Buzz
A hernia occurs when an organ pushes through an opening or weakness in the surrounding muscles or tissues that usually hold it in place. Hernias are most common in the abdominal area, but they can also appear in the groin, belly button, or upper thigh. While most hernias aren't immediately life-threatening, they won't heal on their own and require surgery to prevent potential complications. However, you can try some at-home exercises and lifestyle changes to help improve the condition, starting with Step 1 below.
Steps
Change your lifestyle
Eat smaller meals more frequently. It is recommended to have six smaller meals throughout the day – three main meals and three snacks in between. Avoid large portions in any one meal to prevent acid reflux, especially in cases of hiatus hernia. Acid may move upward into the esophagus when part of the stomach pushes through the diaphragm into the chest.
- This is not an excuse to overeat. Snacks should only supplement the small meals. Start with half or three-quarters of a plate until you get accustomed to the smaller portion size.
Avoid certain foods. In cases of hiatus hernia, it's best to avoid spicy foods, caffeinated beverages, or anything that may irritate your stomach. Foods that used to be favorites but now cause discomfort should be avoided to reduce pressure on the digestive system and your body.
- This may include certain teas, soda, and coffee. Citrus juices and some fruits should also be avoided to maintain the acid balance in the stomach.
- Taking an antacid once a day before meals can help manage hiatus hernia symptoms, especially if you accidentally consume something that upsets your stomach.
Avoid physical activity after meals. Refrain from lying down, bending over, or engaging in intense activity right after eating. Such actions can lead to acid reflux, as mentioned earlier. Avoiding activity after meals can help prevent further damage to already affected areas.
Weight loss. Being overweight increases pressure in the abdomen, pushing the intestines through and eventually causing a hernia. A healthy eating plan (with smaller meals) and regular exercise tailored to your health can help you achieve this goal.
- Before making significant changes to your diet and exercise routine, it's advisable to consult with a doctor. They will provide guidance on safe weight loss that won't negatively affect your health.
Take pain relievers. Pain relievers work by blocking or interfering with pain signals to the brain. If the pain signals don't reach the brain, you won’t feel the pain. While you can visit a doctor for stronger medications, there are some over-the-counter pain relievers you can try. Two categories of pain relievers you may want to consider include:
- Over-the-counter pain relievers. These are usually available without a prescription and can help alleviate pain in certain situations. Common ones include acetaminophen. Be sure to follow the dosage instructions on the packaging based on your weight and age. In some cases, a doctor may suggest taking more for a short time. If in doubt, ask your doctor.
- Stronger pain relievers. These are needed if pain persists after using over-the-counter painkillers. However, use caution, as they can be addictive and may lose effectiveness over time. Examples include codeine and tramadol, which are available by prescription only.
Wear a support band or truss to hold the hernia in place. Wearing a supportive device can help prevent further herniation while you await additional treatment. If surgery is planned, healthcare providers may manually push the hernia back into place and recommend wearing a special belt (called a truss) to keep it in place until surgery. While the effectiveness of this method is not fully proven, wearing a truss after manual hernia reduction may help alleviate symptoms.
- There are various types of support trusses available online for abdominal and inguinal hernias.
- However, wearing such devices can cause pain and discomfort, so be prepared to take over-the-counter pain relievers like Tylenol if needed.
Exercise to prevent a hernia
Side-lying leg lifts. As mentioned earlier, weakened areas, such as the abdominal wall, can cause organs or intestines to move out of place. Therefore, the solution is to exercise and strengthen the muscles around the hernia. A great starting exercise is side-lying leg lifts. Here's how to perform it:
- Start by lying flat with your head elevated above your feet.
- Slowly lift both legs about 35 cm or 30 to 45° upwards. For added resistance, you can have someone gently press down on your legs while you lift them, and remember to slightly separate your legs.
- Hold this position for a few seconds before returning to the starting position. Begin with five repetitions and gradually increase to ten.
Inclined bicycle exercise. You should avoid exercises or activities that require lifting, pulling, or pushing heavy weights, as they can make a hernia more likely. Therefore, an inclined bicycle exercise is a good alternative. Here's how to do it:
- Lie flat with your head lower than your feet and your hands by your sides.
- Bend at the hips and lift your knees towards your chest.
- Use both legs to begin cycling motions. Stop when you start to feel strain in your abdomen.
Knee squeezes. Knee squeezes are also a great exercise to strengthen the abdominal muscles without requiring expensive gym equipment. Here's how to perform the exercise:
- Lie flat with your head lower than your feet and bend both knees. Place a pillow between your knees and hold it there.
