Inguinal hernias. What to do?

Inguinal hernias. What to do?

Just in the US 1.6 million groin hernias are diagnosed every year.  The lifetime prevalence of groin hernias is higher in men (27%!) compared to women at 3%. Most of the time hernias are only on one side of the groin, but in 20% of patients they are on both sides. 

What is a hernia? It is a weak spot or a tear in the abdominal wall. Most patients complain of a bulge in the groin that gets larger over time.  There may be pain or discomfort (or pulling or burning) at the site, but nearly 1/3 of patients have no symptoms. 

What is the best way to diagnose a hernia?  In men, the diagnosis may be obvious on physical exam.  Women often need an ultrasound to confirm a hernia.    Ultrasound is also a good imaging tool in patients with surgical complications after a hernia repair, recurrent hernias or other causes of groin pain. If the ultrasound appears normal, some patients need an MRI to diagnose occult hernias. 

If you have a hernia, there is a risk that the intestines will slip through the abdominal wall defect, fill with air, and then not be able to slip back in.  This increases the risk of bowel perforation, abdominal infections which could lead to death. 

Surgical consultation is the key to managing hernias.  The surgeon will review with you what the options are… most of the time this will mean you will need a surgery to keep the bowel inside the abdomen, and stitching or mesh to fill the abdominal wall defect.  Watchful waiting is NOT suggested if you have symptoms or are a nonpregnant female.

When to go to the hospital?  Intractable abdominal pain needs immediate attention.

About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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