If left untreated, ventral hernias can lead to discomfort, pain, and potentially serious complications. They occur when abdominal tissue or organs protrude through weak spots or tears in the abdominal wall muscles. In this guide, we explain its causes, symptoms, diagnosis, treatment, and prevention.
Causes
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A weak abdominal wall muscle can be caused by factors such as aging, obesity, or pregnancy, making hernias more likely.
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A previous abdominal surgery, especially one involving a large incision, can weaken the abdominal wall and increase the risk of hernia formation.
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Hernias can develop as a result of heavy lifting, coughing, or straining during bowel movements.
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Straining during bowel movements due to chronic constipation can strain abdominal muscles and lead to hernias.
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Some individuals may have a genetic predisposition or congenital weakness in the abdominal wall that increases their risk for ventral hernias.
Symptoms
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When standing, coughing, or straining, a noticeable bulge or lump may appear under the skin.
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Individuals may experience pain, discomfort, or aching at the site of the hernia, particularly during activities that increase intra-abdominal pressure.
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Hernias that are large or contain abdominal organs may cause a feeling of pressure, fullness, or heaviness in the abdomen.
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Symptoms such as nausea, vomiting, or changes in bowel habits may occur with hernias near the stomach or intestines.
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Ventral hernias may become trapped or strangled in some cases, causing severe pain, nausea, vomiting, and potentially life-threatening complications.
Diagnosis
A ventral hernia is typically diagnosed through a combination of a medical history review, a physical examination, and imaging studies:
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Obtaining information about symptoms, risk factors, and previous abdominal surgeries.
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Examine the abdomen thoroughly for bulges, tenderness, and other signs of hernias.
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Ultrasound, CT scans, and MRIs are used to visualize the hernia, assess its size and location, and evaluate potential complications.
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Laparoscopy is sometimes performed to directly visualize the abdominal wall and confirm the presence of a hernia through a minimally invasive procedure called laparoscopy.
Treatment
A ventral hernia's treatment depends on its size, location, symptoms, and overall health:
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In individuals with minimal symptoms and low complications risk, small, asymptomatic hernias can be monitored periodically without immediate intervention.
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Surgery to repair hernias is typically recommended for those with symptoms or large hernias to prevent complications.
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Traditional open surgery involves making an incision over the hernia site, repositioning herniated tissue or organs, and repairing the abdominal wall with sutures or mesh reinforcements.
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Minimally invasive laparoscopic surgery involves making several small incisions and repairing the hernia with specialized instruments and a camera.
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Hernia repair often involves the use of synthetic or biologic mesh to strengthen the weakened abdominal wall and prevent recurrence.
Prevention
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A healthy weight reduces the risk of abdominal wall weakness and hernias.
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Using proper lifting techniques (lifting with the legs, not the back) and avoiding heavy lifting whenever possible can prevent abdominal strain.
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Chronic constipation can be managed by eating a high-fiber diet, staying hydrated, and maintaining regular bowel habits.
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In order to prevent and recover from hernia surgery complications, it is recommended that you quit smoking. Smoking can impair wound healing and increase the risk of complications.
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In order to prevent recurrence of ventral hernias after surgery, it is important to follow postoperative instructions, including restrictions on lifting and physical activity.
