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CreditsIs this topic for you?If you do not have an inguinal hernia , see information on common types of hernias . These include incisional, epigastric, and umbilical hernias in children and adults.What is an inguinal hernia?(say INgwuhnul HERneeuh) occurs when tissue pushes through a weak spot in your groin muscle. This causes a bulge in the groin or scrotum. The bulge may hurt or burn.What causes an inguinal hernia?Most inguinal hernias happen because an opening in the muscle wall does not close as it should before birth. That leaves a weak area in the belly muscle. Pressure on that area can cause tissue to push through and bulge out. A hernia can occur soon after birth or much later in life.You are more likely to get a hernia if you are overweight or you do a lot of lifting, coughing , or straining. Hernias are more common in men. A woman may get a hernia while she is pregnant because of the pressure on her belly wall.What are the symptoms?The main symptom of an inguinal hernia is a bulge in the groin or scrotum. It often feels like a round lump. The bulge may form over a period of weeks or months. Or it may appear all of a sudden after you have been lifting heavy weights, coughing , bending, straining, or laughing. The hernia may be painful, but some hernias cause a bulge without pain.A hernia also may cause swelling and a feeling of heaviness, tugging, or burning in the area of the hernia. These symptoms may get better when you lie down.Sudden pain, nausea , and vomiting are signs that a part of your intestine may have become trapped in the hernia. Call your doctor if you have a hernia and have these symptoms.How is an inguinal hernia diagnosed?A doctor can usually know if you have a hernia based on your symptoms and a physical exam . The bulge is usually easy to feel.ContinuedHow is it treated?If you have a hernia, it will not heal on its own. Surgery is the only way to treat a hernia.If your hernia does not bother you, you most likely can wait to have surgery. Your hernia may get worse, but it may not. In some cases, hernias that are small and painless may never need to be repaired.Most people with hernias have surgery to repair them, even if they do not have symptoms. This is because many doctors believe surgery is less dangerous than strangulation , a serious problem that occurs when part of your intestine gets trapped inside the hernia.But you may not need surgery right away. If the hernia is small and painless and you can push it back into your belly, you may be able to wait.Babies and young children are more likely to have tissue get trapped in a hernia. If your child has a hernia, he or she will need surgery to repair it.A hernia may come back after surgery. To reduce the chance that this will happen, stay at a healthy weight . Do not smoke, avoid heavy lifting, and try not to push hard when you have a bowel movement or pass urine.Frequently Asked Questions
What Is the Prognosis of a Hernia?What Are the Different Hernia Types?A hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. These contents, usually portions of intestine or abdominal fatty tissue, are enclosed in the thin membrane that naturally lines the inside of the cavity. Hernias by themselves may be asymptomatic (produce no symptoms) or cause slight to severe pain. The pain can occur while resting or only during certain activities such as walking or running . Nearly all have a potential risk of having their blood supply cut off (becoming strangulated). When the content of the hernia bulges out, the opening it bulges out through can apply enough pressure that blood vessels in the hernia are constricted and therefore the blood supply is cut off. If the blood supply is cut off at the hernia opening in the abdominal wall, it becomes a medical and surgical emergency as the tissue needs oxygen, which is transported by the blood supply.Common types of abdominal wall hernias include the following:Inguinal (groin) hernia: Making up 75 of all abdominal wall hernias and occurring up to 25 times more often in men than women, these hernias are divided into two different types, direct and indirect. Both occur in the groin area where the skin of the thigh joins the torso (the inguinal crease), but they have slightly different origins. Both of these types of hernias can similarly appear as a bulge in the inguinal area. Distinguishing between the direct and indirect hernia, however, is important as a clinical diagnosis.Indirect inguinal hernia: An indirect hernia follows the pathway that the testicles made during fetal development , descending from the abdomen into the scrotum. This pathway normally closes before birth but may remain a possible site for a hernia in later life. Sometimes the hernia sac may protrude into the scrotum. An indirect inguinal hernia may occur at any age.Direct inguinal hernia: The direct inguinal hernia occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner. It rarely will protrude into the scrotum and can cause pain that is difficult to distinguish from testicle pain. Unlike the indirect hernia, which can occur at any age, the direct hernia tends to occur in the middleaged and elderly because their abdominal walls weaken as they age.Femoral hernia: The femoral canal is the path through which the femoral artery, vein, and