cough due to smoking or other disease, people that cough a lot can actually create a hernia. Pregnancy. Again, women, their bodies, they stretch out, carrying that extra weight for nine months, it can cause a hernia down the road. Constipation, meaning that you have to strain. Any type of straining can cause a hernia, even straining to urinate. An enlarged prostate, undescended testicles. Ascites is when you have a buildup of abdominal fluid from the liver, and then certain medical conditions like Marfan Syndrome, because somebody that has Marfan Syndrome, their extremities are disproportionate to the body. So again, a weakness. Then weakened abdominal muscles due to poor nutrition and heavy lifting.”
What are the symptoms?
Sommer said, “When you have an abdominal hernia, it may be painful, or you have that bulge and if it hurts, and it’s painful to touch, especially when you’re lifting, coughing, straining again, urination or bowel movements, those are warning signs that your body’s telling you there’s something wrong. It may it may disappear, or you might be able to push it back and it’ll stay there for a while, but over time, that weakness builds, and then you won’t be able to push it back. The bulge is there, and it will stay until you get it taken care of. With heavy lifting or exercise, certain things that might have caused the hernia, if that’s part of your daily life, like if you lift heavy objects for a living, repetitive motion is just going to make it weaker.”
What are the symptoms of hiatal hernias?
Sommer said, “Ingestion, heartburn, regurgitation, difficulty, swallowing. Sometimes people feel like they have a pressure in their chest, and it’s actually the hernia pushing up into the diaphragm, making it very uncomfortable.”
How is a hernia diagnosed?
Sommer said, “A lot of times, it’s with a physical exam. You can feel it and a lot of times, people come to us when it’s sometimes the ones that you can push in. It depends, if they’re very large or obese, it’s hard, and they may need to do some other diagnostic testing, like an ultrasound or a CAT scan. Usually when they come in, the bulge is there. It’s apparent. You can feel it, and the diagnosis is made right then and there. Then the option is for surgery, and when you want to get that done. If it becomes really painful, it’s a sign that the hernia is actually strangulating some blood vessels, and it’s cutting off the blood supply to tissue, and then they become what’s called gangrene, and that can be a really big problem, because that’s infection, depending where the blood supply is cut off, sometimes your colon can get wrapped around in there and can get really ugly. So you have to pay attention if you have a hernia, where it is and if the pain is something that is worsening and doesn’t go away, you need to seek medical attention right away.”
There are two types of surgery for hernias.
Sommer said, “Laparoscopy is when it’s minimally invasive. It’s when the surgeon makes several small incisions and they use a laparoscope. There’s less scarring, less bleeding, less pain, shorter recovery time is usually like one to two weeks. Again, even with that being said, you are not going to go do any strenuous or heavy lifting for at least four to six weeks after surgery, because you just don’t want that to reoccur. Sometimes, depending on the size of the hernia, where it is, they need to cut you open, which I have to say, their incisions, even when they do open hernia repair, they’re still very small. So the scarring is still minimal, from what I’ve witnessed over the last several years, but the recovery time is a little bit more. So you’re again, usually about six weeks, you’re really going to take it easy for those six weeks, and still maybe no heavy lifting or strenuous exercise, depending on again, where it is, the severity and so forth.”
Is the mesh still used for the repair?
Sommer said, “It depends. Usually, typically, if it’s a small hernia, at first, they’ll try and repair it without mesh. But sometimes, again, if you have a job or something that has caused that hernia, and you go back to doing that, you’re most likely going to weaken the muscle again, and if it reoccurs then that’s when they usually use mesh.”
What are the side effects?
Sommer said, “Excessive bleeding. So make sure, if you’re on a blood thinner, you take aspirin, a lot of ibuprofen, or if you drink a lot of alcohol, you let somebody know, because you that can increase your risk of bleeding during surgery. Blood clots can occur with any surgery. So if there’s a family history, you have a history of blood clots. I mean, some people get a blood clot, and it’s just something that happens, but it’s something that can occur after surgery. So make sure you just don’t sit and are sedentary after surgery. We want you up moving around, just not really crazy heavy exercise. Some people have reactions to anesthesia. Sometimes people get an infection. It’s not common, but it can happen, and in extreme situations, damage to adjacent organs or breathing problems. These are just some of the risks of surgery, or any surgery, really.”
What can people expect with recovery from a hernia operation?
Sommer said, “Within a week or two, you can usually return to your normal schedule. You can return to work if you don’t have a job that requires physical activity, in about a week, five to seven days, people usually can go back to work. Again, like we talked about, no strenuous activity or heavy lifting for four to six weeks until the healing is complete. Patients recovering from hiatal hernia repair, they usually have to eat small portions. They start them, usually on a liquid diet, and then you go to a soft diet for several days because of where it is, it’s harder to digest because that whole area was repaired. So that takes a little bit longer in the sense of getting your diet back and that’s all because of the type of surgery that it is.”
For more information, click here: https://www.keywestsurgicalgroup.com/