Hi, this is Dr. Parker, General Surgeon, and in this post I want to talk about hernias. Often I have patients come to my office with a diagnosis of a hernia from their primary care physician, but are not exactly clear on what a hernia is, or why it is significant. These are a couple of the questions I hope to clear up in this post.
A hernia is an abnormal hole, most commonly in the abdominal wall, that’s it. Think of the belly as having many “layers”, and generally there are one or two “strong” layers. When these strong layers of tissue become weak, and develop a hole, then this is termed a “hernia”. Typically patients experience a hernia when they have a “bulge” in the groin or navel area. This is actually contents from inside your abdomen (commonly small bowels), sneaking through that hole, and now protruding only under the layers of skin and fat. The strong layer is interrupted, and the small bowel now can get outside of that strong layer, but of course it’s stopped by the skin and fat layers.
If you can “push it back in”, then we call this a “reducible” hernia. That means you can push the contents of the hernia back into the abdomen where the belong, fairly easily. If you cannot push the contents back in, we call this an “incarcerated” hernia (the contents are stuck in hernia jail). When that incarcerated hernia gets the blood supply cut off to those organs (mostly small bowel) we call this a “strangulated” hernia. It is important to differentiate the three because each one has a different time frame in which it should be treated.
I hope this helped you to understand the definition of a hernia. Please see my other posts for specifics on each different location of hernia and how they are best treated.
-Dr. Buck
P.S. Please leave comments or questions below for me. Thanks!
Hi! I had an appendectomy just over a month ago. I am 18, and my appendix had started to rupture so the recovery time was longer and was sent home with an IV and drain in me that were both removed later. My incisions have healed up nicely, and all of my bowel movements have returned to normal too. The only thing bothering me now is that I have a sharp pain right under my right ribcage. The three incisions I had are on my belly button, left side and the very bottom of my stomach, so I don’t know why I would be hurting on the right side. It feels like a knot and hurts when I move and when I breathe in deep. It goes away sometimes, but other times it hurts so bad I have to take really short breaths. Should I be concerned about this???
Thank you for all the great info on your site!
I’m trying to decide if I have an umbilical hernia. I had an appendectomy on July 19. A small area immediately above my belly button continues to be sore with some light lifting and palpation. Typically their is no pain at rest. The area is hard and does not seem to move when pushed on. I knew this hard and tender area was there before surgery because the same area bothered me off and on when I was pregnant. My OB felt like it was a ligament. When I mentioned this sore area to the doc at my follow up appointment he said it could be a hernia or where everything is sutured together. He did not do an assessment, so know I’m left with a sore belly button and no answers. If it is a hernia, do I risk making it worse with lifting and exercise like sit-ups?
Hi Nicole,
It’s possible it’s a hernia, however, it’s likely it is scar tissue from the operation. I think you should take it easy with heavy lifting for about 6 weeks after the operation. If after that you start to do normal activity, and it gets larger….then maybe it’s a hernia. Either way, I would give it a few months as long as the pain is improving. Some physicians use ultrasound to determine if there is a hernia for sure or not, so if it does not improve, or gets worse, you can go back to your surgeon and what he thinks about an ultrasound for definitive diagnosis.
Take care,
-Dr. Buck