An Abdominal or Ventral Hernia occurs when an organ or other piece of tissue protrudes through a weakening in one of the muscle walls that enclose the abdominal cavity. The sac that bulges through the weak area may contain a piece of intestine or fatty lining of the colon (omentum) if the hernia occurs in the abdominal wall or groin. If the hernia occurs through the diaphragm, the muscle that separates the chest from the abdomen, and part of the stomach may be involved.
Thank you for reading this post, don't forget to subscribe!The abdominal wall is made up of layers of different muscles and tissues. Weak spots may develop in these layers to allow contents of the abdominal cavity to protrude or herniate. The most common abdominal hernias are in the groin (inguinal hernia), the diaphragm (hiatal hernia), and the belly button (umbilical hernia). Hernias may be present at birth (congenital), or they may develop at any time thereafter (acquired).
What are the different types of Abdominal or Ventral Hernia?
Hernias of the abdominal and pelvic floor
- Inguinal hernias are the most common of abdominal hernias. The inguinal canal is an opening that allows the spermatic cord and testicle to descend from the abdomen into the scrotum as the fetus develops and matures. After the testicle descends, the opening is supposed to close tightly, but sometimes the muscles that attach to the pelvis leave a weakened area. If later in life there is stress placed on that area, the weakened tissues can allow a portion of the small bowel or omentum to slide through that opening, causing pain and producing a bulge. Inguinal hernias are less likely to occur in women because there is no need for an opening in the inguinal canal to allow for the migration and descent of testicles.
- A femoral hernia may occur through the opening in the floor of the abdomen where there is space for the femoral artery and vein to pass from the abdomen into the upper leg. Because of their wider bone structure, femoral hernias tend to occur more frequently in women.
- Obturator hernias are the least common hernia of the pelvic floor. These are mostly found in women who have had multiple pregnancies or who have lost significant weight. The hernia occurs through the obturator canal, another connection of the abdominal cavity to the leg, and contains the obturator artery, vein, and nerve.
Hernias of the anterior abdominal wall
The abdominal wall is made up of two sets of muscles on each side of the body that mirror each other. They include the rectus abdominus muscles, the internal obliques, the external obliques, and the transversalis.
- When epigastric hernias occur in infants, they occur because of a weakness in the midline of the abdominal wall where the two rectus muscles join together between the breastbone and belly button. Sometimes this weakness does not become evident until later in adult life as it appears as a bulge in the upper abdomen. Pieces of bowel, fat, or omentum can become trapped in this type of hernia.
- The belly button, or umbilicus, is where the umbilical cord attached the fetus to the mother allowing blood circulation to the fetus. Umbilical hernias cause abnormal bulging in the belly button and are very common in newborns and often do not need treatment unless complications occur. Some umbilical hernias enlarge and may require repair later in life.
- Spigelian hernias occur on the outside edges of the rectus abdominus muscle and are rare.
- Incisional hernias occur as a complication of abdominal surgery, where the abdominal muscles are cut to allow the surgeon to enter the abdominal cavity to operate. Although the muscle is usually repaired, it becomes a relative area of weakness, potentially allowing abdominal organs to herniate through the incision.
- Diastasis recti is not a true hernia but rather a weakening of the membrane where the two rectus abdominus muscles from the right and left come together. The diastasis causes a bulge in the midline. It is different than an epigastric hernia because, the diastasis does not trap bowel, fat, or other organs inside it.
Hernias of the diaphragm
- Hiatal hernias occur when part of the stomach slides through the opening in the diaphragm where the esophagus passes from the chest into the abdomen.
- A sliding hiatal hernia is the most common type and occurs when the lower esophagus and portions of the stomach slide through the diaphragm into the chest.
- Paraesophageal hernias occur when only the stomach herniates into the chest alongside the esophagus. This can lead to serious complications of obstruction or the stomach twisting upon itself (volvulus).
- Traumatic diaphragmatic hernias may occur due to major injury where blunt trauma weakens or tears the diaphragm muscle, allowing immediate or delayed herniation of abdominal organs into the chest cavity. This may also occur after penetrating trauma from a stab or gunshot wound. Usually, these hernias involve the left diaphragm because the liver, located under the right diaphragm, tends to protect it from herniation of the bowel.
