Could that pain be a her­nia?

Westside Eagle-Observer - - OPINION - SILOAM SPRINGS RE­GIONAL HOSPI­TAL

If, when you think of a her­nia, it brings to mind a con­di­tion only your fa­ther or grand­fa­ther needed to be con­cerned with, you’re not alone. There are many mis­con­cep­tions about her­nias, and the fail­ure to seek a proper di­ag­no­sis can lead to un­nec­es­sary suf­fer­ing and risk of com­pli­ca­tions. Her­nias ac­tu­ally af­fect an es­ti­mated 2 per­cent of the adult pop­u­la­tion and 4 per­cent of in­fants; but the es­ti­mates for adult, white males can be as high as 20 per­cent. While there are sev­eral types of her­nias that can oc­cur in var­i­ous ar­eas of the body, in­guinal her­nias are, by far, the most com­mon.

An in­guinal her­nia oc­curs when tis­sue — such as part of the in­tes­tine — pro­trudes through a weak spot in the ab­dom­i­nal wall. While in­guinal her­nias are not nec­es­sar­ily dan­ger­ous, it’s best to ex­plore treat­ment op­tions with your physi­cian. A her­nia will not im­prove on its own, can be quite painful and can lead to com­pli­ca­tions when not treated.

Com­mon signs that you might have a her­nia in­clude:

■ A bulge in the area on ei­ther side of your pu­bic bone;

■ A burn­ing or aching feel­ing at the site of the bulge, es­pe­cially when you bend, cough or lift a heavy ob­ject;

■ Heav­i­ness or “drag­ging feel­ing” in your groin area, es­pe­cially at the end of the day; and

■ In some cases, pain and swelling around the tes­ti­cles.

While some her­nias have no ap­par­ent cause, oth­ers might oc­cur as a re­sult of chronic and/or se­vere cough­ing, strain­ing dur­ing bowel move­ments, or stren­u­ous ac­tiv­ity. And although in­guinal her­nias are far more com­mon in men than in women, they can af­fect peo­ple of any age or gen­der.

Some key risk fac­tors in­clude:

■ Be­ing male — Men are eight times more likely than women to de­velop an in­guinal her­nia;

■ Be­ing older — Ab­dom­i­nal mus­cles weaken as you get older;

■ Fam­ily his­tory — Your risk is higher if an im­me­di­ate fam­ily mem­ber has had a her­nia;

■ Preg­nancy — Be­ing preg­nant can weaken ab­dom­i­nal mus­cles and in­crease the pres­sure inside your ab­domen;

■ Chronic cough or con­sti­pa­tion — Both cre­ate a pat­tern of pres­sure on the ab­dom­i­nal walls;

■ Pre­ma­ture birth or low birth weight, where the ab­dom­i­nal wall may not have had suf­fi­cient time to de­velop in the womb.

In some peo­ple, ab­dom­i­nal wall weak­ness oc­curs at birth when the ab­dom­i­nal lin­ing doesn’t close prop­erly for one of var­i­ous rea­sons. In oth­ers, her­nias de­velop later in life when mus­cles weaken due to ag­ing, stren­u­ous ac­tiv­ity, or as a re­sult of an in­jury or ab­dom­i­nal surgery.

If you have pain or a no­tice­able bulge in any area around your groin or pu­bic bone, make an ap­point­ment with your pri­mary care physi­cian. The physi­cian will most likely ask you to stand, and the ex­am­i­na­tion will in­clude feel­ing for a bulge or re­ac­tion when you cough or strain your mus­cles. In the case of an in­guinal her­nia, the bulge may dis­ap­pear when you lie down on the exam ta­ble. Imag­ing stud­ies are typ­i­cally not nec­es­sary, but if the ex­am­i­na­tion isn’t con­clu­sive, you may be pre­scribed an ul­tra­sound or CT scan for a more de­fin­i­tive look at the cause of your dis­com­fort.

Most in­guinal her­nias are not med­i­cal emer­gen­cies, but there are ex­cep­tions. In the case of an in­car­cer­ated her­nia or stran­gu­la­tion, there is the po­ten­tial for life-threat­en­ing com­pli­ca­tions. A her­nia does not get bet­ter over time, and there are no ex­er­cises, med­i­ca­tions or phys­i­cal ther­a­pies that can re­verse the con­di­tion. While some her­nias are con­sid­ered small or mild enough to be left un­treated, most cases are best re­solved sur­gi­cally.

Her­nia re­pair surgery is one of the most com­mon gen­eral surg­eries per­formed in the U.S., with

more than 600,000 pro­ce­dures per­formed each year. If you are deemed a can­di­date for sur­gi­cal re­pair, your sur­geon will ex­plain the pros and cons of the con­ven­tional open method vs. the less in­va­sive la­paro­scopic her­nia re­pair method, and which ap­proach is more ap­pro­pri­ate for your si­t­u­a­tion. Most her­nia op­er­a­tions are per­formed on an out­pa­tient ba­sis, which means you can ex­pect to re­turn home on the same day the surgery is per­formed. With la­paro­scopic surgery, you should ex­pect some sore­ness the first cou­ple of days after the pro­ce­dure, but to be back to your nor­mal ac­tiv­i­ties within a week or so.

If you have con­cerns about any type of ab­dom­i­nal area pain or dis­com­fort, don’t suf­fer need­lessly or risk al­low­ing a mi­nor prob­lem to worsen — make an ap­point­ment with your pri­mary care physi­cian. If you are look­ing for a pri­mary care physi­cian, visit NW-Physi­cians.com.

Jack D. Al­ston, M.D., and Pa­trick Schiefelbein, D.O., are gen­eral sur­geons at Sur­gi­cal As­so­ci­ates of Siloam Springs. They per­form a va­ri­ety of sur­gi­cal ser­vices in­clud­ing la­paroscopy, biopsy, colonoscopy and more. For more in­for­ma­tion, visit SAofSS.com or call 479-215-3040.

Siloam Springs Re­gional Hospi­tal is a 73 li­censed bed fa­cil­ity with 42 pri­vate pa­tient rooms. It is ac­cred­ited by the State of Arkansas Depart­ment of Health Ser­vices and The Joint Com­mis­sion. Some ser­vices in­clude in­pa­tient and out­pa­tient surgery, emer­gency medicine, med­i­cal, sur­gi­cal and in­ten­sive care units, ob­stet­rics, out­pa­tient di­ag­nos­tic ser­vices and in­pa­tient and out­pa­tient re­ha­bil­i­ta­tion. With more than 40 physi­cians on the med­i­cal staff, Siloam Springs Re­gional Hospi­tal pro­vides com­pas­sion­ate, cus­tomer-fo­cused care. SSRH is an af­fil­i­ate of North­west Health, one of the largest health net­works in North­west Arkansas, and through that af­fil­i­a­tion is a mem­ber of the Mayo Clinic Care Net­work, a select group of in­de­pen­dent health sys­tems that work closely with Mayo Clinic to im­prove the de­liv­ery of health care and bet­ter serve their pa­tients and their com­mu­ni­ties. Siloam Springs Re­gional Hospi­tal is lo­cated at 603 N. Progress Ave. in Siloam Springs. For more in­for­ma­tion, visit North­west­Health.com.

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