nerve leave the abdominal cavity to enter the thigh. Although normally a tight space, sometimes it becomes large enough to allow abdominal contents (usually intestine) to protrude into the canal. A femoral hernia causes a bulge just below the inguinal crease in roughly the middle of the upper leg. Usually occurring in women, femoral hernias are particularly at risk of becoming irreducible (not able to be pushed back into place) and strangulated (cutting off blood supply). Not all hernias that are irreducible are strangulated (have their blood supply cut off), but all hernias that are irreducible need to be evaluated by a health care professional.Umbilical hernia: These common hernias (1030) are often noted in a child at birth as a protrusion at the belly button (the umbilicus). An umbilical hernia is caused when an opening in the childs abdominal wall, which normally closes before birth, doesnt close completely. If small (less than half an inch), this type of hernia usually closes gradually by age 2. Larger hernias and those that do not close by themselves usually require surgery when a child is 2 to 4 years of age. Even if the area is closed at birth, umbilical hernias can appear later in life because this spot may remain a weaker place in the abdominal wall. Umbilical hernias can appear later in life or in women who are pregnant or who have given birth (due to the added stress on the area). They usually do not cause abdominal pain .Incisional hernia: Abdominal surgery causes a flaw in the abdominal wall. This flaw can create an area of weakness through which a hernia may develop. This occurs after 210 of all abdominal surgeries, although some people are more at risk. Even after surgical repair, incisional hernias may return.Spigelian hernia: This rare hernia occurs along the edge of the rectus abdominus muscle through the spigelian fascia, which is several inches lateral to the middle of the abdomen.Obturator hernia: This extremely rare abdominal hernia develops mostly in women. This hernia protrudes from the pelvic cavity through an opening in the pelvic bone (obturator foramen). This will not show any bulge but can act like a bowel obstruction and cause nausea and vomiting . Because of the lack of visible bulging, this hernia is very difficult to diagnose.Epigastric hernia: Occurring between the navel and the lower part of the rib cage in the midline of the abdomen, epigastric hernias are composed usually of fatty tissue and rarely contain intestine. Formed in an area of relative weakness of the abdominal wall, these hernias are often painless and unable to be pushed back into the abdomen when first discovered.Hiatal hernia: This type of hernia occurs when part of the stomach pushes through the diaphragm. The diaphragm normally has a small opening for the esophagus . This opening can become the place where part of the stomach pushes through. Small hiatal hernias can be asymptomatic (cause no symptoms), while larger ones can cause pain and heartburn .Diaphragmatic hernia: This is usually a birth defect causing an opening in the diaphragm, which allows abdominal content to push through into the chest cavity.
URL of this page: https:medlineplus.govhiatalhernia.htmlHiatal HerniaSummaryA hiatal hernia is a condition in which the upper part of your stomach bulges through an opening in your diaphragm. Your diaphragm is the thin muscle that separates your chest from your abdomen. Your diaphragm helps keep acid from coming up into your esophagus. When you have a hiatal hernia, its easier for the acid to come up. This leaking of acid from your stomach into your esophagus is called GERD (gastroesophageal reflux disease). GERD may cause symptoms such asBreathing problemsThe wearing away of your teethOften, the cause of a hiatal hernia is unknown. It may have to do with weakness in the surrounding muscles. Sometimes the cause is an injury or a birth defect. Your risk of getting a hiatal hernia goes up as you age they are common in people over age 50. You are also at higher risk if you have obesity or smoke.People usually find out that they have a hiatal hernia when they are getting tests for GERD, heartburn, chest pain , or abdominal pain . The tests may be a chest xray, an xray with a barium swallow, or an upper endoscopy.You dont need treatment if your hiatal hernia does not cause any symptoms or problems. If you do have symptoms, some lifestyle changes may help. They include eating small meals, avoiding certain foods, not smoking or drinking alcohol, and losing weight. Your health care provider may recommend antacids or other medicines. If these dont help, you may need surgery.NIH: National Institute of Diabetes and Digestive and Kidney DiseasesLearn More
