Reducing Your Risk of Hernia Recurrence After Surgical Repair

When any of the abdominal organs protrude through the abdominal wall that normally contains them, it's called a hernia due to a weak spot in the muscles or fascia (connective tissue). It may or may not produce symptoms, such as pain in the abdomen. Most hernias eventually need surgical repair.

At Advanced Surgical Associates of Northern Minnesota, Dr. John Bollins and his team specialize in the surgical treatment of hernias and try to use minimally invasive techniques whenever possible. For some people, hernia recurrence is a problem that keeps on giving. Here's how you can reduce your risk of this complication.

Types of hernias

The type of hernia you have depends on where it’s located:

Femoral hernia: a bulge in the upper thigh, just below the groin; more common in women than men
Hiatal hernia: part of the upper stomach pushes through the diaphragm muscle into the chest
Incisional hernia: tissue pushes through a scar from past abdominal surgery
Umbilical hernia: bulge around the belly button when the muscle doesn’t close completely after birth
Inguinal hernia: bulge in the groin that may extend into the scrotum; more common in men

Most hernias aren't serious, but they shouldn't be ignored. If the organ gets stuck in the hole it's pushed through and can't go back to its normal position, you may experience pain. In severe cases, the blood supply may be cut off, leading to the death of the tissue (necrosis). Since hernias generally worsen over time, most require surgical repair sooner or later.

Causes and symptoms of hernias

You’re more likely to develop a hernia if you have:

A job that involves heavy lifting
A job that requires many hours of standing
A chronic cough or chronic sneezing
Chronic constipation and straining to void
A history of abdominal or pelvic surgery
Pregnancy, especially repeat pregnancies
Chronic obesity (a body mass index, or BMI, over 30)

Not all hernias cause symptoms; the different types may produce different symptoms. A telltale sign of any hernia is a visible lump or bulge that appears with certain physical positions and disappears at other times. When the hernia emerges, you may also feel pressure, a dull ache, or a pinching sensation.

A hiatal hernia, as it pushes into the chest cavity, can cause chronic acid reflux, which you experience as heartburn or indigestion.

Hernia recurrence

While most hernia procedures are successful, there’s always the possibility that the hernia can return at a later time — even months or years later. When it reappears at or near the location of the previous repair, it’s called recurrent.

Recurrent hernias can occur for many reasons, including surgical error, the weakening of the sutures holding the muscle layers together, or a surgical wound that hasn't healed properly.

In addition, recurrent hernias can be caused by various conditions that strain or weaken the abdominal muscles following the initial repair. These include:

Being overweight or obese
Smoking
Diabetes
Steroids, chemotherapy, or other medications that compromise the immune system
Heavy lifting or other strenuous activities

Lifestyle changes, such as losing weight and stopping smoking, or workarounds at a job that requires heavy lifting, can help prevent a recurrence.

If you do have a recurrent hernia, there are several treatment options available:

Observation: for mild cases
Elective surgical repair: used when the recurrent hernia causes excessive pain or discomfort
Emergency surgical repair: used in rare cases, such as when the hernia threatens to strangle a portion of the intestine

Surgical repair entails closing and reinforcing the weakened area in the abdominal wall, often with synthetic mesh. The method Dr. Bollins recommends depends on the hernia's size and location, your overall health, and your desire to be physically active.

Are you seeing a bulge where one shouldn't be? You might have a hernia. To schedule a consultation with Dr. Bollins, call Advanced Surgical Associates of Northern Minnesota at our Hibbing, Duluth, Cloquet or Ely, Minnesota, office or book your appointment online.

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