Types of Hernia

A hernia occurs when a tissue or an organ swells and protrudes out of the membrane covering it. It usually occurs in the abdominal area of the body, but can also occur in the intervertebral discs. Untreated hernia leads to the potential risk of stopping the blood supply to the trapped organ or tissue, causing extreme discomfort and pain.

When daily activities exert continuous pressure on any muscle in the abdomen, they tend to become weak or tear, resulting in protrusion of the intestinal parts, forming a bulge. The symptoms are mainly pain and discomfort, caused by swelling and tenderness of the hernia. This can happen due to various factors, such as obesity, lifting of heavy objects, continuous coughing, fluid in the abdominal cavity and straining during a bowel movement or urination. Sometimes a family history of chronic hernia and weak abdominal muscles can also be a cause.

The type of hernia depends upon the cause and location of its occurrence. Following are the various types of hernia:

Inguinal Hernia
This occurs in the groin and is the most common type. Nearly 75% of all abdominal hernias are inguinal, and they are known to occur more in men than women. Inguinal hernias can be further divided into indirect inguinal hernia and direct inguinal hernia. Both occur in the groin (inguinal canal), where the skin of the thigh joins the torso. In indirect inguinal type, the bulge is formed at the entrance of the inguinal canal, whereas in direct hernia, the contents push through a weak spot in the back wall of the inguinal canal.

Femoral Hernia
This occurs in the femoral canal just below the inguinal ligament. The femoral vein, artery and nerve leave the abdominal cavity, to enter the thigh through the femoral canal. The bulge formed is more rounded and there is a greater risk of strangulating the blood supply. It is caused when the abdominal materials get into and push through the weak part of the femoral canal. Women are more at risk for this type of hernia.

Umbilical Hernia
This hernia is a protrusion at the umbilicus (bellybutton), which is normal at birth, and usually closes itself spontaneously by the age of 2 years. However, larger hernias at the navel have to be surgically removed. The area around the umbilicus is generally weak and decussation of fibers at the linea alba tend to cause bulges that protrude. Occurrence of umbilical hernia is high in pregnant women and obese people.

Incisional Hernia
These occur in the vicinity of any prior surgical incision in the abdominal area, which is not completely healed. Surgery tends to weaken the area around the particular incision in at least 2 - 10 percent people, and these incompletely or inadequately healed areas are especially prone to this type. It is caused due to tension on the unhealed tissue or general disruption of the surrounding areas.

Obturator Hernia
This is a rare form that mostly occurs in women. In this type, there is no external formation of any bulge, but there is nausea, vomiting and bowel obstruction. It is caused due to the protrusion of tissue from the pelvic cavity through an opening in the pelvic bone.

Hiatus Hernia
This occurs in the upper part of the stomach and protrudes into the chest cavity through an opening in the diaphragm. Hiatus hernia commonly occurs among the middle-aged and people who are overweight. Faulty dietary routine is one of the main causes for its occurrence.

Epigastric Hernia
This type rarely comprises any intestinal tissue. It has more of fatty tissues and forms between the navel and lower part of the rib cage in the abdomen.

Spigelian Hernia
Another rare form which occurs mostly towards the right side of the middle of the abdomen, along the edge of the rectos abdominal muscle.

Spinal Disc Herniation
This occurs either in the lower back (lumbar area) or in the cervical vertebrae, and causes back pain that radiates into the thigh or leg. The bulge is caused by the central weak part of the intervertebral disc, pushing out through the fibrous band connecting it. This condition is also known as 'herniated disc', 'bulging disc' or 'pinched nerve', and can lead to sciatica.

Brain Hernia
Also known as cistern obliteration, this life-threatening condition occurs because of excessive intracranial pressure on the brain, or in the absence of high inductively coupled plasma (ICP) testing, when mass lesions such as hematomas (localized swelling filled with blood) occur at the borders of brain compartments.

While treating hernia, certain precautions regarding weight, diet and physical activity should be taken into consideration. Treatment depends on severity. As far as possible, hernia must be treated before it aggravates. Most of them can be safely and surgically removed, but do it only on your doctor's advice.