Is it possible to prevent an abdominal hernia?What is an abdominal hernia?An abdominal hernia occurs when an organ or other piece of tissue protrudes through a weakening in one of the muscle walls that enclose the abdominal cavity. The sac that bulges through the weak area may contain a piece of intestine or fatty lining of the colon (omentum) if the hernia occurs in the abdominal wall or groin. If the hernia occurs through the diaphragm, the muscle that separates the chest from the abdomen, part of the stomach may be involved.The abdominal wall is made up of layers of different muscles and tissues. Weak spots may develop in these layers to allow contents the abdominal cavity to protrude or herniate. The most common abdominal hernias are in the groin (inguinal hernias), in the diaphragm (hiatal hernias), and the belly button (umbilicus). Hernias may be present at birth (congenital), or they may develop at any time thereafter (acquired).What are the different types of abdominal hernias?Share Your StoryHernias of the abdominal and pelvic floorInguinal hernias are the most common of the abdominal hernias. The inguinal canal is an opening that allows the spermatic cord and testicle to descend from the abdomen into the scrotum as the fetus develops and matures. After the testicle descends, the opening is supposed to close tightly, but sometimes the muscles that attach to the pelvis leave a weakened area. If later in life there is a stress placed on that area, the weakened tissues can allow a portion of small bowel or omentum to slide through that opening, causing pain and producing a bulge. Inguinal hernias are less likely to occur in women because there is no need for an opening in the inguinal canal to allow for the migration and descent of testicles.A femoral hernia may occur through the opening in the floor of the abdomen where there is space for the femoral artery and vein to pass from the abdomen into the upper leg. Because of their wider bone structure, femoral hernias tend to occur more frequently in women.Obturator hernias are the least common hernia of the pelvic floor. These are mostly found in women who have had multiple pregnancies or who have lost significant weight. The hernia occurs through the obturator canal, another connection of the abdominal cavity to the leg, and contains the obturator artery, vein, and nerve.Hernias of the anterior abdominal wallThe abdominal wall is made up of two sets muscles on each side of the body, that mirror each other. They include the rectus abdominus muscles, the internal obliques, the external obliques, and the transversalis.When epigastric hernias occur in infants, they occur because of a weakness in the midline of the abdominal wall where the two rectus muscles join together between the breastbone and belly button. Sometimes this weakness does not become evident until later in adult life as it becomes a bulge in the upper abdomen. Pieces of bowel, fat, or omentum can become trapped in this type of hernia.The belly button, or umbilicus, is where the umbilical cord attached the fetus to mother allowing blood circulation to the fetus. Umbilical hernias cause abnormal bulging in the belly button and are very common in newborns and often do not need treatment unless complications occur. Some umbilical hernias enlarge and may require repair later in life.Spigelian hernias occur on the outside edges of the rectus abdominus muscle and are rare.Incisional hernias occur as a complication of abdominal surgery, where the abdominal muscles are cut to allow the surgeon to enter the abdominal cavity to operate. Although the muscle is usually repaired, it becomes a relative area of weakness, potentially allowing abdominal organs to herniate through the incision.Diastasis recti is not a true hernia but rather a weakening of the membrane where the two rectus abdominus muscles from the right and left come together, causing a bulge in the midline. It is different than an epigastric hernia because, the diastasis does not trap bowel, fat, or other organs inside it.Hernias of the diaphragmHiatal hernias occur when part of the stomach slides through the opening in the diaphragm where the esophagus passes from the chest into the abdomen. A sliding hiatal hernia is the most common type and occurs when the lower esophagus and portions of the stomach slide through the diaphragm into the chest. Paraesophageal hernias occur when only the stomach herniates into the chest alongside the esophagus. This can lead to serious complications of obstruction or the stomach twisting upon itself (volvulus).Traumatic diaphragmatic hernias may occur due to major injury where blunt trauma weakens or tears the diaphragm muscle allowing immediate or delayed herniation of abdominal organs into the chest cavity. This may also occur after penetrating trauma from a stab or gunshot wound . Usually these hernias involve the left diaphragm because the liver , located under the right diaphragm, tends to protect it from herniation of bowel.Congenital diaphragmatic hernias are rare and are caused by failure of the diaphragm to completely form and close during fetal development . This can lead to failure of the lungs to fully mature, and it leads to decreased lung function if abdominal organs migrate into the chest. The most common type is a Bochdalek hernia at the side edge of the diaphragm. Morgagni hernias are even rarer and are a failure of the front of the diaphragm.Picture of different types of hernias.Hernia TreatmentSurgical repair is indicated for most hernias. All irreducible hernias need immediate evaluation because of the possibility of becoming strangulated. In some situations, surgery may be delayed or unable to be performed. Your doctor may prescribe trusses or belts to help keep the hernia reduced. People with hernias and those that have had surgical repair of hernias should avoid heavy lifting and other activities that cause high intraabdominal pressure.