- Congenital diaphragmatic hernias are rare and are caused by the failure of the diaphragm to completely form and close during fetal development. This can lead to failure of the lungs to fully mature, and it leads to decreased lung function if abdominal organs migrate into the chest.
- The most common type is a Bochdalek hernia at the side edge of the diaphragm.
- Morgagni hernias are even rarer and are a failure of the front of the diaphragm.
What causes an Abdominal or Ventral Hernia?
A hernia may be congenital and present at birth or it may develop over time in areas of weakness within the abdominal wall. Increasing the pressure within the abdominal cavity can cause stress at the weak points and allow parts of the abdominal cavity to protrude or herniate.
Increased pressure within the abdomen may occur in a variety of situations including
- chronic cough,
- increased fluid within the abdominal cavity (ascites),
- peritoneal dialysis is used to treat kidney failure.
- tumors or masses in the abdomen.
The pressure may increase due to lifting excess weight, straining to have a bowel movement or urinate, or from trauma to the abdomen. Pregnancy or excess abdominal weight and girth are also factors that can lead to a hernia.
What are the risk factors for Abdominal or Ventral Hernia?
Increased intra-abdominal pressure may lead to the weakening of a portion of the abdominal wall, either acutely or gradually over time. Some risk factors include the following:
- Chronic constipation
- Chronic cough
- Recurrent vomiting
- Obesity
- Ascites (an abnormal collection of fluid in the abdominal cavity)
- Peritoneal dialysis
- Abdominal masses
- Pregnancy
- Abdominal surgeries (a risk for incisional hernias)
- Repeatedly moving or lifting heavy objects
Signs and symptoms of Abdominal or Ventral Hernia
Most people can feel a bulge where an inguinal hernia develops in the groin. There may be a burning or sharp pain sensation in the area because of inflammation of the inguinal nerve or a full feeling in the groin with activity. If a hernia occurs because of an event like lifting a heavyweight, a sharp or tearing pain may be felt. However, many people do not have any complaint other than a feeling of fullness in the area of the inguinal canal.
Complications occur when a piece of intestine or omentum becomes trapped (incarcerated) in the hernia sac. A piece of bowel may enter the hernia and become stuck. If the bowel swells, it can cause a surgical emergency as it loses its blood supply and becomes strangulated. In this situation, there can be significant pain and nausea, and vomiting, signaling the possible development of a bowel obstruction. Fever may be associated with strangulated, dead bowel.
A Richter’s hernia is an uncommon type of hernia that leads to strangulation. Only one part of the bowel wall becomes stuck in the hernia. It won’t necessarily cause a complete bowel obstruction initially, since the passageway of the intestine still allows bowel contents to pass, but that portion of bowel wall that is trapped can start to swell, strangulate, and die.
Femoral and obturator hernias present in much the same way as inguinal hernias, though because of their anatomic location, the fullness or lumps may be much more difficult to appreciate.
Umbilical hernias are easy to appreciate and in adults often pop out with an increase in abdominal pressure. The complications again include incarceration and strangulation.
A hiatal hernia does not cause many symptoms by itself, but when a sliding hernia occurs, the abnormal location of the gastroesophageal (GE) junction above the diaphragm affects its function, and stomach contents can reflux into the esophagus. Gastroesophageal reflux (GERD) may cause burning chest pain, epigastric pain and burning in the upper abdomen, nausea, vomiting, and a sour taste from stomach acid that washes into the back of the throat.
A sports hernia is a tear or strain of any tissue in the lower abdomen or groin. It causes pain in the groin or inguinal area. It can involve any soft tissue, including muscle, tendon, or ligament, and can be initiated by physical activity, usually involving twisting or blunt force trauma to the abdomen.
Diagnosis
For inguinal hernias, most patients notice a feeling of fullness or a lump in the groin area with pain and burning. A physical examination can usually confirm the diagnosis. Femoral or obturator hernias are more difficult to appreciate and symptoms of recurrent inguinal or pelvic pain without obvious physical findings may require a CT scan to reveal the diagnosis. Umbilical hernias are much easier to locate with the bulging of the belly button.