- Begin by inhaling. As you exhale, squeeze the pillow with your thighs. Try to keep your pelvis steady. After exhaling, relax the thigh muscles.
- Start with one set of ten repetitions, and gradually increase to three sets.
Crunch-style sit-ups. This exercise helps strengthen the abdominal wall muscles. If you don’t like traditional sit-ups, try this crunch-style variation:
- Lie flat with your head lower than your feet, and bend your knees.
- Start by lifting your upper body, but stop at a 30° angle while contracting your abdominal muscles. Hold this position briefly, then slowly lower your body back to the starting position.
- Begin with one set of 15 repetitions, and gradually increase to three sets.
Exercising in the pool. Doing exercises in water adds resistance, making it harder to maintain balance. This method is also very effective in strengthening the abdominal region. If you have access to a pool, consider the following three exercises:
- Start by walking in the water for 3-5 laps around the pool.
- Next, perform 30 repetitions of hip closing and opening, along with hip stretches and contractions.
- Finally, complete 30 squat repetitions.
Walking. Walking is an excellent way to strengthen both the upper and lower abdominal muscles as well as the pelvic floor. You only need to walk briskly for 45 minutes each day, but you don't have to do it all at once! Even walking for just 10 minutes at a time will provide benefits, in addition to the relaxation it offers.
- Consider making small adjustments, like parking farther from your destination, walking the dog in the morning, or taking your lunch outside to the park while walking to stimulate your appetite.
Yoga. Consult with a healthcare professional before attempting any difficult yoga poses. Yoga is not suitable for everyone. Only perform poses when guided by a yoga instructor who can assist you during practice. If your healthcare provider approves, the following yoga poses are believed to relieve abdominal pressure, strengthen abdominal muscles, and help close the inguinal canal:
- Shoulder Stand (Sarvangasana)
- Fish Pose (Matsyasana)
- Leg Raise Pose (Utthanpadasana)
- Wind-Relieving Pose (Pawanmuktasana)
- Seated Forward Bend Pose (Paschimottanasana)
- Thunderbolt Pose (Vajrasana)
Develop healthier habits
Avoid lifting heavy objects. To prevent strain on the muscles and abdominal area, you should avoid lifting heavy items. If it's unavoidable, ensure you lift with proper posture. Remember to lift with your knees, not your back.
- This means you should bend your knees to lower your body before lifting, so the knees do the work. Keep the object close to your body to evenly distribute its weight. This technique will engage all the muscles without putting excessive pressure on any single group.
Quit Smoking. Smoking can lead to the degeneration of muscles and tissues throughout the body. If you're not quitting for your heart, lungs, hair, skin, or nails, consider doing it for your current condition.
- Additionally, quitting is beneficial for those around you. Try using nicotine patches or gum to reduce cravings. Gradually, you’ll become less dependent on cigarettes – there's no need to quit all at once.
Avoid getting sick. Sneezing, coughing, vomiting, and bowel movements can all create pressure on the intestines and abdominal area. However, these are normal bodily functions. Try to stay healthy to prevent these issues.
- Avoid straining during bowel movements to prevent excessive pressure on the abdominal region, if possible. If you have a persistent cough, seek treatment promptly to avoid adding pressure to your abdominal muscles.
Consider surgery options. If other methods fail, surgery may be required to repair the hernia. Hernia surgery can be performed using the following techniques:
- Laparoscopic surgery. This technique uses a small camera and miniature surgical instruments to repair the hernia through a small incision. The hernia is repaired by stitching the abdominal wall and placing a surgical mesh over the opening. Laparoscopic surgery causes less damage to surrounding tissues and typically requires a shorter recovery time than open surgery. However, there is still a risk of recurrence.
- Open surgery. This technique is more suitable for cases where part of the intestine has moved into the scrotum. Open surgery requires a longer recovery time, and you can resume normal activities about six weeks after surgery.
- Both surgeries are typically performed under local anesthesia or general anesthesia. The surgeon will reposition the herniated tissue, and if any necrotic tissue is present due to lack of oxygen, it will be removed. Hernia surgeries are usually outpatient procedures.
Understand your condition
Recognize inguinal hernias. This is the most common type of hernia. Both men and women have an inguinal canal in the groin area. In men, the inguinal canal is where the spermatic cord runs from the abdomen to the scrotum, supporting the testes. In women, it contains the ligament that holds the uterus in place. Symptoms of an inguinal hernia include:
- A bulge appears on one side of the pubic bone, most noticeable when standing.