Select An ArticleHiatus hernia: Symptoms, diagnosis, treatment and preventionA hiatus hernia happens when part of the stomach squeezes through an opening in the diaphragm, called the hiatus, and into the chest. This is also known as a hiatal hernia.Hiatus hernia is thought to affect around a third of over 50s at some stage. Hiatus hernia is also more common in women, smokers, and people who are overweight.A hiatus hernia may not cause any symptoms, but it can cause gastrooesophageal reflux disease ( GORD ).There are two main types of hiatus hernia. The most common is sliding hiatus hernia where the hernia moves in and out of the chest.Less common is the paraoesophageal hiatus hernia or rolling hiatus hernia. Here, part of the stomach goes through the hole in the diaphragm next to the oesophagus.What causes a hiatus hernia?Its not always known what causes a hiatus hernia, but a weakening of the diaphragm with age may be responsible. In other cases, pressure on the abdomen may be to blame.Hiatus hernia is also possible in newborn babies if their diaphragm hasnt developed properly.How is a hiatus hernia diagnosed?A hiatus hernia can be diagnosed with endoscopy , where a camera on the end of a tube is inserted through the mouth and down into the stomach.Another method is the barium meal Xray, where a special chemical is drunk and then xrays are taken to give a clear image of the hernia.How are hiatus hernias treated?Treatment is only needed if the hiatus hernia is causing problems.Lifestyle changes or medication may be recommended for the symptoms of GORD .If these havent worked, keyhole surgery may be recommended for sliding hiatus hernia.The surgical procedures available are:Laparoscopic nissen fundoplication (LNF) to put the stomach back into its correct position and to tighten the diaphragmParaoesophageal hiatus hernia repair may be needed to reduce the risk of the hernia becoming strangulatedWhen should I seek medical advice about a hiatus hernia?If you have been diagnosed with a hiatus hernia and you develop severe pain in the chest or abdomen, become nauseated , are vomiting or are unable to have a bowel movement or pass wind, you may have a strangulated hernia or an obstruction, which are medical emergencies. Seek medical advice urgently.Next Article:
edit on Wikidata A hernia is the abnormal exit of tissue or an organ , such as the bowel , through the wall of the cavity in which it normally resides. 1 Hernias come in a number of different types. 6 Most commonly they involve the abdomen , specifically the groin. 6 Groin hernias are most common of the inguinal type but may also be femoral . 1 Other hernias include hiatus , incisional , and umbilical hernias . 6 Symptoms are present in about 66 of people with groin hernias. 1 This may include pain or discomfort especially with coughing, exercise, or going to the bathroom. 1 Often it gets worse throughout the day and improves when lying down. 1 A bulging area may occur that becomes larger when bearing down. 1 Groin hernias occur more often on the right than left side. 1 The main concern is strangulation , where the blood supply to part of the bowel is blocked. 1 This usually produces severe pain and tenderness of the area. 1 Hiatus or hiatal hernias often result in heartburn but may also cause chest pain or pain with eating. 3Risk factors for the development of a hernia include: smoking, chronic obstructive pulmonary disease , obesity , pregnancy , peritoneal dialysis , collagen vascular disease , and previous open appendectomy , among others. 1 3 2 Hernias are partly genetic and occur more often in certain families. 1 It is unclear if groin hernias are associated with heavy lifting. 1 Hernias can often be diagnosed based on signs and symptoms. 1 Occasionally medical imaging is used to confirm the diagnosis or rule out other possible causes. 1 The diagnosis of hiatus hernias is often by endoscopy . 3Groin hernias that do not cause symptoms in males do not need to be repaired. 1 Repair, however, is generally recommended in women due to the higher rate of femoral hernias which have more complications. 1 If strangulation occurs immediate surgery is required. 1 Repair may be done by open surgery or by laparoscopic surgery . 1 Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia . 1 Laparoscopic surgery generally has less pain following the procedure. 1 A hiatus hernia may be treated with lifestyle changes such as raising the head of the bed, weight loss, and adjusting eating habits. 3 The medications, H2 blockers or proton pump inhibitors may help. 3 If the symptoms do not improve with medications the surgery known as laparoscopic fundoplication may be an option. 3About 27 of males and 3 of females develop a groin hernia at some time in their life. 1 Inguinal, femoral and abdominal hernias were present in 18.5 million people and resulted in 59,800 deaths in 2015. 4 5 Groin hernias occur most often before the age of one and after the age of fifty. 2 It is not known how commonly hiatus hernias occur with estimates in North America varying from 10 to 80. 3 The first known description of a hernia dates back to at least 1550 BC in the Ebers Papyrus from Egypt. 7Contents
