Digestive Disorders Health Center

Understanding Hernia -- Diagnosis & Treatment

How Is a Hernia Diagnosed?

A doctor's physical exam is often enough to diagnose a hernia. Sometimes hernia swelling is visible when you stand upright; usually, the hernia can be felt if you place your hand directly over it and then bear down. Ultrasound may be used to see a femoral hernia, and abdominal X-rays may be ordered to determine if a bowel obstruction is present.

What Are the Treatments for a Hernia?

In babies, umbilical hernias may heal themselves within four years, making surgery unnecessary. For all others, the standard treatment is conventional hernia-repair surgery (called herniorrhaphy). It is possible to simply live with a hernia and monitor it. The main risk of this approach is that the protruding organ may become strangulated (its blood supply is cut off), and infection and tissue death may occur as a result. A strangulated intestinal hernia may result in intestinal obstruction, causing the abdomen to swell. The strangulation can also lead to infection, gangrene, intestinal perforation, shock, or even death.

Conventional Medicine for a Hernia

Your doctor may manually press your hernia back into place and advise you to wear a special belt, known as a truss, that holds a hernia in place until surgery. Over-the-counter pain relievers can help ease discomfort.

Hernia surgery is performed under either local or general anesthesia. The surgeon repositions the herniated tissue and, if strangulation has occurred, removes the oxygen-starved part of the organ. The damaged muscle wall will frequently be repaired with synthetic mesh or tissue.

Increasingly, herniorrhaphy is being performed using a laparoscope, a thin, telescope-like instrument that requires smaller incisions and involves a shorter recovery period and less post-operative pain. Hernia repairs are usually performed as an outpatient procedure. There are usually no dietary restrictions, and work and regular activity may usually be resumed in one or two weeks. Complete recovery takes three to four weeks, with no heavy lifting for two to three months.

Hernias may return -- although in less then 5% of cases after surgery -- so preventive measures are especially important to avoid a recurrence.