by Dr Mondel George MD, MEd, BSc
If you have any experience on the Caribbean island of Grenada, you must appreciate natives’ unexplainable obsession for fresh fruits.
The passion for food worldwide may rarely a pear in the medical field, with lumps being termed as seeds or toe calluses being called corns for examples.
Medical ailments such as hernias have also been given fruit-like characteristics. It is not unusual to hear phrases such as “I’m waiting for my hernia to ripe” and “I am going to cut my hernia” which can be berry misleading about the pathology and surgical treatment of hernias. This article aims to give insight on abdominal hernias, including symptoms and how they can be repaired.
An Abdominal Hernia can be described as a protrusion of the internal content of the abdomen between the walls that constrain it. The abdominal wall is made of a collection of muscles that are arranged in different direction to increase the strength of the barrier that protect and constrain the abdominal contents; your abs muscle on your belly is an excellent example. Weakness in this muscular wall and increase of internal abdomen pressure can cause contents, such as the intestines (bowels/tripe) to protrude through these areas. This is a simple way to describe any hernia ‘a weakened area in the walls enclosing a cavity that allows internal organs to protrude with pressure.’
There are multiple places hernias can occur, at currant, the most common being the Inguinal, which occurs at the inner groin. The naming of hernias are usually done by their location or aetiology (cause) eg. Incisional, which results following an incision (surgery); Femoral which occurs at outer groin; Umbilical which occurs at the navel or belly button, and Hiatal which occurs in the upper stomach.
The most common symptom of an Inguinal, Incisional, Femoral and Umbilical hernia is a painless mass bulging plum at the affected area. This mass can be elicited by coughing or increasing abdominal pressure. These intestinal protrusions can become very complicated and troubling at anytime. This bulging mass can be accompanied by pain, nausea, or vomiting when the mass, usually intestines, becomes difficult to return into the muscular wall and gets incarcerated (trapped) between or outside of the abdominal wall. This pain will send any one bananas. When the mass cannot be reduced to its original anatomical position, it is medically referred to as being incarcerated. Locally we state that hernia is ‘ripe’ and may be associated with the above mentioned pain, nausea and vomiting. If the intestines are trapped in the opening of the walls, the result will be decreased blood flow to that area of the intestines leading to necrosis (death) of the bowels. This is referred to as a Strangulated hernia and is deemed a surgical emergency.
If you have an incarcerated hernia that is not able to be reduced (pushed back into place), you may require surgical intervention. At this point Grenadians tell you ‘Mango and cut the hernia.’ While an incision might be required around the hernia to allow enough room for the return of the herniated content into the abdominal cavity, the majority of the surgery is all about strengthening the walls that were weakened. The surgery usually involves stitching the muscular walls together and adding a mesh for additional support. That’s it! Nothing is usually cut out or removed.
No one likes the idea of surgeries, however, these surgeries are rarely complicated and generally patients olive. You can avoid the complications of your hernia by having an elective surgery (scheduled surgery before a disease turns into an emergency or becomes complicated).
If you suspect that you might have a hernia, you should seek medical advice and let your fruits ripe, not your hernia.