Hernias that are incarcerated or strangulated present a greater challenge since the potential complication of dead bowel increases the urgency. The health care professional seeks clues of obstruction, including a history of pain, nausea, vomiting, or fever. During a physical examination, a doctor may often discover that a patient has a markedly tender abdomen. These hernias are often exquisitely tender and firm. The exam may be enough to suspect incarceration or strangulation and require immediate consultation with a surgeon. Doctors may use X-rays or CT scans to confirm the diagnosis, depending upon the clinical situation.
Doctors may be able to diagnose hiatal hernias associated with GERD by learning a patient’s medical history during his or her physical exam. A chest X-ray can reveal part of the stomach within the chest. If there is concern about complications including esophageal inflammation (esophagitis), ulcers, or bleeding, a gastroenterologist may need to perform an endoscopy.
Types of surgery repair an Abdominal or Ventral Hernia
Inguinal hernia repair is one of the most common surgical procedures performed in the U.S. with almost a million operations occurring each year. Most abdominal wall hernias are repaired electively when the health of the patient can be maximized to decrease the risk of both the surgery and the anesthetic.
Surgery to repair a hernia may use a laparoscope or an open procedure called a herniorrhaphy, where the surgeon directly repairs the hernia through an incision in the abdominal wall. The type of operation depends upon the clinical situation and the urgency of surgery. The decision as to which operation to perform depends upon the patient’s clinical situation.
Other abdominal wall hernias can similarly be repaired to strengthen the defect in the abdominal wall and decrease the complication risk of bowel incarceration and strangulation.
Sliding hiatal hernias may be treated surgically to place the stomach back into the abdominal cavity and to strengthen the gastroesophageal junction. However, doctors do not routinely offer surgery because most symptoms are due to GERD and medical therapy is often adequate. Medication, diet, lifestyle changes, and weight loss may help control symptoms and minimize the need for surgery.
Paraesophageal hernia repair is done to prevent the complication of strangulation or volvulus.
Nonsurgical treatments for Abdominal or Ventral Hernia
In allopathic treatment if an inguinal or umbilical hernia is small and does not cause symptoms, a watchful waiting approach may be reasonable. Routine follow-up may be all that is needed, especially if the hernia does not grow in size. However, if the hernia does grow or if there is concern about potential incarceration, then surgery may be recommended.
Patients who are at high risk for surgery and anesthesia may be offered a watch and wait approach which is in my opinion is a very bad idea (Dr Qaisar Ahmed).
Trusses, corsets, or binders can hold hernias in place by placing pressure on the skin and abdominal wall. These are temporary approaches and potentially can cause skin damage or breakdown, and infection because of rubbing and chafing. They are often used in older or debilitated patients when the hernia defect is very large and there is an increased risk of complications should they undergo surgery.
Unless the defect is large, umbilical hernias in children tend to resolve on their own by 1 year of age. Surgery may be considered if the hernia is still present at age 3 or 4, or if the defect in the umbilicus is large.
Hiatal hernias by themselves do not cause symptoms. Instead, it is the acid reflux that causes gastroesophageal reflux disease (GERD). Treatment is aimed at decreasing acid production in the stomach and preventing acid from entering the esophagus.
Complications
The major complication of a hernia is incarceration, where a piece of bowel or fat gets stuck in the hernia sac and cannot be reduced. Swelling can occur to the point that blood supply to the tissue is lost and it dies. This is called a strangulated hernia.
If a hiatal hernia is large, part of the stomach and esophagus can displace into the chest. Depending on the situation and anatomy, the stomach can twist (volvulus), potentially leading to strangulation. This is a surgical emergency.
Prognosis for an Abdominal or Ventral Hernia with allopathy
Most patients who undergo elective hernia repair do well. Incisional hernias may recur up to 10% of the time. The prognosis for patients who undergo emergent hernia repair because of incarcerated or strangulated bowel depends upon the extent of surgery, how much intestine is damaged, and their underlying health and physical condition before the surgery. For this reason, elective hernia repair is much preferred.
Homeopathic treatment for Abdominal or Ventral Hernia
Hernia is a surgical condition, but it can be corrected by well selected Homoeopathic medicines.
Nux Vomica
Bruised soreness of abdominal walls (Apis; Sulph). Flatulent distension, with spasmodic colic. Colic from uncovering. Liver engorged, with stitches and soreness. Colic, with upward pressure, causing short breath, and desire for stool. Weakness of abdominal ring region. Strangulated hernia (Op). Forcing in lower abdomen towards genitals. Umbilical hernia of infants.