- Pain or discomfort in the lower abdomen when bending, coughing, or lifting objects.
- Inguinal hernias are more common in men because the inguinal canal doesn’t fully close, creating a weak spot prone to herniation. Typically, a man’s testes will descend through the inguinal canal shortly after birth, and the canal closes almost completely afterward. An inguinal hernia develops when the intestine pushes through the inguinal canal.
Identifying a Hiatal Hernia. A hiatal hernia occurs when part of the stomach pushes through the diaphragm into the chest cavity. It is most common in individuals over 50. This condition can cause acid reflux, leading to a burning sensation as stomach acid leaks back into the esophagus. Symptoms of a hiatal hernia include:
- Acid reflux – a burning sensation when stomach acid moves upward into the esophagus due to part of the stomach being pushed through the diaphragm.
- Chest pain. Digestive products and stomach acid reflux into the chest, causing sharp pain.
- Difficulty swallowing. Part of the stomach pushed through the diaphragm may lead to regurgitation of digestive products, causing the feeling that food is stuck in the esophagus.
- Congenital defects can also cause this condition in children.
Recognizing an Incisional Hernia. An incisional hernia occurs when the intestine pushes through a surgical scar or weak tissue area after abdominal surgery.
- A bulge or swelling at the site of a previous surgery is the primary symptom. The intestine pushing through the scar or weak tissue causes this swelling.
Recognizing an Umbilical Hernia in Infants. Infants under six months may develop an umbilical hernia if the intestine pushes through the abdominal wall near the belly button.
- Signs that an infant has an umbilical hernia include persistent crying and a bulge or swelling near the belly button.
- If the abdominal wall fails to close properly, it creates a weak spot where an umbilical hernia can develop. This condition often resolves by the time the baby reaches one year old. If it doesn't, surgery may be required to treat the hernia.
Understanding the Causes of Hernias. Hernias can develop suddenly or gradually. They may result from weakened muscles or pressure exerted on the body.
- Common causes of muscle weakness include:
- Age
- Chronic coughing
- Injury or surgery
- Incomplete closure of the abdominal wall from birth (congenital defect)
- Factors that increase pressure on the body and lead to hernias include:
- Ascites (fluid in the abdomen)
- Constipation
- Pregnancy
- Lifting heavy objects
- Chronic coughing or sneezing
- Sudden weight gain
Be Aware of Risk Factors. Several factors increase the risk of developing a hernia, including:
- Chronic constipation
- Chronic coughing
- Cystic fibrosis (damages lung function and causes chronic coughing)
- Obesity or being overweight
- Pregnancy
- Personal or family history of hernias
- Smoking
- Some of these risk factors can be controlled. Since hernias can recur, it's best to address these factors to reduce the risk of the condition returning.
How will they diagnose a hernia? Each type of hernia is diagnosed differently. Here’s how they go about it:
- Inguinal hernia or incisional hernia. The doctor will perform a physical exam and feel for a bulge in the abdomen or groin area, which becomes more pronounced when you stand, cough, or exert yourself.
- Hiatal hernia. X-rays with barium or endoscopy will be used to diagnose a hiatal hernia. During a barium X-ray, the patient drinks a barium solution and a series of X-ray images are taken of the digestive tract. Endoscopy uses a small camera attached to a tube that is inserted through the throat down into the esophagus and stomach. These tests help the doctor visualize the position of the stomach inside the body.
- Umbilical hernia. Ultrasound using high-frequency sound waves will create images of the internal structures of the body, diagnosing an umbilical hernia in infants. An umbilical hernia in newborns usually resolves within four years. Newborns with this condition simply need close monitoring from the doctor during their growth.
Understand the potential complications of a hernia. While some hernias may not pose an immediate threat, if left untreated, they can progress and cause severe pain. It's best to consult a doctor as soon as you notice signs of a hernia. Two major issues may arise if you neglect treatment:
- Intestinal obstruction. This condition can cause intense pain, constipation, and nausea when a part of the intestine becomes trapped within the abdominal wall.
- Strangulated bowel. This can occur when the intestine doesn’t receive enough blood flow. The intestinal tissue may become infected, impairing its function, and this is a life-threatening medical emergency.
Advice
- Some types of hernias may not show symptoms unless discovered during a routine health check-up.
- If left untreated with surgery, some hernias can grow larger. Always get checked to assess whether you have a hernia.
