The abdomen is a walled cavity; the pressure inside this can rise to quite substantial levels – especially when lifting heavy objects, coughing, sneezing etc. A hernia results when a weakness develops in the wall of this cavity; the commonest site is the groin area and a weakness of this site is called an inguinal hernia. There are 2 major types of inguinal hernia but the treatment is much the same. Once a hernia occurs it usually enlarges with time. At very best it can stay the same but will never cure itself. It is a mechanical defect & the only effective treatment is surgery. There have been major advances in the surgical techniques of hernia repairs recently. These involve insertion of synthetic material (Prolene) to plug & strengthen the defect. The advantage of this is that it avoids pulling tissues together – hence tension-free repair. This means that there is far less (or no) discomfort following surgery & that it can be carried out under local anaesthesia rather than general anaesthesia. Light sedation is normally given during surgery & the patient goes home a few hours later. Another major advantage is that this type of repair is very strong, allowing return to work within a week or 2, without any significant danger of the hernia recurring.

If you are not going to have surgery to repair your hernia or while you are waiting for a convenient time for you to have surgery, you should minimise the chances of your hernia enlarging &/or causing discomfort by following these instructions if at all possible & if they are relevant to you.

• Avoid heavy lifting as this will exert excess pressure on & may enlarge your hernia.
  
  

• Excessive straining can worsen your hernia. For example, if you are constipated & need to strain to pass motions, take steps to correct this, including eating a high residue diet containing 2 – 3 tablespoonfuls of Natural Bran daily &, if necessary, Lactulose (available from chemists without prescription) 10mls (one tablespoonful) 1 – 3 times daily.
  
  

• If you smoke cut it down or stop it altogether. Not only does smoking damage your health but also the resulting cough puts pressure on your hernia, stretching it further.
  
  

• In situations where you cannot avoid straining, coughing or lifting, if at all possible, place a hand over your hernia & press hard to stop it from bulging. You may have been provided with a temporary truss to wear for this purpose.

If your hernia is the type which "reduces" – i.e. "goes back" fully & it suddenly refuses to do so &/or it becomes continuously painful – get medical help immediately as it may need urgent surgery.

Further information on hernia:

Please also see http://www.surreydaysurgery.co.uk