Apis Melifestida
Sore bruised on pressure when sneezing. Extremely tender. Dropsy of abdomen. Peritonitis. Swelling in right groin.
Allium Cepa
Rumbling in bowels. Very offensive flatus. Strangulated hernia. Belching, with rumbling in and puffing up of the abdomen. Violent cutting pain in the left lower abdomen. Pains in hepatic region, spreading into the abdomen. Violent pains in left hypogastrium, with urging to urinate, urine scalding. (Strangulated hernia has been known to follow the eating abundantly of cooked onions). Abdomen distended, rumbling, urging, and finally diarrhoea.
Calceria Carbonica
Sensitive to slightest pressure. Liver region painful when stooping. Cutting in abdomen; swollen abdomen. Incarcerated flatulence. Inguinal and mesenteric glands swollen and painful. Cannot bear tight clothing around the waist. Distention with hardness. Gall-stone colic. Increase of fat in abdomen. Umbilical hernia. Trembling; weakness, as if sprained.
Cocculus Indicus
Distended, with wind, and feeling as if full of sharp stones when moving; better, lying on one side or the other. Pain in abdominal ring, as if something were forced through. Abdominal muscles weak; it seems as if a hernia would take place.
Aurum Metallicum
Right hypochondrium hot and painful. Incarcerated flatus. Swelling and suppuration of inguinal glands. Hernia. Burning heat and cutting pain in hypochondrium. Abdomen inflated. Exostosis in the pelvis. Tendency of hernia to protrude, sometimes with cramp-like pains and incarcerated flatus. Swelling of the (lower part) of the testicle. Swelling of the testes, with aching pain on touching and rubbing. Induration of the testes. Testes mere pendant shreds (in pining boys). Hydrocele. Prolapsus and induration of the matrix. Swelling of axillary glands.
Rhus Toxicodendron
Violent pains, relieved by lying on abdomen. Swelling of inguinal glands. Pain in region of ascending colon. Colic, compelling to walk bent. Excessive distention after eating. Rumbling of flatus on first rising, but disappears with continued motion.
Lachesis
Enlargement of abdomen. Hernia. Pains in abdomen, in consequence of a strain in the loins. Pains generally pressive in umbilical region with acute pullings, with contraction of abdomen. Peritonitis; pus formed. Inflammation of intestines. Extravasation of blood in peritoneum. Swelling in caecal region; must lie on back, with limbs drawn up. Pressure in testes, as if a hernia were going to protrude.
Lycopodium Clavatum
Hernia, right side. Liver sensitive. Brown spots on abdomen. Dropsy, due to hepatic disease. Hepatitis, atrophic from of nutmeg liver. Pain shooting across lower abdomen from right to left. Tension round hypochondria. Burning pain in the abdomen. Hernia. Excoriation between scrotum and thighs. Dropsical swelling of genital organs.
Silica Tera
Swelling and induration of hepatic region. Shootings in hypochondria. Painful inguinal hernia. Swelling of prepuce.
Opium
Abdomen hard, and distended, as in tympanites. Tympanites. Lead-colic. Incarcerated inguinal hernia.
Bryonia Alba
Pains in the liver, mostly shooting, tensive, or burning. Hernia. Tractive pains in the hypochondrium. Hard swelling in the hypochondriac and umbilical regions. Hard swelling around the navel. Swelling and inflammation of the labia majora. Swelling of one of the labia, with a black and hard pustule.
Tabacum
Great sensitiveness of abdomen to slightest touch sometimes with nausea and vomiting. Pressive pains in umbilical region, with spasmodic retraction. Genital organs flabby. Varicocele.
Hydrocotyle Asiatica
Scleroderma, elephantiasis, leprosy, skin thickened, itching and hardened. Constipation. Favus. Gangrene. Borborygmi in different parts. Flatus. Violent contractions of intestines. Pain; every few minutes; transverse colon. Constriction. Drawing in spermatic cords. Vulva, vagina and cervix red. Heat in bottom of vagina; pricking and itching at its orifice.
