Introduction
Hernia & physics ?
If you are a STEM person you will want to know all about the science. Laplace's law states that the larger the hernia the greater the tension in the wall of the sac and overlying tissues. This means that as a hernia gets larger, there is more tension in the wall and it enlarges more. A rather viscious cycle.
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So most hernia tend to enlarge with time. But the rate they get bigger varies and may take years. You may be pleased to know that despite Laplace's law not all hernias get larger.
Can I leave it alone ?
The answer is - 'maybe'. If it is not causing a problem it may not need to be fixed. This will depend on the type of hernia, where it is, the size, how much trouble it causes & your general health. The risks of repair will be balanced against the risk of your hernia causing a problem in the future. The greater the discomfort or pain the better it is to consider fixing it.
Many small groin hernia will not enlarge and may not change over many years.
I was told my hernia is 'reducible' ?
This means that that the bulge can be easily pushed back into the abdomen. You may have to lie down and relax for this to happen. If it can not be reduced it is, not surprisingly, 'irreducible'. These are more troublesome and should be fixed. Of course a reducible hernia can become non reducible or incarcerated.
What is my inside a Hernia ?
Just about any thing in the abdomen can get into a hernia, especially if the hernia is large. Fat, small bowel and large bowel are the most common as they are mobile. As a groin hernia get bigger it pulls things along with it, so the bladder and large bowel can slide down and become part of the wall of the hernia. Care has to be taken so they are not damaged during repair. This is known as a 'Sliding' hernia.
Why fix it then ?
How big can it get ?
While most are small, if left some hernia can become very large. This was common in the recent past when repair was risky. Really large hernia are more difficult to fix but there is now almost no reason to leave a hernia to grow .
Well some hernia's can go on to cause major problems even if they are not troubling you at the moment. This can be serious.
What sort of problems ?
As a hernia is a hole, commonly in the abdominal muscle wall, things can get caught in it and stuck. The herniated tissue may swell and the pressure can block the blood flow and the tissue dies. This usually occurs without any warning and is painful and will result in an emergecy trip to the Casualty Department.
Incarcerated Hernia
This simply means something is stuck in your hernia and can not get out. Like being stuck in goal. If you have an incarcerated hernia it means the stuff in the hernia will not go back into the abdomen and the bulge or lump will not go away even if you relax and lie down.
This is commonly fat from within the abdomen and although painful it is not life threatening.However bowel can get caught and this may block and cause a bowel obstruction.
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Obstructed Hernia
Obstruction refers to a hernia that has bowel caught within and the bowel is blocked. This is usually caused by compression or kinking. The blockage can be partial or complete. If the bowel is not completely blocked symptoms of a bowel obstruction can be intermittent. A hernia causing bowel obstruction should be fixed.
Strangulated Hernia
This is as bad as it sounds. Strangulated means that whatever is caught in the hernia has lost its blood supply and will die. Dead bowel turns green and is life threatening and needs urgent surgery.
Are hernia common ?
Groin or inguinal hernia are very common occuring in up to 15 % of men. Without surgery they caused enormous hardship. Hernia surgery has continued to improve over 100 years and we have to look at some of the old photos to appreciate how lucky we are.