Share Your StoryBy itself, a hiatal hernia causes no symptoms, and most are found incidentally when a person has a chest Xray or abdominal Xrays (including upper GI series, and CT scans, where the patient swallows barium or another contrast material). It also is found incidentally during gastrointestinal endoscopy of the esophagus, stomach and duodenum (EGD).Most often if symptoms occur, they are due to gastroesophageal reflux disease (GERD) where the digestive juice containing acid from the stomach moves up into the esophagus.The stomach is a mixing bowl that allows food and digestive juices to mix together to begin the digestive process. The stomach has a protective lining that prevents acid from eating away at the stomach muscle and causing inflammation.Unfortunately, the esophagus does not have a similar protective lining. Instead, it relies on the lower esophageal sphincter (LES), a band of muscle located at the junction of the stomach and esophagus, and the muscle of the diaphragm surrounding the esophagus to act as a valve to prevent acid from refluxing from the stomach into the esophagus. Moreover, to the LES, the normal location of the stomach and esophageal junction within the abdominal cavity is important in keeping acid where it belongs. There is increased pressure within the abdominal cavity compared to the chest cavity, particularly during inspiration which would normally cause the acid and contents from the stomach to reflux back into the esophagus, but the combination of pressure exerted within the lowermost esophagus from the LES, and the muscle of the diaphragm create a zone of higher pressure that keeps stomach acid in the stomach.In the situation of a sliding hiatal hernia, the GE junction moves above the diaphragm and into the chest, and the portion of the higherpressure zone due to the diaphragm is lost. Acid is allowed to reflux back into the esophagus causing inflammation of the lining of the esophagus and the symptoms of gastroesophageal reflux disease (GERD).These symptoms may include:nausea , vomiting or retching (dry heaves)burpingwaterbrash, the rapid appearance of a large amount of saliva in the mouth that is stimulated by the refluxing acidSymptoms usually are worse after meals, and may be made worse when lying flat. The symptoms may resolve with sitting up or walking .In some patients, reflux into the lower esophagus sets off nervous reflexes that can cause a cough or even spasm of the small airways within the lungs ( asthma ). A few patients may reflux acid droplets into the back of their throat. This acid can be inhaled or aspirated into the lung causing coughing spasms, asthma , or repeated infections of the lung including pneumonia and bronchitis . This may occur in individuals of all ages, from infants to the elderly. Fortunately, this is very uncommon.Most paraesophageal hiatal hernias have no symptoms of reflux because the GE junction remains below the diaphragm, but if the hernia is large, the way the stomach rotates into the chest, there is the possibility of volvulus of the stomach in which the stomach twists upon itself. Fortunately, paraesophageal hernias are relatively uncommon. Nevertheless, volvulus of the stomach is a surgical emergency and causes difficult, painful swallowing, chest pain, and vomiting.Hiatal HerniaWhat are Symptoms of Hiatal Hernia?A hiatal hernia is an abnormality where a part of the stomach slides up into the chest cavity, past the diaphragm. It is usually caused by a weakness of the diaphragm muscle. You may not have any symptoms with your hiatal hernia. However, sometimes, hiatal hernias may cause acid reflux or gastroesophageal reflux (GERD), which is when stomach acid backs up into the esophagus. This may lead to symptoms such as:a burning sensation in your chest (heartburn),acid taste in your mouth,chest pain,