Plumbum Metallicum
Inflation and induration of abdomen. Violent colics, with constrictive pain, especially in umbilical region. Large, hard swelling in ileocecal region, very sensitive to contact or least motion; sneezing or coughing. Inflammation, ulceration and gangrene of intestines. Swelling and inflammation of genital organs.
Chamomilla
Burning cuttings in the epigastrium, with difficulty of respiration, and paleness of the face. Shooting in the abdomen, principally on coughing, on sneezing, and on touching it. Painful sensibility of the abdomen to the touch, with sensation of ulceration in the interior. Inguinal hernia; pressure towards the inguinal ring, as if hernia were about to protrude. Abdominal spasms. Hernia to prepuce.
Belladonna
Violent pain in the abdomen,-Shootings in sides of the abdomen, on coughing, on sneezing, and on being touched. Pains and burning in the hypochondria. Pressure in the abdomen. Hernia. Hernia hypochondria. Hernia to the prepuce. In women: Violent pressure towards the genital parts, as if all were going to protrude, principally when walking, or when in a crouching posture. Shooting in the internal genital parts.
Aconit Nepalus
Constriction, tension and pressure in the hypochondriac region, sometimes with fullness and a sensation of weight. Burning pain, shootings, stinging and pressure; Hernia. Testicles feel swollen, painful to touch; hernia. Puerperal peritonitis.
Aesculus Hippocastanum
Tenderness in the hypochondrium. with much distress in epigastrium. Hernia. Inflamed cervix uteri, retroversion, prolapsus, enlargement and induration, when characterised by great tenderness heat and throbbing.
AurumMetallicum
Burning heat and cutting pain in hypochondrium. Colic with sensation of great uneasiness and inclination to evacuate. Tensive aching and fullness in the abdomen. Abdomen inflated. Exostosis in the pelvis. Tendency of hernia to protrude, sometimes with cramp-like pains and incarcerated flatus. Swelling and suppuration of the inguinal glands from syphilis or the use of mercury. Swelling of the testes, with aching pain on touching and rubbing. Induration of the testes. Testes mere pendant shreds. Hydrocele. Prolapsus and induration of the matrix, prolapse of rectum.
To visit our YouTube page Click Here
Magnesium Muriaticum
Pressing pain in liver; worse lying on side. Liver enlarged with bloating of abdomen; Congenital scrotal hernia, must use abdominal muscles to enable him to urinate. Violent and constant distension of abdomen, with constipation. hernia to testicles.
Calceria Phosphoricum
Hernia. Hydrocele. Malnutrition. Weak and pale with flabby muscles. Colic, soreness and burning around navel.
Cocculus Indicus
Distended, with wind, and feeling as if full of sharp stones when moving; better, lying on one side or the other. Pain in abdominal ring, as if something were forced through. Abdominal muscles weak;Hernia. Painful pressing in uterine region, followed by haemorrhoids.
Granatum
Pain in stomach and abdomen; worse about umbilicus; ineffectual urging. Itching at anus. Dragging in vaginal region, as if hernia would protrude. Swelling resembling umbilical hernia.
Staphysagria
Hot flatus. Swollen abdomen in children, flatus, colic and pelvic tenesmus. Severe pain abdominal hernia. Incarcerated flatus. Diarrhoea after drinking cold water, with tenesmus. Constipation. Haemorrhoids. Prolapsus uteri. Cystocele (locally and internally). Cystitis in lying-in patients.
P. S : This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
For proper consultation and treatment, please visit our clinic.
Location, address and contact numbers are given below.
NoN of above mentioned medicine(s) is/are the full/complete treatment, but just hints for treatment; every patient has his/her own constitutional medicine.
To order medicine by courier, please send your details at WhatsApp– +923119884588
Dr. Sayyad Qaisar Ahmed (MD {Ukraine}, DHMS), Abdominal Surgeries, Oncological surgeries, Gastroenterologist, Specialist Homeopathic Medicines.
Senior research officer at Dnepropetrovsk state medical academy Ukraine.
Location: Al-Haytham clinic, Umer Farooq Chowk Risalpur Sadder (0923631023, 03119884588), K.P.K, Pakistan.
Find more about Dr Sayed Qaisar Ahmed at :
https://www.youtube.com/Dr Qaisar Ahmed