Living better without your herniaAt Midwest Hernia Center, we personalize our services to best suit each patient.During the past two decades, Midwest Hernia Center has become a leader in the most valuable advances in hernia surgery. Our experienced surgeons continually seek out innovations in hernia repair methods. Patients travel from around the world to benefit from our expertise.Surgery is the best treatmentA hernia will not heal on its own. Surgery is needed to repair the defect in the abdominal wall. If not treated, a hernia can get larger. It can also lead to serious medical complications. The good news is that hernia surgery can be done quickly and safely, and in most cases, you can go home the same day as your surgery.Surgery is often the best solution for the discomfort of a hernia. Hernia surgeries are typically outpatient procedures, and patients can return to ordinary activities within a few days. There are two types of surgeries we most often perform areOpen Mesh Repair andLaparoscopic Repair.Hernias often show up as a bulge under the skin and pain is a typical symptom.Surgeries are performed at Fairview Southdale Hospital and Fairview Ridges Hospital .Abdominal pain? It could be a herniaIf you experience abdominal pain when lifting, coughing, urinating or during other activities, you may have a hernia. A hernia is a weakness in the wall of the abdomen that allows its contents to push outward, potentially causing a bulge under the skin. Pain can either be dull or sharp and may radiate into the hip, back and legs, and may subside when you lie down or rest.The type of hernia you have depends on its location. Most hernias form in the groin at or near what is known as the internal ring. This is the entrance to a canal between the abdomen and groin. Hernias can also occur in the abdomen, thigh, or genitals. Common types of hernia include:Incisional hernia occurs at the site of a previous surgical incisionUmbilical hernia occurs at the navelIndirect inguinal hernia occurs in the groin at the internal ringDirect inguinal hernia occurs in the groin near the internal ringFemoral hernia occurs just below the groinEpigastric hernia occurs in the upper abdomen at the midlineHiatal herniaSports herniaAbout UsIn the mid 1980s, traditional hernia treatments seemed frustratingly painful and imperfect to our physicians. Midwest Hernia Center physicianssought out safer and better solutions, performing extensive research on hernia treatment. Based on the findings, dramatic changes were made in how we treat hernias.Using durable synthetic mesh became the preferred mode of treatment. With this technique, surgeons could use local anesthesia with sedation, instead of riskier general anesthesia. Eventually, lessinvasive laparoscopic surgery became available, further improving patient recovery times.Midwest Hernia Center now has ten experienced surgeons, who regularly receive training on the latest techniques in hernia repair. We continually seek out innovations in hernia repair methods and products, and patients travel from around the world to benefit from our expertise. Our surgeons have become leaders in treating sports hernias, and have operated on hundreds of amateur and professional athletes, most of whom return to athletic activity painfree.Although weve grown in size and recognition over the last two decades, well always remain dedicated to our mission of providing the best, patientcentered hernia repair. We continue to use proven advances that yield the least possible discomfort and the fastest possible recovery.Midwest Hernia Center
Hiatal herniaHiatal herniaA hiatal hernia occurs when the upper part of your stomach bulges through your diaphragm into your chest cavity.A hiatal hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm).Your diaphragm has a small opening (hiatus) through which your food tube (esophagus) passes before connecting to your stomach. In a hiatal hernia, the stomach pushes up through that opening and into your chest.A small hiatal hernia usually doesnt cause problems. You may never know you have one unless your doctor discovers it when checking for another condition.But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Selfcare measures or medications can usually relieve these symptoms. A very large hiatal hernia might require surgery.SymptomsMost small hiatal hernias cause no signs or symptoms. But larger hiatal hernias can cause:HeartburnRegurgitation of food or liquids into the mouthBackflow of stomach acid into the esophagus (acid reflux)Difficulty swallowing